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Suggest treatment for severe acid reflux

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Posted on Tue, 4 Apr 2017
Question: I have been suffering with Acid Reflux for the past week. I did not have any Reflux issues prior to being on a 2 week run of the antibiotic Clindamycin.

There's a lump in my throat most of the time, and I have stopped eating solid food - as there is too much discomfort. I am miserable, and I've been to the ER twice. ER doc prescribed me 40mg Protonix 1/day. I'm also taking a Probiotic, and I started taking Gaviscon last night. I didn't have an acid attack last night, but right now I feel like I've got a lot of mucus/phlegm in my throat, but I can't get it to come up.

I have an appt Monday afternoon with a Gastroentorologist.

Any advice?
doctor
Answered by Dr. Ramesh Kumar (3 hours later)
Brief Answer:
Severe gastritis overlapped with functional dypepsia most likely.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.

As per your query,
Firstly I would suggest you to switch over to Nexium(Esomeprazole). Initially take it 40mg twice daily, However if not relieved doses can be increased to 80mg twice a day.Though Esomeprazole is of the same class as Pantoprazole yet trials show it is superior to other PPI's in treating reflux disorder and severe acute dyspepsia. Protonix 1 per day is a bit low dose as per the intensity of your symptoms.
On the day of appointment ask your gastroenterologist to add Prokinetic drug like
Option 1
Levosulpride-It is a sulpride isomer and exerts its prokinetic effect by blocking D2 receptors. Recent trials have shown that combining it with PPI's have excellent effect in patients suffering from acid reflux.

Option 2
Domperidome-Very effective in treating reflux not controlled by PPI's especially when combined with Rabiprazole.

Acotiamide- Trials showed that 30mg doses taken thrice daily were highly effective in treatment of of dyspepsia.The positive effect of acotiamide on both gastric emptying and gastric accommodation,Gastric accommodation and gastric emptying in acotiamide group were significantly enhanced in people taking it.
Just taking natural supplements will not do as you are having severe dyspepsia due to long term antibiotic therapy.
These medications suggested above should be discussed with your Gastroenterologist. Ask him /her to increase the doses from minimal to optimal.
Mucous is because of severe irritation of gastric and esophageal lining by acid reflux.It's a natural protective phenomenon.To prevent mucosa from damage body secretes large amount of mucous to trap irritant's and prevent their direct contact with mucosa.
As reflux will settle down,mucous production will automatically stop.
Strict adherence to the diet suggested below is required along with medications-
-Take a low fat easily digestible food.
-Eat lot of raw salads esp. vegetables.
-No alcohol or smoking.
-No aerated beverages or soda.
-Avoid meat or processed food.
-Avoid cheese, Dairy,Milk etc.
-Take a lot's of yoghurt in food.
-Avoid spicy or fast food(No pizza or Burger).
-If possible try vegans diet in dinner and normal diet in lunch.
-Drink at least 8 cups of water everyday.
-avoid all fruits which are citrus.Avoid orange or pineapple juice.
-Eat 1 cups of fruit like banana daily.

You can go for a Endoscopy if not relieved by above suggested treatments.

In case of further query feel free to ask.

Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (1 hour later)
My throat is very tight anddry tight now. What would you recommend?
doctor
Answered by Dr. Ramesh Kumar (28 minutes later)
Brief Answer:
Follow up advice.

Detailed Answer:
Hi again,

Tablet Mucomix(N acetyl cystein) 600mg can be taken twice daily along with Bromohexine 8mg twice daily.(Get a prescription from your Physician). It will relieve congestion.
Increase dose of Protonix to 40mg twice daily.
However proper investigations and treatment is required.
I hope you understand the intensity of situation and the fact that i can't examine you physically.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2755 Questions

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Suggest treatment for severe acid reflux

Brief Answer: Severe gastritis overlapped with functional dypepsia most likely. Detailed Answer: Hi, Thanks for choosing HealthcareMagic for your query. As per your query, Firstly I would suggest you to switch over to Nexium(Esomeprazole). Initially take it 40mg twice daily, However if not relieved doses can be increased to 80mg twice a day.Though Esomeprazole is of the same class as Pantoprazole yet trials show it is superior to other PPI's in treating reflux disorder and severe acute dyspepsia. Protonix 1 per day is a bit low dose as per the intensity of your symptoms. On the day of appointment ask your gastroenterologist to add Prokinetic drug like Option 1 Levosulpride-It is a sulpride isomer and exerts its prokinetic effect by blocking D2 receptors. Recent trials have shown that combining it with PPI's have excellent effect in patients suffering from acid reflux. Option 2 Domperidome-Very effective in treating reflux not controlled by PPI's especially when combined with Rabiprazole. Acotiamide- Trials showed that 30mg doses taken thrice daily were highly effective in treatment of of dyspepsia.The positive effect of acotiamide on both gastric emptying and gastric accommodation,Gastric accommodation and gastric emptying in acotiamide group were significantly enhanced in people taking it. Just taking natural supplements will not do as you are having severe dyspepsia due to long term antibiotic therapy. These medications suggested above should be discussed with your Gastroenterologist. Ask him /her to increase the doses from minimal to optimal. Mucous is because of severe irritation of gastric and esophageal lining by acid reflux.It's a natural protective phenomenon.To prevent mucosa from damage body secretes large amount of mucous to trap irritant's and prevent their direct contact with mucosa. As reflux will settle down,mucous production will automatically stop. Strict adherence to the diet suggested below is required along with medications- -Take a low fat easily digestible food. -Eat lot of raw salads esp. vegetables. -No alcohol or smoking. -No aerated beverages or soda. -Avoid meat or processed food. -Avoid cheese, Dairy,Milk etc. -Take a lot's of yoghurt in food. -Avoid spicy or fast food(No pizza or Burger). -If possible try vegans diet in dinner and normal diet in lunch. -Drink at least 8 cups of water everyday. -avoid all fruits which are citrus.Avoid orange or pineapple juice. -Eat 1 cups of fruit like banana daily. You can go for a Endoscopy if not relieved by above suggested treatments. In case of further query feel free to ask. Thanks.