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Suggest Treatment For Acid Reflux

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Posted on Fri, 27 Oct 2017
Question: dx acid reflux, reactions to variety of PPIs and H2. last 3mos feels like throat strangling after any and all food. now phobic of food. no food for 2 days.
doctor
Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
needs to be addressed as soon as possible

Detailed Answer:
HI, thanks for using healthcare magic

It can understand the fear that can occur as a result of a strangling sensation but it needs to be addressed as soon as possible or it may become very difficult to overcome.

Treatment would require both medical and psychological therapy to get over the fear because it is a combination of both causing it.

The severe reflux can cause a sticking sensation, acid taste in the mouth, regurgitation of food/drink, burning pain and feeling as though food is stuck but there is also a psychological component to your lack of eating, there is a psychological component to all fears and phobias.

You can be given a host of medications but if this is not supported by counselling even for a short period of time, may not be effective.

Soft foods and drinks can be used now. Use drinks such as ensure or any very high calorie drink that may be able to temporarily replace a meal.
You know that these drinks would not cause choking or strangling because they are liquids.

Use small amounts at a time if you are scared, use 1 tsp to 1 tbs every few minutes till you complete the drink. This way you get some nutrition.

For a reflux, you can consider a combination of medication (ppi, H2) that way you may not need a high dose of either. The combination may be effective.
If this is not an option then tums or a magnesium or aluminum based product can be used

Need to see your doctor as soon as possible to let him or her know about the fear so he or she can refer you to a doctor (psychologist) for assessment and counselling.
The counselling would in the form of cognitive behavioral therapy which looks at thoughts and ideas that affect our perception/attitude.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (44 hours later)
Thank you for your help. My follow up question is about diet. Seems like everything recommended for GERD is really bad for blood sugar and everything recommended to keep blood sugar stable is bad, like brutal bad, on my acid reflux. I tried Ensure and it raised my blood sugar to 269, at two hour marked, dropped to 52 at 4 hours. I tried eating plain, cooked ground beef and it stabilized my blood sugar, but had horrible acid reflux last night and still through today, tight burning throat, chest tight and pressure.
doctor
Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
smaller portions, try glycerna

Detailed Answer:
HI

You can try glycerna or other drinks that are for diabetics

Use smaller amounts of food, small portions, this would reduce reflux.

Also eliminate spices, mint, tomato, onions, caffeine, citrus drinks

Please feel free to ask anything else
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James (13 minutes later)
Thank you, I'll try the Glucerna, but that seems to be nothing but chemicals and no real nutrition based on ingredient list?? Can I make a version at home with a whey or protein powder, would that give me enough nutrition /minerals/vitamins at least until I get my stomach problems solved? Also, I do drink 6-8 glasses of water a day, but have been constipated (going once every 3-4 days, feels incomplete ) the last few weeks. is it from just not eating enough or could it be something that started all this like gastroparesis? I did a small test at home with blood sugar, ate one small flour tortilla, BS at 1hr was 92, 2 hours 189, t 3 hrs was 318, it stayed over 200 for 4.5 hours and finally dropped to 49 around hr5. Does this indicate slow digestion, or normal??
doctor
Answered by Dr. Michelle Gibson James (2 hours later)
Brief Answer:
you can make a home nutrition drink

Detailed Answer:
HI

Yes, you can make a nutrient drink at home till you are able to use solid food but this is only a temporary measure.
You would need to speak to your doctor about the phobia so that you can use solid food.

The decreased intake of solids would impact on your bowel movements. Liquids alone or primarily consistently are not enough for good bowel movements.

Unfortunately this test would not give an absolute idea of digestion, only your body's blood sugar response to the food used. It may be able (the 2 hour value) to determine if you are diabetic or at risk. This is because it looks at how your body's insulin is responding to the food used.

There are specific tests that are used to check gastric emptying.

There are specific values for fasting and 2 hour blood sugar. The 2hour reading would be in the pre diabetic range. This means that the person is not a diabetic but at risk of becoming a diabetic at some point

If you are already known to be a diabetic, a 2 hour of 189 is high, it should be less than 140.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (1 hour later)
Thank you very much for all your time and input. I really appreciate you explaining everything so clearly. I've only been diagnosed with reactive hypoglycemia after a five hour GTT. Fasting 112, 1st hour 149, 2nd 258, 3rd 389, 4th 192 and 5th 31. GP said bc of my fasting and last number, I'm not diabetic. I can't eat any carbs, no fruits/veggies, no milk, even low glycemic foods make my blood sugar high. So, I was eating nothing but meat and cheeses, which is maybe why my stomach got so bad?? I will try to ask again for a referral to a gastroenterologist, endo and psychologist. How do you tell the difference between something like anaphylaxis and allergic asthma and all the GERD throat and chest symptoms??
doctor
Answered by Dr. Michelle Gibson James (14 minutes later)
Brief Answer:
consider an allergy tests

Detailed Answer:
HI

Anaphylaxis is a very severe allergic reaction requiring hospital emergency management in the vast majority of cases so if a reaction of some sort has resolved on its own with no epipen (used in persons with very severe allergies) involved- then it is unlikely anaphylaxis

An allergy test would be the best way to determine if there are any food allergies. Allergy tests can check for a wide range of foods.

IN most persons, allergies to foods do not usually present with reflux symptoms. Usually have skin symptoms (itching, rash, swelling, weals), abdominal pain, diarrhea, nausea etc
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (10 minutes later)
Thank you very much. That's good to know, I've never broken out in hives, had itching, swelling of tongue, lips, throat or diarrhea. I do get a mild burning sensation in my stomach after I eat or if my stomach is very empty. I feel more reassured about trying to reintroduce more foods into my diet now. I think the tight throat scared me so much that I just latched on to the "worst case scenario " and then it just snowballed. you've been a tremendous help and I cant thank you enough. Blessings to you and yours.
doctor
Answered by Dr. Michelle Gibson James (5 minutes later)
Brief Answer:
no problem

Detailed Answer:
I wish you the best

If you need any further help, can let me know

Blessings
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Michelle Gibson James

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Practicing since :2001

Answered : 16810 Questions

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Suggest Treatment For Acid Reflux

Brief Answer: needs to be addressed as soon as possible Detailed Answer: HI, thanks for using healthcare magic It can understand the fear that can occur as a result of a strangling sensation but it needs to be addressed as soon as possible or it may become very difficult to overcome. Treatment would require both medical and psychological therapy to get over the fear because it is a combination of both causing it. The severe reflux can cause a sticking sensation, acid taste in the mouth, regurgitation of food/drink, burning pain and feeling as though food is stuck but there is also a psychological component to your lack of eating, there is a psychological component to all fears and phobias. You can be given a host of medications but if this is not supported by counselling even for a short period of time, may not be effective. Soft foods and drinks can be used now. Use drinks such as ensure or any very high calorie drink that may be able to temporarily replace a meal. You know that these drinks would not cause choking or strangling because they are liquids. Use small amounts at a time if you are scared, use 1 tsp to 1 tbs every few minutes till you complete the drink. This way you get some nutrition. For a reflux, you can consider a combination of medication (ppi, H2) that way you may not need a high dose of either. The combination may be effective. If this is not an option then tums or a magnesium or aluminum based product can be used Need to see your doctor as soon as possible to let him or her know about the fear so he or she can refer you to a doctor (psychologist) for assessment and counselling. The counselling would in the form of cognitive behavioral therapy which looks at thoughts and ideas that affect our perception/attitude. I hope this helps, feel free to ask any other questions