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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest remedies for persistent heartburn while on Prednisone

Answered by
Dr.
Dr. Arnab Banerjee

Critical Care Specialist

Practicing since :2012

Answered : 1304 Questions

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Posted on Fri, 26 Aug 2016 in Digestion and Bowels
Question: since 1992 I have dealt with heartburn. in 1998 I had surgery (closing my esophageal sphincter) in the past decade I have had the 48 hour PH test with no indication of excess acid in my esophagus (PH levels during severe heartburn were no lower than 6) I have been to mass general for this PH testing along with an endoscopy and a swallowing test. I've had an upper GI with no reflux noted. my condition seems to be caused by activity especially with food in my stomach. and it's not what I eat it's simply that I eat. no medication regiment has worked. I had a CT he most and they administered 30 mg of prednisone (two tabs before the scan) later that day I was in the most heartburn pain I have ever been in. it lasted about an hour. since then my heartburn attracts happen more often than before. the last endoscopy showed irritation in my stomach lining (for the first time) but meds are not helping I've tried them ALL. can you give me any advice?
doctor
Answered by Dr. Arnab Banerjee 5 hours later
Brief Answer:
Need some further details regarding..

Detailed Answer:
Hello xxxxxxxxxxxxxxxxx, Welcome to HCM,

I've gone through your query and understand your concern..

By now you must be knowing that considering Heartburn and GERD, there's always a functional and physiological part..so initially you had the surgery then later on further medications and investigations to rule out the pathology..

Seems like you've been through a lot already, so please share some more information and if possible then please upload your last few investigations including the latest CT scan report and endoscopy reports etc. You can upload them at the reports section or e-mail them to YYYY@YYYY by keeping the subject as ATTN: Dr XXXXXXX and i'll get them..let me have a closer look at them so that i can give you some specific advice regarding..

No i'm not going in to the details of the medications as clearly, with such a prolonged history and extensive work-ups you must've been tried everything by now(as you've also mentioned)..

Yes, steroid tablets like prednisone in an all ready affected stomach can further damage and cause severe gastric irritation, that's why you've felt so..

So please let me know the details so that I can guide you more specifically..

Also let me know about your current health status, what are the other problems apart from this, any other significant past/present medical/surgical ailments ?

Awaiting for your response..


Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Arnab Banerjee 2 hours later
well i do not have the ct report. i can say i have no arterial blockage. as i had mentioned, basically, all of my tests results have come back negative except the last endoscopy which showed irritation of my stomach lining but it did not really concern my new pcp it was rather mild and not at the severity that would cause my symptoms. i do have diabetes my last a1c was 6.8 about a month ago. i am heavy but i was having the heartburn even when i wasn't. since the worsening of my heartburn i can no longer play sports. before i could play golf as long as i didn't eat. now it makes no difference i get heartburn (painful) from the first hole and for the next 2 or three holes. i drink antacid before i begin and again at the 3rd hole and the symptoms quell a bit and i am able to play without severe pain.
i can no longer shovel snow or mow my lawn without stopping every 5 minutes because that's how long before i HAVE to stop due to pain. after another 5 minutes or so the pain eases and i start again until i need to stop and rest.
i may be able copy and paste my last set of test results. i'll check it out tomorrow. thank you
doctor
Answered by Dr. Arnab Banerjee 1 hour later
Brief Answer:
follow-up consultation..

Detailed Answer:
Hello xxxxxxxxxxxx, Welcome back,
Thanks for following up,

Yes, with all those symptoms and those previously mentioned one's also, i'm keen to look deep in to your detailed investigation reports, as till now, none of those reported findings are really that much concerning for a disease process like heartburn to go on persistently for past 24 years !!

That's why i'm not opining on anything as of now before dig in to it further..

Please wait for the time being, before indulging in to any such strenuous activities like shoveling snow, as it involves a lot of stretching over the gastric region, and with even minimum irritation inside the stomach , it can be very painful..

Diabetes is definitely another contributory factor in long term, but A1C 6.8 is not that bad, but can be better if comes below 6.5..

And along with your next follow-up, please share the complete diet list that you usually follow, if any drinks(alcoholic - in details) and the list of current medications with their dosage how you're following them, let's see if I can modify some of them too, as they are the part of lifestyle which play big role in long term benefits too..

I'll be looking forward for your next detailed follow-up Mr ? (please share your name next time if you feel like), Myself Dr Arnab by the way..

Have a nice day..

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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