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Dr. Andrew Rynne

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Hi. I've been having stomach pain for the last 2

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2039 Questions

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Posted on Thu, 24 Jan 2019 in Digestion and Bowels
Question: Hi. I've been having stomach pain for the last 2 days. I thought it was due to my acid reflux, so I've increased my acid reflux medicine which has not helped. I haven't been nauseous or vomiting and I do not have a fever. It even hurts when I lay on my stomach as well as take deep breaths.
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Answered by Dr. Ramesh Kumar 7 hours later
Brief Answer:
Peptic ulcers?

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.

GERD is a condition in which stomach acid travels up the esophagus, which can then create ulcers and scars that constrict the esophagus over time slowly.As now pain is not responding to medication I would suggest you to go for following tests-
Manometry-This test allows to determine if muscle disorders exist in the esophagus, thus making it difficult to push food and liquids down into the stomach.
Endoscopy should be done to see the condition of intestinsl mucosa and ulcers.
.Every time the acid from stomach refluxes back into esophagus it injures esophageal mucosa.This injured mucosa undergoes severe spasmodic contractions due to inflammation causing sensations of abdominal spasm.


Now lets move to your treatment-
See as the name suggests ACID REFLUX should be treated in two phases-
1)Control production of acid-For which you are on Pantoprazole.
2)To prevent the acid formed inside stomach to reflux back into esophagus-(This part of treatment is not covered by your doctor)-I would suggest you to add Levosulpiride. Itis a prokinetic drug and is very effective in controlling reflux of acid back into esophagus.A better way is to take it with Rabeprazole trials have shown that its very effective when combined with Rabeprazole.So you can switch over to Rabeprazole from Pantoprazole.
3)Sucralfate is used to treat and prevent l ulcers.Sucralfate works by forming a coating' over the ulcer. This protects the ulcer from the acid of the stomach, allowing it to heal. Sucralfate is best taken with water on an empty stomach 1 hour before meals and at bedtime. It should be taken daily by you and would help in healing ulcers.If there are ulcers on endoscopy.
General precautions are-
Follow a bland diet (low acid levels, low in fat, not spicy)
Eat frequent, small meals.
Lose weight.
Avoid the use of alcohol, tobacco, and caffeine.
Do not eat food less than 2 hours before bedtime.
Raise the head of the bed before sleeping.
Avoid clearing of the throat.
Follow up with report.

Above answer was peer-reviewed by : Dr. Yogesh D
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