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Have gas and pressure depending on posture, headache, taking Prilosec. Can someone help?

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have gas, pressure that seems to move depending on how i sit and sometimes move. I stand up it's usually fine but if i sit down a while i can literally feel it coming on. so i stand up and it takes a while to go back to normal feeling. almost as if tuff is moving from my stomach up to my chest and can sometimes cause shortness of breathe. After i have sat and it starts to bother me it will get bad and turn into back/left shoulder pain. Sometimes when i sit it feels like my legs and even arms can be effected by it. Causes pain and discomfort, again, depends on how i sit and or which chair i sit in. My kitchen table wooden chair is the worst. i get tingling, burning, and sharp pain which moves in those areas. when i first wake up, i don't feel like this. but if i sit down to drive my vehicle it bothers me daily and often. No fun, nobody seems to know what's going on with me and pass it off as gerd which i take prilosec otc for... Sometimes my lower back is bothered too. burning, tingling, and often as if my leg/foot falls asleep. if i sit too straight up i'll get headaches all day long with the occasional brake, it bothers my eyes too when that headache starts. Sometimes it causes muscle pains in my back and shoulders shortly after it starts. i'm seriously going crazy dealing with this as well as trying to control the pain. The doctors here in Vermont waste my time and money then send me on my way. Last one asked me "why are you doctor shopping & i don't know what's going on in your life but it's gotta be something your stressing about and you should think about it and try to stop". My girlfriend is starting to think i'm making this up because the doctors offer no solution and have no idea why i feel like this. Well, except they tell me not to do things that cause this pain and discomfort but i should be able to do normal things in my life, including drive a vehicle, without having this issue but i can't because it happens daily. Can someone please HELP ME? i have also been feeling depression like feeling and often wonder if i have to die to finally get better and or to stop this. I know that may seem a little excessive but it's the truth and it's unfortunatly how i feel on a regular basis. Some days i don't have any pain or discomfort ( only when i don't have to sit for a while in one spot or when i don't have drive my vheicles)
Posted Tue, 25 Sep 2012 in GERD
Answered by Dr. Anil Grover 4 hours later
Thanks for writing in.
I am a medical specialist with an additional degree in Cardiology. I read your mail with diligence. I see many a patients with exactly your symptoms and on investigation find no evidence of any heart disease as a cause of chest pain. You, in all probability have: Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile spills back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms which you have so eloquently described.
Signs and symptoms of GERD include acid reflux and heartburn. Both are common digestive conditions that many people experience from time to time. When these signs and symptoms occur at least twice each week or interfere with your daily life, doctors call this GERD.

As sensory nerves of all the organ from upper part of abdomen and neck & head, upper limbs, food pipe, heart, front and back of chest share common pathway therefore the symptoms are felt differently but always limited to these.
If you're bothered by frequent heartburn or other signs and symptoms. I urge you to see your doctor by appointment your doctor may be able to diagnose GERD with that information alone. Your doctor may also suggest tests and procedures used to diagnose GERD, including:
1. An X-ray of your upper digestive system. Sometimes called a barium swallow or upper GI series, this procedure involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract. Then X-rays are taken of your upper digestive tract. The coating allows your doctor to see a silhouette of the shape and condition of your esophagus, stomach and upper intestine (duodenum).
Passing a flexible tube down your throat. Endoscopy is a way to visually examine the inside of your esophagus. During endoscopy, your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat. The endoscope allows your doctor to examine your esophagus and stomach. Your doctor may also use endoscopy to collect a sample of tissue (biopsy) for further testing. Endoscopy is useful in looking for complications of reflux, such as Barrett's esophagus.
2. A test to monitor the amount of acid in your esophagus. Ambulatory acid (pH) probe tests use an acid-measuring device to identify when, and for how long, stomach acid regurgitates into your esophagus. The acid monitor can be a thin, flexible tube (catheter) that's threaded through your nose into your esophagus. During the test, the tube stays in place and connects to a small computer that you wear around your waist or with a strap over your shoulder. Or the acid monitor can be a clip that's placed in your esophagus during endoscopy. The probe transmits a signal to a small computer that you wear around your waist for about two days, and then the probe falls off to be passed in your stool. Your doctor may ask that you stop taking GERD medications to prepare for this test.
3. A test to measure the movement of the esophagus. Esophageal motility testing measures movement and pressure in the esophagus. The test involves placing a catheter through your nose and into your esophagus.
There are over the counter medicines available which can be tried to medicines you are already taking for GERD (as Prilosac, you had mentioned). None the less some life style changes, I am sure most you have done, just to re capitulate:
Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is healthy, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help in devising a weight-loss strategy that will work for you.
Avoid tight-fitting clothing. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn.
Eat smaller meals. Avoid overeating by eating smaller meals.
Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by six to nine inches. If it's not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.
Don't smoke. Smoking decreases the lower esophageal sphincter's ability to function properly

