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Dr. Andrew Rynne

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Suggest treatment for severe acid reflux and abdominal pain

Answered by
Dr.
Dr. Happykumar Kagathara

Gastroenterologist, Surgical

Practicing since :2006

Answered : 434 Questions

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Posted on Wed, 15 Mar 2017 in Digestion and Bowels
Question: I have a question about Acid Reflux and Stomach Issues ....

Can Anyone Help me .... ??
My Symptoms are ...

Horrible Rumbling in the stomach that I feel ....

Pain in the Stomach .... Sometimes in one place and other times it can be everywhere ....

Bloating sometimes ....

Hard Burping ......

I feel a Lumpy feeling in my Suprasternal Notch .....

A Constant Tickle in my Throat .....

And Fatigue at times

Thank You XXXXXXX
doctor
Answered by Dr. Happykumar Kagathara 1 hour later
Brief Answer:
acid reflux

Detailed Answer:
Hello,
I can understand your concern about GI symptoms.
1) Your symptoms are suggestive of acid reflux in which some amount of acid produced in stomach will reflux back into esophagus.
2) there will be inflammation in oesophagus due to this acid reflux related chemical reaction and this might develop symptoms related to heart burn, nausea, upper abdominal or lower chest discomfort.
3) Sometimes this reflux would be so severe that it can reach upto throat, or mouth. In such conditions, esophagus might have extreme inflammation.
4) Hiatus hernia is most common cause of reflux. In this condition the opening from which esophagus enter into stomach become wide due to which some part of upper portion of stomach will move into chest and this contribute to development of reflux.
5) Though there are other conditions can cause reflux which can be treated with medicines, treatment for hiatus hernia is surgery.
6) You might require upper GI endoscopy with special emphasis to rule out reflux and hiatus hernia.
7) If reflux is present for more than 50% length of esophagus in endoscopy, you have severe symptoms since long time then invasie 24 hr Ph monitoring test is recommended to check extent and severity of reflux.
8) But for reflux, symptomatic treatment with medications is sufficient to control symptoms.

Hope I answered your query. If you have any further doubts, I would be happy to help you.
Have a nice day!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Happykumar Kagathara 24 minutes later
If I change Diet and use Functional Medication ......

Can this work its way out .......

As I am a Very Active Athlete .......

I have heard that in Many Many Cases if a Person would have a Hiatus Hernia ....

They really don't need to get it fixed .....

Am I hearing wrong ... ???
XXXXXXX
doctor
Answered by Dr. Happykumar Kagathara 10 minutes later
Brief Answer:
symptomatic approach with medications vs cure with surgery

Detailed Answer:
Hello,
1) Functional medication will give you symptomatic relief only till you will take medications. Such severe reflux warrants evaluation to find the cause so that proper treatment can be initiated.
2) Yes, all hiatus hernia does not require surgery. I suggested surgery based on your symptoms severity.
3) Making alkaline and reducing acid in stomach is different matter. Whatever medication you take to alkalise yourself, your stomach juice will be acidic only with Ph of less than 7.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Happykumar Kagathara 13 minutes later
What if I try the Functional Method first ......

And Get myself back to Normal from Over Alkalizing.....

And see where that leads me ..... If that doesnt work then Surgery should be the Last Option ....
XXXXXXX
doctor
Answered by Dr. Happykumar Kagathara 1 minute later
Brief Answer:
SUrely yes.

Detailed Answer:
This would i surely recommend to you rather jumping directing for detailed evaluation.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Happykumar Kagathara 4 hours later
I don't want to do for and
Endoscopy .....

Cant a doctor just feel down by a Hiatus Hernia and diagnose form there ???
doctor
Answered by Dr. Happykumar Kagathara 3 hours later
Brief Answer:
Ct scan can detect hiatus hernia

Detailed Answer:
Hello,
It is possible by contrast CT scan in specific position. This modality of investigation skip the necessity of endoscopy for diagnosis.
Although CT scan can not diagnose as small hiatus hernia as endoscopy.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Happykumar Kagathara 2 days later
So I go to 2 Doctors ..... I know Quite well ....

And they tell me I have GERD ......

So One thing I forgot to ask them ... Maybe you can Help .....

