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Took pantaprazole for acid reflux. Feeling burning in oesophagus with vomiting. What is causing this?

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General & Family Physician
Practicing since : 2003
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A form of these symptoms has happened 3 times. I've had Acid Reflux for quite some time. I take Pantaprazole twice a day and add (2) 150 Zantac at bedtime. I've recently had an Endoscopy of the Esophagus and it was normal. I was waking up 2-4 time a night with basically "Vomit" in my mouth. I would take Gaviscon (at this time I was only taking Pantaprazole in the am). My Esophagus was burning!!! I started off getting a cough drop. Then I found relief with a Popsicle. With the addition of the evening dose, the Acid Reflux got better for a while. About a month ago, I woke up with a "clear liquid" pouring out of my mouth. I ran to the sink and rinsed my mouth out. It left a horrible taste. The next time the liquid was coming out of my nose. Last night, I woke up with the liquid coming out of my mouth and I rinsed it out and when I blew my nose, there was a "pinkish" color on my tissue - also I could see very small black discolorations in the tissue. The horrible smell was back also. I went to get back into the bed and felt the liquid coming out of my nose. I carried it into the bathroom with my hands together. When I got in the light, there were several small "square" soft tissue like creamy colored pieces in my hand. The next thing I knew my nose was pouring with a creamy or slightly yellow stream coming out of both nostrils. I held my head over the sink and continued to try to wipe the mucous off my face as it poured out. The next thing I knew I was gagging and finally began to dry heave. That horrible taste was worse than ever. Honestly I don't know what to think except an impaction in my sinuses that also involve drainage accumulating in my mouth. Oh and once something like this happens - I get a cough that won't go away with a cough drop, chewing gum, anything that would give me a "taste" that sort of "soothes" my throat. I have a drs. appt. with my Primary Care Physician Monday morning, and then with my ENT Monday afternoon. Can you give me some idea of what could be causing the episodes? I forgot to list that I have BiPolar II. Thanks so much!
Posted Sat, 27 Oct 2012 in Digestion and Bowels
Answered by Dr. Mihail Iepure 3 hours later
Welcome to Healthcare Magic,
Your symptoms are suggestive for gastro esophageal acid reflux and in generally your medication is correct with proton pump inhibitors ( pantoprazole, omeprazole,)and H2 blockers(ranitidine) but you have to add regularly antacids such like Maalox , Rennie, ( chewable tablets or syrup ) plus general considerations: avoid non- steroidal anti-inflammatory drugs like Ibuprofen or Aspirin, smoking, alcohol, large fatty meals, spicy food, coffee, soda, stress. I noted you have done Esophagus Endoscopy , but you need additional Endoscopy exam of your stomach and duodenum , possible that “horrible taste” is traces of bile , anyhow gastroduodenal endoscopy definitely will clarify. I noted from your description you had creamy, yellow nasal secretions that are signs of possible sinus infections, but ENT exam and X-ray again will clarify your condition, by meantime you may clean with saline spray and then use local decongestants such oxymetazoline.
I wish you good luck and speedy recovery,
Hope this helps and I have answered your query. If you have additional queries don’t hesitate to ask.

Best Regards,

Above answer was peer-reviewed by
Follow-up: Took pantaprazole for acid reflux. Feeling burning in oesophagus with vomiting. What is causing this? 18 hours later
Last evening (Friday) I wrote a detailed explanation of a problem I've been dealing with over the past few weeks. As I read in your "policy" - I would have an answer or suggestion as to what might be going on with these episodes within 24-hours. It is my understanding that my answer will be free if you don't respond within that time frame. I'd certainly rather have some sort of idea as to what might be going on so that when I see my doctors, I will be a little more prepared and not ramble on about something that is neither important nor relative.

I think I can look back and see exactly what time I submitted my health issue. I just wanted to let you know that as of Saturday, 6:40 EST I've not received any sort of answer.
I think I failed to mention that along with the Pantoprazole I do also take (2) 150 Zantac tablets. I'm not familiar with the "name" of the Endoscopy of the stomach, but at the same time that I had the Esophageal Endoscopy, I also had a Colonoscopy. Does that show the stomach and duodenum? And yes, I started on a Saline Nasal Spray this past Wednesday, after my last "episode".

I think I forgot to mention that when I had an Endoscopy around 2001 my Gastroenterologist found a Hiatal Hernia. I sleep on 4 pillows to reduce the Acid Reflux occurrences, but if I turn over too quickly at night, the rolling movement and also if I lean down to pick something up while I'm in the bed (also at nighttime) seems to trigger the Acid Reflux, as if "bile" from my stomach acids runs into the hernia causing the horrible burning sensation. I have rarely experienced Acid Reflux during the day time, but these other symptoms that awaken me and occur when I turn over in bed too quickly never happen during the daytime, even if I'm lying down, as most of my Acid Reflux occurs during the time I'm asleep.