I know we doctors have let you down. Believe me your symptoms are genuine and real. I do not thing I am wasting my time writing all this which is available on on net and most you must be taking. But that is life my friend. Stress in our modern life is like common cold that is too common it is we (you and me) who have to change our reaction. We have to be little philosophical in our life and the symptoms related to other people's behavior will no longer effect us. No need to feel depressed about the whole situation. You would be causing more harm to yourself. There is nothing like doctor shopping if you want a second opinion it is your right. If you have any further question(s) number them I will answer each and everyone no matter how much time it takes and the soonest. Cheer up and take care. Good Luck.
With Best Wishes

Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
Follow-up: Have gas and pressure depending on posture, headache, taking Prilosec. Can someone help? 18 hours later
Dr. XXXXXXX i can understand that. My real issue is that it happens so often and i'm almost always in some kinda pain from it... How can i fix this or stop it? I do not eat acidy foods and nothing at least 2-3 hrs before bed. My doctors don't help me with my pain and discomfort because they won't/don't just prescribe pain medication without a HUGE argument and or they think anybody they prescribe them to must be abusing them. No joke, even if your in pain, they will give the hardest time, which obviously causes me stress and yes, i do get anxiety from this happening because it's as if nobody wants to listen or believe me, let alone want to help me to get better. Most of them state "your not alone" but in reality i am alone with this issue including dealing with all the pain and discomfort. It impacts my daily life to the point where i have considered that it would/could be better if i died. No i'm not suicidal but i truly suffer daily without relief and it has gotten to that point.

I only get heart burn if i don't take the prilosec otc for 3-5 days. If i don't then it's like my throat is full of XXXXXXX that i can easily puke out. at that point i don't eat anymore. i wanna get some relief so bad that i can't even tell you!
Other issue ** Why does this almost always happen when i sit down in wooden chairs and or in my vehicles. I have to find the "perfect angle or height" or else i'm gonna be in discomfort at first, shortly followed by back/chest/neck/shoulder pain. it comes on and does not go away for the rest of the day at least. The doctor told me to take a 10mg muscle relaxer when that happens, which seems to help but it's not gone and it does not fix it obviously. It will also come back after the meds ware off OR not until i go to sleep (if i can fall asleep) then i wake up the next day and almost always feel fine, even after i eat a muffin or bagel (both plain) , until i get in my vehicle and drive for 2-10 mins (continiously trying to move the seat to better my position when it gets real bad) it gets severe and i get so much pressure it causes me to have shallow breathing and or at least a hard time breathing (as if i have to take XXXXXXX breathes)... It also seems to bother my throat as if something needs to come up or didn't go down properly, or feels like it is stuck. Which that issue is bad too.
I wouldn't be on here, and i did pay to get these answers, if it wasn't a daily challenge and struggle to deal with. I have no issue watching what i eat but 2 years ago it got so bad i lost 52 lbs (yes i was over weight but still) in less than 45 days time. Couldn't eat without major issues and it also felt really hard to swallow any food. The doctors both called it Gerd and said i must be over reacting about how bad it is because nobody they have seen seems to have it this extreme and or never described this like i am. Again, this is seriously hard for me to deal with and at times gets really really really bad. I'm sure this could be why i'm getting depression feeling on top of the rest of this stuff. it's difficult by any standards.
Thank you for listening as well as for the response. Don't know if you have some more insight or could offer some things i might do for relief? That would be more than appreciated!! Have a great day, all the best.

