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What causes nausea and pain when suffering from esophagitis?

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Posted on Sat, 20 Sep 2014
Question: I had edg taken. It showed i have esophagitis. The burning in chest seems to be getting worse.
Is the worse the pain is the more damaging it is? I also have nausea. I am 65 years old
doctor
Answered by Dr. Prakash H Muddegowda (34 minutes later)
Brief Answer:
It could be gastroesophageal reflux disease

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Looking at the medical history and query, my opinion is as follows:

1. Esophagitis at present appears to be due to gastro esophageal reflux disease.

2. It is due to acid in stomach moving up into esophagus due to weakness of esophageal gastric sphincter.

3. Once the sphincter is tightened and acid production is reduced (along with reduced abdominal pressure or reduced pressure in stomach), the symptoms will reduce.

Due to continuing irritation and reduced sphincter activity, you could feel nausea. It will slowly reduce, once the treatment is started.

Non-pharmacologic therapy includes:
a. Avoid spicy foods, beverages, alcohol, smoking, coffee etc, which increases acid production.
b. Weight reduction if overweight
c. Avoid getting into lying down position immediately after food. Taken food atleast 2-3 hours prior. Also avoid overeating, take small multiple adequate meals to reduce abdominal pressure. If required, raise the bed level to reduce reflux.
d. Have regular good sleep and reduce stress.

Pharmacological therapy includes:(As it is distressing, do start at the earliest)
a. Antacids, when pain is severe
b. Proton pump inhibitors like omeprazole help in reducing acid production and helps in healing of esophageal inflammation, and thereby reducing pain.
c. During early stages, prokinetic agents like metoclopramide or cisapride can be used for short time as it strengthens gastroesophageal sphincter. (Do not take for more than 10 days, as they have adverse reactions related to nervous system)

Do take the prescription from your doctor.

Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (8 hours later)
I am on omeprazole 20mg now. Still having constant right chest pain. I have been taking since July. Any suggestions? Also, what is sphicter and how is it reduced. Is esophagitis curable? Thanks!
doctor
Answered by Dr. Prakash H Muddegowda (1 hour later)
Brief Answer:
Yes, curable. Cause needs to be identified.

Detailed Answer:
Hi,
Thanks for asking again.

Esophagitis is only inflammation of esophagus. If the cause is treated, it is completely curable.
The cause here is possibly the acid reflux from the stomach. Once it is under control, it will be slowly heal. I am assuming the ulcer is on the lower end of esophagus, if it is in middle or upper location, cause might be different.

If its on the lower end of esophagus, you might have to take the medication of omeprazole twice. (Dosage increase is necessary, as it is not helping) Alternately you can go for next generation proton pump inhibitors. Do meet your doctor for prescription.
Sphincter is an anatomical structure, which is like a door in a natural passage. It opens from one end to let the contents (eg: food) and afterwards closes. However, in reflux disease, the stomach contents can move back into esophagus causing esophagitis.
Along with non-pharmacologic therapy, you need to add a prokinetic agents (for a very short period to allow esophagus inflammation to heal) to improve sphincter control.

If you are not sure about the report, do attach it. Continue both the therapies.

Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (1 hour later)
Hello again--they did not say anything about an ulcer from the EDG test. So I am not sure if I have that. They did do a biopsy 1 1/2 week ago during the EDG test. Havent heard anything on that yet. I think this was caused by frequent vomiting--so I would assume all the info you have given me still goes.
The pain I am getting on my right chest--is that heartburn or from the inflammation? I hope the pain isnt making the inflammation worse. Thanks for all of your info!!
doctor
Answered by Dr. Prakash H Muddegowda (14 minutes later)
Brief Answer:
Do follow both pharm and non pharm therapy

Detailed Answer:
Hi,
Thanks for asking again.

Sorry to confuse you. When i said ulcer, i meant inflammation. If inflammation persists, it could lead to ulcer. The biopsy report is usually available within a week maximum. When you meet your doctor again, you can ask for the report.

Heart burn is same as gastro esophageal reflux disease which leads to inflammation. All are same. Inflammation is causing the pain. Once the reflux reduces, either through anti emetics, or prokinetics along with proton pump inhibitors, everything will get back to normal.

Frequent vomiting could cause damage and inflammation in esophagus. However, try small meals along with both non-pharmacological and pharmacological therapy. Vomiting is possibly due to gastritis and the same treatment can be continued.

You are welcome.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (6 hours later)
I had pain in my chest all day. Does that mean it is severe?//what are the severe symptoms? I am a nervous wreck about this. Thanks again
doctor
Answered by Dr. Prakash H Muddegowda (2 hours later)
Brief Answer:
Reduce stress. Take cold milk.

Detailed Answer:
Hi,
Thanks for asking again.

The stress is increasing the acidity, which is getting in to the esophagus causing further inflammation. You need to relax, it will reduce pain.

You should be more in upright position rather than in lying down position, when awake.

Severe symptoms would be ulcer formation, when can present as bleeding. Your stools would be tarry black (if not on iron therapy) or you might vomit blood stained contents.