When I saw my Gastroenterologist a few months ago before my Upper Endoscopy and Colonoscopy, I described in detail about my Acid Reflux (he didn't say anything about "Gerd"), I told him that I was diagnosed with a Hiatal Hernia years ago and wondered if that could be causing some of my problems. He didn't make any comment either way except to discuss the fact that I did need the Endoscopy. After the procedure was done, I was still a little "loopy" and didn't specifically ask about any findings with my hernia.

I have to admit that I forgot to mention one more symptom that I'm having. On occasion when I put something in my mouth that needs to be chewed - such as meat, popcorn, potato chips, etc. my Esophagus seems to close and I can't seem to swallow at all until I get something liquid and then it goes right on down. I've wondered if my Esophagus needed to be stretched, but I did mention the problem to my Gastro. dr. and didn't want to act like I was trying to diagnose myself so I never asked him about stretching the opening of my Esophagus. I'm beginning to feel that my visit to him before the Upper Endoscopy and Colonoscopy didn't come close to giving me asnwers as to why I'm having these symptoms and I got no explanation, except to say "Everything looked good".

I absolutely love my Primary Care Physician who I've been a patient of for over 30 years. He referred me to my Gastro. dr. when I initially suspected Celiac (my sister was diagnosed 6 years before I admitted that most likely I had Celiac). The first think I told my Gastro. dr. at my initial visit was about my sister being a Celiac and that led to a quick assumption that I had that same problem. (I'm beginning to think that I am the one who made that diagnosis!) :-)

I see my Primary Care Dr. before I see the Gastro. and plan to tell him about my appt. with the Gastro. and the symptoms that I continue have and now the additional symptom with the mucous, etc. Could my sinuses be impacted? (I may have already asked you that.)

Thanks so much for your help. It will make me feel more knowledgeable when I try to explain the lack of help with my previous issues and feel more adequate when I try to explain the additions of my newest symptoms.
I'm sorry, I mistakenly said I had an appt. with my Gastro. on Monday. My second appt. is with my ENT. He is also an excellent physician, along with my Primary Care. When I see him I plan to ask him if I need a second opinion or find a new Gastro. who I can trust to show more interest in helping me!
Thank you, XXXXXXX
Answered by Dr. Mihail Iepure 6 hours later
Welcome back XXXXXXX
Thank you for additional info, this really helps.
Colonoscopy will not show and have not any correlation with stomach and duodenum, this test will examine your colon, large intestine. As I mentioned just esophageal endoscopy is not enough, you need gastroduodenal endoscopy that will examine your stomach and duodenum ( to rule out any gastritis, erosion, etc.) this will help clarify cause and source of your acid reflux is due to your stomach condition or due to hernia. Hiatal hernia very frequently accompanied by GERD ( gastro esophageal reflux disease) as I see from your past history your signs and symptoms are very suggestive( when you lie down, sleeping).Best method to diagnose hiatal hernia is barium study( barium swallow ) and chest X-ray. At this stage your treatment is correct with PPIs( proton pump inhibitors) and Zantac, you may add antacids ( I have mentioned above). Regarding difficulty swallowing, there possible due to repeatedly and frequent refluxes you developed esophagitis (irritation/inflammation) of your esophagus that must be checked again, their answer “ everything looked good “ is not satisfactory, because you are symptomatic. You have to make appointment with gastroenterologist for definitely diagnosis, you need clearly answer to your questions from them. ENT assessment and X-ray of your sinuses will help clarify sinus conditions; in case of any sinus infection you will need decongestants and antibiotics. If acid reflux is due to hiatal hernia and will persist or will worsened despite treatment with proton inhibitors, then you have to consider surgery option.

I wish you good luck and speedy recovery,
Hope this helps and I have answered your query. If you have additional queries don’t hesitate to ask.
Best Regards,
Ps: We are in different time zones, I am right now in NATO Air base in Kandahar so we have almost 7 hours’ time difference, thank you for understanding.

Above answer was peer-reviewed by
Follow-up: Took pantaprazole for acid reflux. Feeling burning in oesophagus with vomiting. What is causing this? 12 hours later
Dr. Mihail,

Thank you so much for the additional information. I think it will help me to be more informed, understand the benefits of further testing, and actually know what will be necessary to return the quality of life, as well as being able to get a full night of uninterrupted sleep.

Since I know I can ask questions for a month, I may want to consult you with a prognosis, as well as the course of action that my doctors agree on. I have decided that I'm going to have my Gastroenterologist. I should have gone with my "gut" and ask for one before I had the Endoscopy and Colonoscopy. After "he" initially diagnosed me with Celiac, there was something that just "didn't seem right", so I found a wonderful Gastro. dr. at the University of Alabama here in B'ham. The bad news was that she got a XXXXXXX to return to the research that she was most interested in. I have missed her in put terribly.

If I have other questions, will I be able to continue with you? I certainly hope so. Thank you for all your help.
Answered by Dr. Mihail Iepure 9 hours later
Yes XXXXXXX you took absolutely right decision and I wish you good luck find best gastroenterologist that definitely will clarify your condition. Of course if you have additional queries don’t hesitate to ask, what is in my power I always will help and support you.
Best Regards,

Above answer was peer-reviewed by
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