Answered by Dr. Anil Grover 4 hours later
Thanks for writing back.
There is no denying of the fact that you have a physical problem or rather a mechanical problem of tone of lower valve of food pipe called lower esophageal sphincter which is not performing its function properly. This allows acidic contents of your stomach to spill into esophagus. Doctors in Vermont have understanding. I searched and found the following recommendation which are universally acclaimed as Best from Mayo Clinic Minnesota. Let me quote from there as far as treatment of GERD is concerned. Beginning of quote (for general view By Mayo Clinic staff no permission needed) I quote:
Treatments and drugs

GERD surgery

Substitute for esophageal sphincter

Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don't experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.

Initial treatments to control heartburn
Over-the-counter treatments that may help control heartburn include:
Antacids that neutralize stomach acid. Antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.
Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 25, Zantac 75, Zantac 150). H-2-receptor blockers don't act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form.
Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC).

Contact your doctor if you need to take these medications two or more times a week or your symptoms are not relieved.
Prescription-strength medications
If heartburn persists despite initial approaches, your doctor may recommend prescription-strength medications, such as:
Prescription-strength H-2-receptor blockers. These include prescription-strength cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).
Prescription-strength proton pump inhibitors. Prescription-strength proton pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).
Rarely, these medications may lead to bone loss and increase the risk of a bone fracture. Your doctor may suggest that you take a calcium supplement to reduce these risks.

These medications may decrease the effectiveness of the blood-thinning medication, clopidogrel (Plavix). If you are prescribed a proton pump inhibitor and are taking Plavix, tell your doctor.
Medications to strengthen the lower esophageal sphincter. Called prokinetic agents, these medications help your stomach empty more rapidly and help tighten the valve between the stomach and the esophagus. Side effects, such as fatigue, depression, anxiety and other neurological problems, limit the usefulness of these medications.
GERD medications are sometimes combined to increase effectiveness.
Surgery and other procedures used if medications don't help
Most GERD can be controlled through medications. In situations where medications aren't helpful or you wish to avoid long-term medication use, your doctor may recommend more invasive procedures, such as:
Surgery to reinforce the lower esophageal sphincter (Nissen fundoplication). This surgery involves tightening the lower esophageal sphincter to prevent reflux by wrapping the very top of the stomach around the outside of the lower esophagus. Surgery can be open or laparoscopic. In open surgery, the surgeon makes a long incision in your abdomen. In laparoscopic surgery, the surgeon makes three or four small incisions in the abdomen and inserts instruments, including a flexible tube with a tiny camera, through the incisions.
Surgery to create a barrier preventing the backup of stomach acid. A device (Esophyx) is inserted through the mouth into the stomach. The device is used to fold the tissue at the base of the stomach into a replacement for the sphincter valve, to keep stomach acid from washing into your esophagus. Your doctor may recommend this procedure if medications aren't effective or if you're not a candidate for Nissen fundoplication. It's not clear who is best suited for this treatment, and research is ongoing.
A procedure to form scar tissue in the esophagus (Stretta procedure). This approach uses electrode energy to heat esophageal tissue. The heat creates scar tissue and damages the nerves that respond to refluxed acid. The scar tissue that forms as your esophagus heals helps to strengthen the muscles. Your doctor may recommend this procedure if medications aren't effective or if you're not a candidate for Nissen fundoplication. It's not clear who is best suited for this treatment, and research is ongoing.
Surgery to strengthen the lower esophageal sphincter (Linx). The Linx device is a ring of tiny magnetic titanium beads that is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the opening between the two closed to refluxing acid, but weak enough so that food can pass through it. The new device has been approved by the Food and Drug Administration. It can be implanted using minimally invasive surgery methods.

Now after reading this it appears much can be done and doctors who know all this ought to be more empathetic with you. I suggest you go for second opinion if necessary out of your state (I am sure there must be some way with Insurance company : you can be visiting another place and fell unwell, which you are; the insurance company would have the list of out of state hospitals where you are entitled for treatment). Frankly, I am dismayed by the attitude of members of my profession displayed towards a suffering person. If you have any other follow up query I will be only too happy to answer. Good Luck.
With Best Wishes

Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
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