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Have heart arrhythmia and glaucoma acid reflux. Prescribed ranitidine. Tried omeprazole, no results. Medication again?

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General Surgeon
Practicing since : 2008
Answered : 5762 Questions
My doctor has given me ranitidine 150 mg for my upper esophagus and it didn't work. I tried omeprazole same results, its not working for me. A couple of years back my previous doctor (retired) gave me azithromycin 250mg tablets 6-pak and it took care or the problem. I wonder if I need this medication again? Please help me. Thank you
Posted Sun, 23 Jun 2013 in General Health
Answered by Dr. Grzegorz Stanko 14 minutes later

Thank you for the query.

First of all it is good to know what are we dealing with. Acid reflux can be a disease itself (it is called GERD - gastroesophageal reflux disease) or it can be a symptom of other disease.

As a symptom it can appear due to stomach chronic inflammation, Helicobacter Pylori infection or even stomach cancer.
Due to chronic acid reflux, in the stomach or esophagus lesions which can lead to a cancer could appear (like intestinal metaplasia or Barretts esophagus).

Azithromycin can be useful only in case of Helicobacter Pylori. It is an antibiotic.
It is possible that your symptoms are triggered by Helicobacter Pylori infection and its eradication will set you free from symptoms. And without its eradication, Omeprasole or Ranitidine are ineffective.

As stomach cancer and other serious stomach conditions should be ruled out at first I suggest you to get scheduled for gastroscopy. During this test H.Pylori infection can be also checked.

Hope this will help. Feel free to ask further questions.
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Follow-up: Have heart arrhythmia and glaucoma acid reflux. Prescribed ranitidine. Tried omeprazole, no results. Medication again? 56 minutes later
Dr. G. Stanko I forgot to include on my Query, a professional sample of Dexilant five day 60 mg box, that my doctor gave me to use if omeprazole didn't work. I have not used it, do you think that will work? You know my wife just found my file that I saved of the esophagogastroduodenoscopy done on 8-11-2009 and it said Indications: GERD (530.81, Heartburn (787.1)
Findings: Esophagus : There was a small hiatus hernia visible in the esophagus.
Stomach: The stomach appeared to be normal.
Duodenum: The Duodenum appeared to be normal.
Recommendations: Continue taking the following medication as prescribed: Protonix. Of course this was almost 4 years ago. What do you think? will this help you? Thank You
Answered by Dr. Grzegorz Stanko 7 hours later
Dexilant is a medicine very similar to Omeprasole (same chemical group). It might work for you indeed. However, this looks like someone is testing medicines on you. Sooner or later some medicine will work for you. But like I have mentioned before, it is extremely important to establish what is causing your symptoms and to rule out all serious diseases. Without the diagnose, taking medicines is pointless. In some cases it may delay proper diagnose.

You have had a gastroscopy 4 years ago. This is good. But 4 years is long enough for stomach or esophagus changes. Try to imagine that stomach acid irritates and destroys stomach cells day by day. That is why with GERD and hiatus hernia, you should have gastroscopy every few years. And you should definitely have it if symptoms get worse.

If all the bad things will be ruled out, than you may start looking for best medicine for you. So please get scheduled for gastroscopy. In a meanwhile you may try Dexilant or continue Protonix (dont take both together).

Hope this will help.
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