• question-icon

    Suggest treatment for severe heartburn and back pain

default
Posted on Tue, 1 Aug 2017 in Digestion and Bowels
Question: I've had heartburn for 4 days straight now, and nothing is helping, everything I swallow including water burns after ingested. I also have an extremely ache in the middle of my back, I also have been with a lot of stress lately?
doctor
Answered by Dr. Ramesh Kumar 23 minutes later
Brief Answer:
Take a proton pump inhibitor with prokinetic drug.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic.
I am a Gastroenterologist and would be answering your query.

Reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.The backwash (reflux) irritates the lining of your esophagus and causes GERD.In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the XXXXXXX is weak or relaxes inappropriately, allowing the stomach's contents to flow up into the esophagus. If not treated, chronic acid reflux can injure the esophagus and, in some people, progress to a precancerous condition known as Barrett’s esophagus.

Usually we manage GERD with a combination of medication and lifestyle changes. If symptoms persist or are severe, innovative endoscopic and surgical procedures can be done that provide long-term symptom relief.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy.

Please request your gastroenterologist to start you on PPI-antacids like Rabeprazole or Esomeprazole.Ranitidine will not help you much. Esomeprazole can be used in the dosage as high as 80 mg twice daily.Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms. Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.Prokineic should be added in your regimen.

An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.

Acotiamide is another wonderful 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

Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, grapes and apples
Fiber.
Fatty foods and carbonated drinks.

Try Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Take a high-quality probiotic.
Take external enzyme supplements.
Exercising, to help keep food moving through your system.
Thanks.







Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2436 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Gastroesophageal reflux disease

doctor1 MD

Hi! My 6 year old son s throat burns all the time, has been since around Dec., 2010. He s been tested for acid reflux; EE; and had samples from all...

doctor1 MD

I have occasional acid reflux and a few days ago my right ear started hurting. It was after a few days of eating more acidic foods and I wanted to...

doctor1 MD

I have this ongoing cough that lingers for 7 weeks so far, it began with a mild fever. There is a weird feeling in my throat, a dull burning...

doctor1 MD

my daughter is a special needs patient with SMA, Scolosis Sleep Apnea Gerd IBS and Asthmas Both ovaries are on her right side with one being larger...

doctor1 MD

I had and was treated for strep. It has been a month, and I still have a lingering cough . Why is the cough hanging on? Have you had similar...

doctor1 MD

Pain on left upper side of chest, out of breath, sweating in cold room, extremely fatigued and acid reflux .

doctor1 MD

HI, I seem to have a chest cold - in the morning a lot of mucus some yellow and Greene. then during the day a lot of dry cough . Now at night feel...

Get personalised answers from verified doctor in minutes across 80+ specialties

195 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Ramesh Kumar
  • Q - Suggest treatment for abdominal hernia

  • Q - What does my biopsy report indicate?

  • Q - How can chronic constipation be treated?

  • Q - Suggest treatment for gastritis and acid reflux

  • Q - What causes severe abdominal pain?

  • Q - Suggest treatment for internal hemorrhoids

  • Q - What causes blood in stools while having diverticulitis?

  • Q - Suggest treatment for symptoms of irritable bowel syndrome

  • Q - Suggest treatment for GERD

  • Q - Suggest treatment for IBS

backtotop2