Brief Answer:
May need to check for h. pylori

Detailed Answer:

Hi,

With a history of severe heartburn requiring a number of different meds, you may want to rule out the presence of h pylori infection.

This is an infection that can occur in the stomach/small intestines that causes severe worsening of reflux symptoms.

It can be identified by a blood test and it is treated with a combination of antibiotics and reflux medication.

If getting this test done is not an option at this point, then you can consider the following -

(1) Switching the zantac to a proton pump inhibitor at least for a few weeks.

Though zantac and pepcid suppress acid production in the stomach, they are not as effective as the proton pump inhibitors. They are able to suppress it to a greater extent eg protonix, prevacid, nexium etc.

(2) Determine if any diet changes need to be made. These are the diet changes for reflux- (a) reduce the size of meals to reduce acid production. Small frequent meals instead of large meals.

(b) Reducing the use of caffeine, mint, tomato/another citrus, onion, chocolate, spicy or fatty foods.

(c) Waiting 2 hours after eating before laying down.

I hope this helps your query.

Regards,
Dr. Michelle Gibson James, General & Family Physician

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