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Suggest Treatment For Severe GERD Symptoms

Posted on Thu, 23 Jul 2015

Question: Hey Dr,

I recently started taking Nexium 40mg (The one in the attached image) again since I started having really bad GERD symptons. I haven't had to take it for 4 months since I have had no GERD symptons, but they started to become real painful again. Now I remember my doctor saying and based on the label on the packaging that I have to take one tablet a day, 1 hour before meals. What I don't remember is how many days/weeks I should take Nexium for?

Regards, XXXXXXX

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Duration depends upon severity

Detailed Answer:
Hello and Welcome

I appreciate your concern

Duration depends upon severity of GERD. For GERD Without Erosive Esophagitis, 4 weeks treatment is usually enough. An additional 4 weeks therapy can be advised if symptoms do not resolve.

For GERD With Erosive Esophagitis 4-8 weeks treatment should be done with Maintenance dosing of 20 mg PO once for 6 months . IV therapy can be considered if the initial symptoms persist and then converted to oral regimen.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any medication.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (50 minutes later)

Sounds good, if my symptoms were to resolve before the full 4 weeks can I stop taking it or is it better to do the 4 weeks anyway? Also if I get some of the side effects like diarrhea or constipation should I stop taking them?

Answered by Dr. Dr. Muhammad Sareer Khalil (4 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Ideally , 4 weeks course should be completed.

The symptoms aren't usually severe to warrant stopping the medication and usually PPIs like esomeprazole are very well tolerated.

Please consult your doctor before deciding on any medication.

Wishing you best of health

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Cool makes sense is there any foods I should avoid until the acid reflux/gerd symptoms resolve because I am feeling a lot of pain in my throat from the acid build up. I tried Eno and Gaviscon but they didn't have a huge effect and this has been going on for a week now which is why I started my Nexium dose again.

Answered by Dr. Dr. Muhammad Sareer Khalil (15 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hello.

In my clinical experience, in cases where recurrent episodes of gastritis and GERD occurs, I add metoclopramide, sucralfate and bismuth subsalicylate for two weeks to adequately treat any erosion or ulceration that could be causing symptoms despite completing nexium. Try to avoid citrus fruits like oranges, grapes, lemons, limes. Other foods to avoid are tomatoes, sauces, spicy oily and fried food, tea, coffee, chocolates. Try to eat small meals and avoid night time meals. Your last meal should be at least 3 hours before you go to sleep. Elevate your bed head and exercise daily for at least 30 minutes. These interventions / life style changes will help you in the long term.

Let me know if you have any query

Wishing you best of health

Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar