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Suggest treatment for severe acid reflux despite taking Nexium

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Posted on Fri, 3 Feb 2017
Question: I have acid reflux and ive had it for a while now. Fof about 6 months. I am taking 40mg nexium daily in the morning and it has gotten better but its not completelty gone. What makes my acid reflux better is chewing gum and when i go to the gym for some reason... the main symptom that i have is that i have a weird taste in my mouth. It is almost like a mint or spicy taste in my mouth. I have two questions: 1. Is this taste in my mouth acid reflux or can it be something else like a nexium side effect? 2. Can my acid reflux be caused by stress? When i go to the gym it gets better and when i am not nervous it just generally tends to be alot better.
doctor
Answered by Dr. Ramesh Kumar (52 minutes later)
Brief Answer:
Details incorporated!

Detailed Answer:
Hi,
Thanks for choosing HCM for your query!

Answers to your questions are as follow-

1)Yes the taste in your mouth is because of acid reflux,No its not the side effect of nexium.You are having a problem medically termed as GERD(gastro esophageal reflux disorder associated with reflux esophagitis.It is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe .The weird taste in this mouth is because of this back flow only.This problem can be associated with heart burn and gastritis also.
Advice
Ask your gastroenterologist to increase the dose of Esomeprazole ,Esomeprazole can be used in dosage as high as 80mg twice daily ,Ask him to add Domepridome 30mg slow release once daily,This will slow down the reflux of acid back and would provide symptomatic relief.An antacid containing local anaesthetic could be added to drug regimen.Acotiamide is a new drug and is very effective in controlling symptoms of GERD and esophagitis.In trials- Acotiamide,a gastrointestinal motility modulator,at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.

2)Yes stress and anxiety increases the symptoms,Over anxiety stimulates the vagal nerve innervating stomach and esophagus,Hence causing increased motality and reflux.Anxiety and stress are associated with increased symptoms.Trials have shown that person with GERD are 4 times more susceptible to acid peptic disorders then a person with normal levels of anxiety and stress.Thats why you feel better on exercising or when you are not nervous.Please ask your doctor to consider adding low dose of anti-anxiety medications like Etizolam for few weeks,This will help you recover much faster.

Though not asked by you yet some general instructions apart from medicines to help you inFast recovery are-

- Increase XXXXXXX warm water intake
- Try to eat vegetable,Take a lot of Yoghurt along with food.
- Eat plentiful "fresh oranges" and "pear "
- do some exercise everyday as per your capacity try to take a 20 minute walk.
-Don't worry too much.
- Take a diet which is very low in Fat.
-Add lot of vegetables and fruits to your diet.
-Fruit juices should be taken.
- Frequent and small meals should be taken.
-Take small amount of food every 2 hours,Don't take large meals at one time.

Thank you!
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar (50 minutes later)
Hello Dr. and thabk you for your very detailed response. Inwill not be able to see my doctor for a month. Can you reccomend any over the counter medication that will help me? Whether is is natural supplement or not? Also should i take nexium 40mg in the morning and 40mg at bedtime?
doctor
Answered by Dr. Ramesh Kumar (15 minutes later)
Brief Answer:
.

Detailed Answer:
Hi,
Yes you can take neksium twice daily(rember to take it empty stomach atleast one
Syrup mucaine gel(oxethazaine with aluminium hydroxide and magnesium hydroxide) 10ml twice daily can be taken 5 minutes before meals with half cup of water,Its a over counter medication.
No its not a natural product.

Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2638 Questions

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Suggest treatment for severe acid reflux despite taking Nexium

Brief Answer: Details incorporated! Detailed Answer: Hi, Thanks for choosing HCM for your query! Answers to your questions are as follow- 1)Yes the taste in your mouth is because of acid reflux,No its not the side effect of nexium.You are having a problem medically termed as GERD(gastro esophageal reflux disorder associated with reflux esophagitis.It is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe .The weird taste in this mouth is because of this back flow only.This problem can be associated with heart burn and gastritis also. Advice Ask your gastroenterologist to increase the dose of Esomeprazole ,Esomeprazole can be used in dosage as high as 80mg twice daily ,Ask him to add Domepridome 30mg slow release once daily,This will slow down the reflux of acid back and would provide symptomatic relief.An antacid containing local anaesthetic could be added to drug regimen.Acotiamide is a new drug and is very effective in controlling symptoms of GERD and esophagitis.In trials- Acotiamide,a gastrointestinal motility modulator,at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults. 2)Yes stress and anxiety increases the symptoms,Over anxiety stimulates the vagal nerve innervating stomach and esophagus,Hence causing increased motality and reflux.Anxiety and stress are associated with increased symptoms.Trials have shown that person with GERD are 4 times more susceptible to acid peptic disorders then a person with normal levels of anxiety and stress.Thats why you feel better on exercising or when you are not nervous.Please ask your doctor to consider adding low dose of anti-anxiety medications like Etizolam for few weeks,This will help you recover much faster. Though not asked by you yet some general instructions apart from medicines to help you inFast recovery are- - Increase XXXXXXX warm water intake - Try to eat vegetable,Take a lot of Yoghurt along with food. - Eat plentiful "fresh oranges" and "pear " - do some exercise everyday as per your capacity try to take a 20 minute walk. -Don't worry too much. - Take a diet which is very low in Fat. -Add lot of vegetables and fruits to your diet. -Fruit juices should be taken. - Frequent and small meals should be taken. -Take small amount of food every 2 hours,Don't take large meals at one time. Thank you!