Certain parts of the day ... I may feel like I got hit by a truck ( Fatigue and Body aches ) ...... Can this be the GERD .....

ALL my Blood Work .... which I just got .... EVERYTHING is EXCELLENT .....

Wondering if GERD can do this to a person .....

Curious ....
XXXXXXX
doctor
Answered by Dr. Happykumar Kagathara 7 hours later
Brief Answer:
Nutrition related symtpom

Detailed Answer:
Hello,
I apologize for late reply.
This symptom of generalized body ache is not related to GERD.
GERD cause heart burn, nausea, reflux, occasional upper abdominal pain.
Your symptoms might be related to nutritional causes or vitamin deficiencies or trance element deficiencies.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Happykumar Kagathara 18 hours later
Why is it ..... That sometimes after I eat ..... is when I feel terrible for 30 minutes or a bit more ..... with GERD ????

doctor
Answered by Dr. Happykumar Kagathara 5 hours later
Brief Answer:
Reflux of stomach acid

Detailed Answer:
Hello,
Because when you eat, secretion of stomach acid is stimulated to facilitate further digestion.
This stomach acid mix with ingested food and this mixture move ahead in small intestine for further digestion.
IN presence of GERD, small part of stomach acid/mixture of acid with food reflux back into lower esophagus. And this produce symptoms of heartburn, nausea.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Happykumar Kagathara 21 minutes later
I don't get Heartburn or Reflux anymore .....

When I get a little Anxious ... I kind of feel some Esophagus spasms .....

and I get constant tickle in my throat ......

I do talk a lot for work and have to clear my throat .... Phlegm ...

Seems like I also get Excess Saliva .... at times ....

And then because of that .... I will get a blister on in between the upper and lower lip .....

This is Crazy ....

Feels like I get bouts of the flu without having the flu .....

Like I've been hit by a truck .... Just when you start feeling good .... It hits you .....

1. Is this how GERD reacts ??? .... and

2. How long before recovery .... ???

I am using a Functional Doctor --- On Cleanse and Supplements ....

Functional Doctor says I have to get My Acid Correct in my Gut ....

Regular MD tells me to take over the counter stuff to get the Acid Out ....

So Confused .....
doctor
Answered by Dr. Happykumar Kagathara 23 hours later
Brief Answer:
they are not flux-disease/232326?iL=true" >GERD symptoms

Detailed Answer:
Hello,
No none of above mentioned symptoms are related to GERD except feeling of esophageal spasm.
Excess saliva is related to more your habit of talkativeness.
Blister between lips and flu like symptoms might be due to viral infection (Herpes).
Whatever they mentioned about acid stuff, it means to prevent chemical reaction of acid in oesophagus by reducing reflux episodes of GERD.
But your mentioned symptoms in last query are not due to GERD and would recommend to consult physician for flu symptoms + blister on lips.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Happykumar Kagathara 24 minutes later
They just tell me its Anxiety.....

doctor
Answered by Dr. Happykumar Kagathara 2 minutes later
Brief Answer:
Blister is not due to anxiety

Detailed Answer:
No. Blisters are not develop just because of anxiety. It require physical examination of lesion before concluding the diagnosis.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Happykumar Kagathara 38 minutes later
This is Crazy .... because it comes and goes with this GERD I have ....

I just had Ton of Blood Work done and Everything Came Back .....

Better than Awesome .....

I did every test you could do ... The Docs said why did you do that ...

Its Ridiculous ..... You Over Tested ....

But I have to tell you .... All My Labs came out Excellent ......
XXXXXXX
doctor
Answered by Dr. Happykumar Kagathara 26 minutes later
Brief Answer:
no need for any lab at all.

Detailed Answer:
There is no need for doing any extra lab at all.
For GERD, once endoscopy is sufficient and this you had already. Recent literature suggested role of anxiety on GERD symptoms intensity (Not well proven).
In last query, my concern was towards blister with flu like symptoms. Definitely these are not due to GERD.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Happykumar Kagathara 17 hours later
I have NEVER had a Endoscopy .....

In 2008 I was Diagnosed with IBS
and Severe Anxiety and OCD

So I have PERFECT Labs .....

