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Suggest Treatment For Chronic Esophageal Reflux
Question: Hi Dr. Rynne,
I am a 36 year old female with esophageal reflux which started in college and began to be a chronic problem about 5 years ago. It is now daily. I am not overweight and I have no known food allergies. I have had two EGDs and both have shown a normal esophagus and duodenum. I have been on Pecid, Tums, Omeprazole, Protonix and am currently on Nexium with a lot of over the counter help. Nothing gives me full relief and what little relief I get is short lived. . I wake up at night feeling very nauseous, cough a lot at night and during the day and can feel the acid go into my sinuses. My stomach feels painful below my breast bone and between the ends of my rib cage. I have made many dietary changes with no relief. I'll follow the BRAT diet for weeks without change. I have eliminated diary, any carbonated beverages, chocolate, tomatoes etc with no change. I will, however, seem to go into spontaneous remission for 1-2 days without any changes on my part.
My last EGD was yesterday. As it was found normal, they are going to try me on Aciphex of Dexilant. If that doesn't work, they are going to give me Elavil. I'm willing to give the meds a shot but I wonder about further testing to identify cause, such a stomach motility test. I know this is a common problem but it's effecting my quality of life and continues to worsen. I also have been diagnosed with Sjorgren's (diagnosed due to very dry eyes and joint pain about 3 years ago) and Raynaud's (very recent diagnosis). Could any of these be a part of the problem? Also, why Elavil?
Thank you, XXXXXXX
I am a 36 year old female with esophageal reflux which started in college and began to be a chronic problem about 5 years ago. It is now daily. I am not overweight and I have no known food allergies. I have had two EGDs and both have shown a normal esophagus and duodenum. I have been on Pecid, Tums, Omeprazole, Protonix and am currently on Nexium with a lot of over the counter help. Nothing gives me full relief and what little relief I get is short lived. . I wake up at night feeling very nauseous, cough a lot at night and during the day and can feel the acid go into my sinuses. My stomach feels painful below my breast bone and between the ends of my rib cage. I have made many dietary changes with no relief. I'll follow the BRAT diet for weeks without change. I have eliminated diary, any carbonated beverages, chocolate, tomatoes etc with no change. I will, however, seem to go into spontaneous remission for 1-2 days without any changes on my part.
My last EGD was yesterday. As it was found normal, they are going to try me on Aciphex of Dexilant. If that doesn't work, they are going to give me Elavil. I'm willing to give the meds a shot but I wonder about further testing to identify cause, such a stomach motility test. I know this is a common problem but it's effecting my quality of life and continues to worsen. I also have been diagnosed with Sjorgren's (diagnosed due to very dry eyes and joint pain about 3 years ago) and Raynaud's (very recent diagnosis). Could any of these be a part of the problem? Also, why Elavil?
Thank you, XXXXXXX
Brief Answer:
It can be due to Sjogren's or H pylori infection
Detailed Answer:
Hi dear.Thanks for your query.
I have throughly read your query and deeply understand your concerns.
Yes, Sjogren's syndrome results in lack of saliva which results in impaired clearance of acid and may result in gastroesophageal reflux and esophagitis.
Hence I were to evaluate by doing barium swallow and barium swallow through to find out the gastric function.
Since H pylori infection is also an equally important cause of relapse of acidity I were to ask for the tests-Urea breath test, stool antigen test.
If both are negative then I would suggest stomach biopsy which confirms the diagnosis by identifying the exact cause and plan further management.
Hope this answers your query.
It can be due to Sjogren's or H pylori infection
Detailed Answer:
Hi dear.Thanks for your query.
I have throughly read your query and deeply understand your concerns.
Yes, Sjogren's syndrome results in lack of saliva which results in impaired clearance of acid and may result in gastroesophageal reflux and esophagitis.
Hence I were to evaluate by doing barium swallow and barium swallow through to find out the gastric function.
Since H pylori infection is also an equally important cause of relapse of acidity I were to ask for the tests-Urea breath test, stool antigen test.
If both are negative then I would suggest stomach biopsy which confirms the diagnosis by identifying the exact cause and plan further management.
Hope this answers your query.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for your help. I forgot to add that I have had a blood test for h pylori that was negative. Would it still be worth it to pursue further testing for it? Thanks, again!
Brief Answer:
Ignore H. pylori test if your blood test is negative
Detailed Answer:
Thanks for sharing the information.
If your blood report for H pylori is negative you can ignore those H pylori tests do the rest.
Feel free to post me further queries you are having.
Get well soon.
Regards
Ignore H. pylori test if your blood test is negative
Detailed Answer:
Thanks for sharing the information.
If your blood report for H pylori is negative you can ignore those H pylori tests do the rest.
Feel free to post me further queries you are having.
Get well soon.
Regards
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
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