How can severe acid reflux be treated?

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Posted on Wed, 4 Oct 2017 in Digestion and Bowels
Question: 54 yo women. Transient reflux/ heartburn....
54 yo women. Transient reflux/ heartburn. Now appears here to stay. Waking up with burning tongue and terrible taste in my mouth, nausea, belching and pain below breastbone. Tried Zantac 150 bid last week and now taking nexium 40mg qd with an aciphex. With a little more relief but not much. Seeing agi next week but I really don't want to get scoped. Is there something else to try before having a procedure ?
Also today I felt fine and took nothing and ate. By 9pm I had terrible stomache cramps and had constipation followed by 2 hours of diarrhea. I also now have a horrible taste in my mouth again
XXXX
doctor
Answered by Dr. Ramesh Kumar 31 minutes later
Brief Answer:
reflux disorder.

Detailed Answer:
Hello Dear,
Thank you for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
As per the narration provided by you you are a text book case of Reglux disorder.The backflow of stomach acid and juices into the esophagus cause this sour or bitter taste.Retrosternal pain(behind breast bone) is a classical feature of pain due to acid reflux.Our stomach is lined with mucosal layer which can tolerate acidic medium however when this acid is refluxed back into esophagus it irritates the mucosa there causes inflammation which leads to pain and severe heart burn.
Tests suggested are-

Endoscopy repeat should be done to see the condition of ulcers.
Role of endoscopy is to find out if there are ulcers also.

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 Nexium and Ranitidine.
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. Its 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 Nexium.
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.
4) Take tums two times a day.
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.


Please don't skip meals.Tjs would lead to production of large amount of acid which will further increase the problem.

Hope my answer was helpful.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2404 Questions

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