Then in December I thought I was having Palpitations in my heart .... Wore a Heart Monitor for 24 hrs .... Heart is Perfect !!! Doctors told me I was having Esophagus Spasms and issues are due to Anxiety ....

Then I felt like I was getting a Constant tickle in the back of my Throat ...

When I had to clear my throat I would always have to spit out phlegm .....

So I am now using a Functional Doctor and my Symptoms are this :

1. My Stomach has calmed down by 85% meaning my stomach is 85% better....

2. No Heartburn --- but I rarely got Heartburn

3. No Acid Reflux coming back up .... I use to have that but not much ... Rarely ....

4. I still get Esophagus Spasms .... but they have gotten better by 90%

5. Feeling like there is a Lump in my Suprasternal Notch .... which use to be there all the time ... It felt like I had a Golf Ball stuck in the bottom of my throat ...

6. Still got the Tickle that comes on and off .... but I notice when I push on the right side of my Suprasternal Notch -- That is where the Tickle is ....

7. Now at times I am even getting a feeling of a scratchy throat ....

8. Still think when my tickle is in the back of my throat but on the bottom of my throat .... on Each side of bottom of the Suprasternal Notch ..... Sometimes the cough will make me cough .... but not always .... an when I do I spit out phlegm ....

9. Still have Excess Saliva .... and it seems like it not created a cold sore on the right side of my lip .....

10. And When my Anxiety and OCD kicks in ... all this seems to escalate and become worse .....

Please Help .....

P.S. .... And can Anxiety really be causing this tickle .... ????

doctor
Answered by Dr. Happykumar Kagathara 9 hours later
Brief Answer:
need endoscopy

Detailed Answer:
Hello,
I apologize for late reply.
1) From your last follow up, I would recommend to have an upper GI endoscopy based on feeling of suprasternal lump with tickling feeling, occasional esophageal spasms, occasional heartburn.
2) Anxiety might cause symptoms of GERD.
3) If you have lump in suprasternal area and associated tickling sensation then it would not be associated to anxiety.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Happykumar Kagathara 4 hours later
Seeing that I am getting better with Functional Doctor .....

My Doctor that fixed My Hernia in my Groin and my MD ....

Said keep working with Functional Doctor for 3 months .... If symptoms are still there then work from there .....

I think when my Anxiety gets real High which can be often from OCD .....

That is when everything all symptoms come on strong ....

I have Only been working with Functional Doctor for 2 weeks and things have gotten better .....

I wanted to give you All my Symptoms so you can see All that is happening .... This only started about 8 weeks ago ... Was real bad and now a bit better after seeing Functional Doctor ....

Functional Doctor says on a Scale of 1 - 10 of 10 being the worse ... I am a 2 maybe a 3 and through diet and Functional Supplements he can stop all this without any scopes ... He told me No scopes yet .....

I was giving you everything that has happened ( not at the same time) ...So you could understand what has happened ... The crazy thing is that this didn't slowly work its way up to this point .... It All came to me All at Once .... Its was Crazy ...

Most All Symptoms are a Lot better and some even gone with Functional Doctor now.... The Docs said that i should give this Functional Doctor time ( 3 months ) .... before I try anything else ....

What has me confused is Functional Doctors all told me I wasn't Digesting my for properly because I didn't have enough Acid and the Acid in the gut was not as low as it should be .... And the Conventional Doctors want to give me Medication to take away Acid ....

I also suffer from Bad Tinnitius and PPI's and All the Medications for Any o these issues are Ototoxic and can create permanent ringing of the ears which I already have and if you have it .... It will make it worse .... of which mine id debilitating already and I am not ready for Tinnitus to go Louder and I would want to blow my head off .....

I hope and Pray that Functional Doctor protocol will eliminate All that has gone on and what is going on still at the moment .....

Thoughts ...
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Follow up: Dr. Happykumar Kagathara 2 minutes later
Also the Lump and Tickle in my Throat comes and goes depending if my Anxiety and OCD is bad .... If my Anxiety and OCD is High .... Everything seems to happen and get worse .... Even to the Point of a cold sore ( which I NEVER get) breaks out on the side of my Mouth ....


doctor
Answered by Dr. Happykumar Kagathara 43 minutes later
Brief Answer:
Continue with Functional doc.