Try taking cold milk or ice cream, it should give a soothening effect. Also antacids should be useful.

Importantly, thinking about it will increase stress and more pain.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (1 hour later)
Hi. I really appreciate your answers. Why would my chest feel so sore? It feels like most of my right side of chest is sore
You said this is curable. I sure hope it is. Will i ever be able to go back to eating good burgers again? Thanks again. P.s. i did have a glass of skim milk
doctor
Answered by Dr. Prakash H Muddegowda (56 minutes later)
Brief Answer:
Yes, you will get better.

Detailed Answer:
Hi,
Thanks for asking again.
Yes, you will get completely better and eat burgers.
You have to follow everything religiously both pharmacological and non pharmacological therapies. Follow seriously for two months.

The inflammation can lead to severe tenderness in chest and back too, and if severe, you could feel whole body weakness too. Follow medication and diet strictly. Importantly relax.
After two months, you can be as you want.
Hope it helps.
Any further queries, happy to help again.

If you do not have any further queries, please close the discussion and rate the answer.
Dr. Prakash HM


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (10 hours later)
Hi. This morning i feel so nausea Is that because of the sphinter muscle? Is that an off and on symptom? Also, I woke up with pain. Thanks for all of your help
doctor
Answered by Dr. Prakash H Muddegowda (14 minutes later)
Brief Answer:
Take antacids and cold water.

Detailed Answer:
Hi,
Thanks for asking again.
Nausea is due to
1. Inflammation in esophagus and esophagus trying to relieve itself and associated contractions. As it stops contracting due to tiredness, you will feel less nauseous. It will be on and off, varying with pain.
2. Sphincter weakness and acid reflux increasing the inflammation.

Pain will be present until inflammation is present. You can take something cold like milk or cold water or ice cream to reduce pain. Hopefully, you increased or taking twice proton pump inhibitors. It should reduce acidity. Relax and avoid stress. Go for a walk if possible.
When you meet your doctor, do ask for biopsy report.
Hope it helps.

Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (7 minutes later)
hi. i havent increased the ppi med since I havent been to doctor yet. i wasnt sure if I should do it on my own You got me worried now when you mentioned biopsy report. i would think the dr would have called if anything serious--but who knows
doctor
Answered by Dr. Prakash H Muddegowda (35 minutes later)
Brief Answer:
do not worry. relax

Detailed Answer:
Hi,
Do not worry. I am sure, your doctor would have called you. Needed only a biopsy confirmation, so that we can aggressively treat acidity.
If you are not meeting him very shortly, you can take it PPI twice daily. It is an over the counter drug. If you are meeting, you can discuss and finalize. Do not take tension. Relax.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (2 hours later)
the ppi i have is a prescription. 20mg. Is that that same as over the counter? this pain and sensation is driving me nuts today. i want to take 2 of the pills but since it is a prescription I wasnt sure. I really appreciate all of your inputs
doctor
Answered by Dr. Prakash H Muddegowda (13 minutes later)
Brief Answer:
you can take twice daily.

Detailed Answer:
Hi,
Thanks for asking again.
Yes. You can take it twice daily. Should reduce acid production. It is also available without prescription. Take it for at least a month to notice improvement.
Do elevate your bed or use pillows at night to avoid night exposure of esophagus to acid. Symptoms should improve.
Avoid being in lying flat position for long.
Avoid stress.
Follow all therapies advised earlier.
Any further queries, happy to help again.
If you do not have any further queries, do close the discussion and rate the answer.
Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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What causes nausea and pain when suffering from esophagitis?

Brief Answer: It could be gastroesophageal reflux disease Detailed Answer: Hi, Thanks for asking. I am Dr. Prakash HM and I will be answering your query. Looking at the medical history and query, my opinion is as follows: 1. Esophagitis at present appears to be due to gastro esophageal reflux disease. 2. It is due to acid in stomach moving up into esophagus due to weakness of esophageal gastric sphincter. 3. Once the sphincter is tightened and acid production is reduced (along with reduced abdominal pressure or reduced pressure in stomach), the symptoms will reduce. Due to continuing irritation and reduced sphincter activity, you could feel nausea. It will slowly reduce, once the treatment is started. Non-pharmacologic therapy includes: a. Avoid spicy foods, beverages, alcohol, smoking, coffee etc, which increases acid production. b. Weight reduction if overweight c. Avoid getting into lying down position immediately after food. Taken food atleast 2-3 hours prior. Also avoid overeating, take small multiple adequate meals to reduce abdominal pressure. If required, raise the bed level to reduce reflux. d. Have regular good sleep and reduce stress. Pharmacological therapy includes:(As it is distressing, do start at the earliest) a. Antacids, when pain is severe b. Proton pump inhibitors like omeprazole help in reducing acid production and helps in healing of esophageal inflammation, and thereby reducing pain. c. During early stages, prokinetic agents like metoclopramide or cisapride can be used for short time as it strengthens gastroesophageal sphincter. (Do not take for more than 10 days, as they have adverse reactions related to nervous system) Do take the prescription from your doctor. Hope it helps. Any further queries, happy to help again. Dr. Prakash HM