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Suggest Treatment For GERD

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Posted on Tue, 17 Oct 2017
Question: Dear Doctor,

I have been diagnosed as having GERD, this is further to a re occurrence of swallowing and digestive problems following a Hiatus Hernia operation over 20 years ago. The problem re occurred around 4-5 years ago and despite 2/3 endoscopies, the consistent diagnosis was GERD. The Doctors in question were reluctant to perform any surgery as the condition is irreversible and suggested, as my complaint is both swallowing as my oesophegus has a deviation/ crooked passage and I often suffer acidic reflux, dependent upon the food I consume, that I manage the issue myself taking tablets. I have been prescribed 2 ( Mosapride citrate 5mg and Nexium 20mg). I take 1x1 of each daily. Up until very recently, they have seemed to help me cope in most instances, except for red meat.
Despite regularity taking the above tablets, I am now suffering a re occurrence of the difficulty swallowing almost everything and was wondering whether to up the intake of these tablets (e.g 2 per day) or up the volume as there are stronger doasges of both tablets.
Can you advise as to a good or practical solution to this issue.

Secondly, I am a little concerned that having taken these tablets for a couple of years there may be an adverse effect to my overall situation as I now appear to have a gallstone issue and was wondering whether these issues are associated?
Thank you in advance.
Kind regards
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
the dose can be escalated

Detailed Answer:
Hello,

the dosage for mosapride can be escalated up to 5mg 3 times daily. Esomeprazole (nexium) can also be given at a higher dosage. 40mg once daily is common. 40mg twice per day can be given for short-term treatment of esophagitis (and other disorders unrelated to your case).

Concerns have been raised recently about chronic use of proton pump inhibitors like esomeprazole but there are not adequately documented. The concerns are mostly related to renal function and the brain. Patients who need to treat acidity (like you) do have to take such drugs to avoid complications of reflux. So the current recommendations 'mandate' for continued use of these drugs when necessary.

Taking the drugs (and any potential for side effects) sounds more reasonable than risking 'burning' your esophagus with stomach acid. I wouldn't worry about the gallstone regarding the drugs. A gallstone can be worrisome on its own though as it may cause various complications including the dreaded pancreatitis. You'd better consult a surgeon about that.

I hope you find my comments helpful!
Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3791 Questions

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Suggest Treatment For GERD

Brief Answer: the dose can be escalated Detailed Answer: Hello, the dosage for mosapride can be escalated up to 5mg 3 times daily. Esomeprazole (nexium) can also be given at a higher dosage. 40mg once daily is common. 40mg twice per day can be given for short-term treatment of esophagitis (and other disorders unrelated to your case). Concerns have been raised recently about chronic use of proton pump inhibitors like esomeprazole but there are not adequately documented. The concerns are mostly related to renal function and the brain. Patients who need to treat acidity (like you) do have to take such drugs to avoid complications of reflux. So the current recommendations 'mandate' for continued use of these drugs when necessary. Taking the drugs (and any potential for side effects) sounds more reasonable than risking 'burning' your esophagus with stomach acid. I wouldn't worry about the gallstone regarding the drugs. A gallstone can be worrisome on its own though as it may cause various complications including the dreaded pancreatitis. You'd better consult a surgeon about that. I hope you find my comments helpful! Kind Regards!