Detailed Answer:
Well, if you have pain discomfort with pain score of 2 or 3 then I would suggest to continue treatment with functional doc.
You have some confusion about stomach acid.
Stomach acid itself is acidic whether you take any medication or not but it will remain acidic because this is its nature. By taking medications like PPI and other you only control secretion of stomach acid into stomach. Also less production of acid (as seen in severe gastritis) cause improper digestion and responsible for symptoms of bloating, burping, occasional loose stool. But even with these, stomach acid will be towards lower in Ph.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Happykumar Kagathara 1 hour later
I did have the Bloating and HARD burping .......

With Functional Doctor .....

Stomach Pains are almost gone .... 90% Better ......

Bloating -- Gone

Hard Burping --- Decreased by a 70% -- When I do Burp it is not Acid Juicy ...but quite Gassy as I taste what I ate ... from Gas of Burp ....

Rarely get the Heart burn .....

Still get On and Off Lumpy feeling in My Throat --- Anxiety and Worry about My Condition makes this get Worse .....

Still got the Tickle that comes on and off .... but I notice when I push on the right side of my Suprasternal Notch -- That is where the Tickle is ....
At times I am even getting a feeling of a scratchy throat ....
Still think when my tickle is in the back of my throat but on the bottom of my throat .... on Each side of bottom of the Suprasternal Notch ..... Sometimes the tickle will make me cough .... but not always .... an when I do I spit out phlegm ....

Still have Excess Saliva .... and it seems like it not created a cold sore on the right in-between the upper and lower lip in the corner of my mouth....

And When my Anxiety and OCD kicks in because I WORRY ... The Anxiety and Worry seems to escalate and become worse .....

Last Night I tested everything and went off the diet and ate Cheeseburger .... and things seemed to have gotten worse now the Next Day .... Not a Lot ... but a Little worse .....

Thoughts ???



doctor
Answered by Dr. Happykumar Kagathara 1 hour later
Brief Answer:
Perfect improvement

Detailed Answer:
This improvement looks perfect.
I think what you are describing here as a suprasternal lump with tickle is a thyroid cartilage he normal part in construction of inner throat. SO there is no need to be worried about this tickle as it is normal.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Happykumar Kagathara 35 hours later
Ok ....

I got One for you ....

When I eat ... I will get Gas that comes up as a Burp ..... No Acid .... But a Long Hard Burp .....

So now it seems like My Throat Muscle is sore from all that Long Hard Burping ....

So I went in to see my Regular MD Doctor and he gave me a Complete Neck - Throat Exam .... and his words Exactly is "Everything is Normal Anatomy" .....

Everything is Normal .....

So with the GERD Gas .... and Long Hard Burping from the GERD gas ( No Acid) .... Just Gas Burping .... Can this make a Throat Muscle Sore .....
doctor
Answered by Dr. Happykumar Kagathara 24 hours later
Brief Answer:
Burping doesn't cause so severe symptoms

Detailed Answer:
Hello,
I apologize for late reply.
No. only burping without acid reflux (bitter taste in throat or chest) can not cause such severe symptom that you develop throat sore. Yes, you might feel occasional discomfort in chest but not upto throat.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Happykumar Kagathara 20 minutes later
Not saying that I have a sore throat ....

Seems like a muscle is sore in the throat from the Hard burp ....

Like if you work out ..... Your muscles hurt .....

So from Long Hard Burps --- Just Gas Burps .... Sometime where you feel the Lumpy feeling in your throat from GERD .... It will sometime feel like Instead of that feeling .... like its just a muscle overworked ....

Kind of Hard to Explain .... But Never Experiencing Anything like that .... Just seems like a sore throat muscle at times .....
doctor
Answered by Dr. Happykumar Kagathara 28 minutes later
Brief Answer:
throat sore and muscle overwork are different

Detailed Answer:
No, both of these are different.
feeling of muscle overwork in throat is not due to GERD. GERD only cause sore feeling inside your throat due to reflux of acid.
If you are experiencing muscle related issue in throat then it might be due to excessive voluntary burping which strain your neck muscle also but this is very rare.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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