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Suggest treatment for acid reflux and heartburn

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Posted on Fri, 11 Dec 2015
Question: I have a problem with acid reflux and heartburn. At age 17, I got surgery to correct a Hiatal Hernia. That surgery made my heartburn go away. Now I am at age 37 and the heartburn is back. It feels as if my stomach acid is stronger than my esophagus. It burns like rancid acid; I sometimes throw up because of it. I would like to discover the truth about heartburn. It doesn't seem like a normal scientific bodily function. It feels like I am actually being attacked by someone or something externally. I'm taking 80mg of Prilosec a day. It works, but there is still some discomfort. I am trying to seek the answer to the heartburn problem which more and more people are experiencing to date. I am hoping that modern medicine has made some advancements in this field. Thanks.
doctor
Answered by Dr. T Chandrakant (7 hours later)
Brief Answer:
Please provide details.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/37 - surgery for Hiatal Hernia 20 years ago - got the heartburn corrected - heartburn is back and your Endoscopy shows esophageal ulcer - have tried all antacids - burns like rancid acid - throw up occasionally - feels like actually being attacked by someone or something externally - Current medications: Clozapine, 450 mg, Concerta, 36 mg and Prilosec, 40 - 80 mg - it works but still some discomfort - your thoughts about seeking the answer and hope for medical advancements...

Please provide me some more details so that we can discuss further:
- Since when the heartburn restarted?
- Do you remember anything related to the factors that instigated heartburn this time?: can be some illness, stress, anxiety, incidences, medicines, change in food and so on.
- What exactly are your symptoms?
- When was the Endoscopy done? Please attach the reports and the photos if you have.
- Since when have been on Concerta and Clozapine?
- Some personal questions: you may answer only if you are comfortable with.
Marital status, correlation with family, friends, at work place and socials; Anything else you would like to share. Nature of your work, travel, pressures.

Your feedback on all the points will help us to have a cordial discussion and you may find what you have mentioned above.
Awaiting for your detailed feedback.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (29 hours later)
Please provide me some more details so that we can discuss further:
- Since when the heartburn restarted?
2009.

- Do you remember anything related to the factors that instigated heartburn this time?: can be some illness, stress, anxiety, incidences, medicines, change in food and so on.
I had been locked up in the county mental health system with psych medicine, hospital food, anxiety...

- What exactly are your symptoms?
My stomach acid is really high on the ph level. It travels up my esophagus and burns.

- When was the Endoscopy done? Please attach the reports and the photos if you have.
My last endoscopy was 6 months ago. Found the ulcer and put on Prilosec.

- Since when have been on Concerta and Clozapine?
I have been on Clozapine since 2009 (I think). Concerta, earlier this year.

- Some personal questions: you may answer only if you are comfortable with.
Marital status, correlation with family, friends, at work place and socials; Anything else you would like to share. Nature of your work, travel, pressures.
I am single, see my parents on a weekly basis. Hang out with friends every now and then. My work is music. Under no significant pressure at this time. I left the mental hospital in September 2014. I have a home now.
doctor
Answered by Dr. T Chandrakant (3 hours later)
Brief Answer:
Lax lower esophageal sphincter = GERD.

Detailed Answer:
Sincere thanks for your detailed feedback, self-explanatory.
The history is suggestive that you have a condition called GERD - gastroesophageal reflux disease.
Nice to know that you are involved into music, have a home and out of the mental hospital.
You have a had an instigating factor which started you with GERD which has not been reverted back.
I think you need an additional medicines with Prilosec.
- Motility regulator like Domperidone at 8 hourly dosages.
- Antacid liquid at 3 hourly intervals particularly when you are on empty stomach and avoid taking antacid with the medicines you are already taking.

It is the lax lower esophageal sphincter that allows the acid and other stomach contents to come up in the esophagus and may be the pharynx to cause the symptoms you have.

I hope this answer helps you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (1 hour later)
That's a great answer. Thanks!
doctor
Answered by Dr. T Chandrakant (49 minutes later)
Brief Answer:
Thanks and you are most welcome

Detailed Answer:
Hi.
Thanks for your appreciation.
...

You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
XXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19204 Questions

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Suggest treatment for acid reflux and heartburn

Brief Answer: Please provide details. Detailed Answer: Hi. Thanks for your query. To recapitulate: Male/37 - surgery for Hiatal Hernia 20 years ago - got the heartburn corrected - heartburn is back and your Endoscopy shows esophageal ulcer - have tried all antacids - burns like rancid acid - throw up occasionally - feels like actually being attacked by someone or something externally - Current medications: Clozapine, 450 mg, Concerta, 36 mg and Prilosec, 40 - 80 mg - it works but still some discomfort - your thoughts about seeking the answer and hope for medical advancements... Please provide me some more details so that we can discuss further: - Since when the heartburn restarted? - Do you remember anything related to the factors that instigated heartburn this time?: can be some illness, stress, anxiety, incidences, medicines, change in food and so on. - What exactly are your symptoms? - When was the Endoscopy done? Please attach the reports and the photos if you have. - Since when have been on Concerta and Clozapine? - Some personal questions: you may answer only if you are comfortable with. Marital status, correlation with family, friends, at work place and socials; Anything else you would like to share. Nature of your work, travel, pressures. Your feedback on all the points will help us to have a cordial discussion and you may find what you have mentioned above. Awaiting for your detailed feedback.