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What Causes Warm Sensation And Sore Throat When Treating GERD?
Question: Hi,
GERD - I started having discomfort about three months ago not severe or really uncomfortable, more a sensation. A warm (not really burning) in my chest and I was burping more than usual. Over the counter anti-acids didn't really work so I went to my Dr. She suggested that I go on 40mg of Prilosec for two months to calm the inflammation down and see how it goes. Whilst I was on the Prilosec I had no symptoms at all. She has now advised to come off the 40mg and do 20mg a day or every other day to ease me off it. I'm pretty active but a few pounds over weight.
So over the past couple of days I've noticed myself burping a bit more and also a warm sensation and sore throat (although I thing the sore throat could be a bit of a cold/run done). My Dr doesn't seem overly concerned and said if the symptoms come back after I stop taking the medication she would send me for an endoscopy. I asked why and she said to check for an infection or something.
My questions are:
1. Could I not just stay on 40mg a day ongoing?
2. After only experiencing this for a few months and not severe could I have damage to my esophagus like Barretts Esophagus?
3. There seems to be info that an endoscopy is not need unless there are severe symptoms or if the mediation didn't work (mine did work whilst I was on it).
4. They say if they symptoms prevail after taking the medication for 2 months then you should have an endoscopy. Do they mean if the medication didn't work at all or the symptoms came back when you stopped?
5. What course of action do you think I should take?
P.S I had an abdominal CT scan and MRI six months ago (for something else) so I assume if there was anything nasty going on (tumor) in my esophagus/stomach that something would have shown up on those, correct?
Thanks in advance!
GERD - I started having discomfort about three months ago not severe or really uncomfortable, more a sensation. A warm (not really burning) in my chest and I was burping more than usual. Over the counter anti-acids didn't really work so I went to my Dr. She suggested that I go on 40mg of Prilosec for two months to calm the inflammation down and see how it goes. Whilst I was on the Prilosec I had no symptoms at all. She has now advised to come off the 40mg and do 20mg a day or every other day to ease me off it. I'm pretty active but a few pounds over weight.
So over the past couple of days I've noticed myself burping a bit more and also a warm sensation and sore throat (although I thing the sore throat could be a bit of a cold/run done). My Dr doesn't seem overly concerned and said if the symptoms come back after I stop taking the medication she would send me for an endoscopy. I asked why and she said to check for an infection or something.
My questions are:
1. Could I not just stay on 40mg a day ongoing?
2. After only experiencing this for a few months and not severe could I have damage to my esophagus like Barretts Esophagus?
3. There seems to be info that an endoscopy is not need unless there are severe symptoms or if the mediation didn't work (mine did work whilst I was on it).
4. They say if they symptoms prevail after taking the medication for 2 months then you should have an endoscopy. Do they mean if the medication didn't work at all or the symptoms came back when you stopped?
5. What course of action do you think I should take?
P.S I had an abdominal CT scan and MRI six months ago (for something else) so I assume if there was anything nasty going on (tumor) in my esophagus/stomach that something would have shown up on those, correct?
Thanks in advance!
Brief Answer:
Agree with your doctor.
Detailed Answer:
Hello,
I went through your queries, let me answer them one by one.
1.Prilosec like drugs are meant for short term relief,they affect gastric acid meant for digestion so long term use not extremely advisable.Also if there is GERD even with drugs at optimal dose, you still might get intermittent reflux leading to esophageal issues and even lung aspirations. So endoscopy is indicated to have look at your gastroesophageal sphincter. H.Pylori infection is common association with reflux, endoscopy can help confirm this.
2.Barrett's esophagus is possible with even few months symptoms. Esophageal mucosa is not designed to handle gastric acid.
3.Screening endoscopies have got pretty common.So academically it are indicated in patients with severe symptoms, but for practical purposes its better to undertake it rather than blindly/symptomatically treating some thing, that too for long term.
4.If symptoms are recurring means there is some other cause which is not cleared off by short course of medication.Common cause is reduced strength of esophageal sphincter or a small gastroesophageal hernia. In such cases symptoms are relieved only when you are taking drugs .This is very likely underlying thought of your doctor to get endoscopy done.
5.Steps would be get a gastroenterologist involved and endoscopy done. Send samples to lab to see for infection. If needed get esophageal pH studies and esophageal manometry done. Gastroenterologist will advise you on investigations to be done.Then plan treatment accordingly.
6.CT and MR can of course rule out tumor or other major causes , but are not investigations for GERD as they cant demonstrate functional behavior of food tube/esophagus.
Hope this helps. Please ask if there are doubts. Regards.
Agree with your doctor.
Detailed Answer:
Hello,
I went through your queries, let me answer them one by one.
1.Prilosec like drugs are meant for short term relief,they affect gastric acid meant for digestion so long term use not extremely advisable.Also if there is GERD even with drugs at optimal dose, you still might get intermittent reflux leading to esophageal issues and even lung aspirations. So endoscopy is indicated to have look at your gastroesophageal sphincter. H.Pylori infection is common association with reflux, endoscopy can help confirm this.
2.Barrett's esophagus is possible with even few months symptoms. Esophageal mucosa is not designed to handle gastric acid.
3.Screening endoscopies have got pretty common.So academically it are indicated in patients with severe symptoms, but for practical purposes its better to undertake it rather than blindly/symptomatically treating some thing, that too for long term.
4.If symptoms are recurring means there is some other cause which is not cleared off by short course of medication.Common cause is reduced strength of esophageal sphincter or a small gastroesophageal hernia. In such cases symptoms are relieved only when you are taking drugs .This is very likely underlying thought of your doctor to get endoscopy done.
5.Steps would be get a gastroenterologist involved and endoscopy done. Send samples to lab to see for infection. If needed get esophageal pH studies and esophageal manometry done. Gastroenterologist will advise you on investigations to be done.Then plan treatment accordingly.
6.CT and MR can of course rule out tumor or other major causes , but are not investigations for GERD as they cant demonstrate functional behavior of food tube/esophagus.
Hope this helps. Please ask if there are doubts. Regards.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thanks very much for your answers. Very much appreciated and helpful. Even though Barrett's could occur quickly is it more likely that it is usually associated with more severe symptoms and long term GERD?
What type of drugs are good for long term use?
Thx again!
What type of drugs are good for long term use?
Thx again!
Brief Answer:
Thanks for follow up.
Detailed Answer:
Occurrence of Barrett's in not always associated with severe symptoms.
Its more of how your esophageal mucosa reacts to gastric acid.
No drug is absolute and good for long term use. So one has to just use one that suits and use judiciously.
Lifestyle,diet changes and food habits can help more than drugs.
Regards
Thanks for follow up.
Detailed Answer:
Occurrence of Barrett's in not always associated with severe symptoms.
Its more of how your esophageal mucosa reacts to gastric acid.
No drug is absolute and good for long term use. So one has to just use one that suits and use judiciously.
Lifestyle,diet changes and food habits can help more than drugs.
Regards
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
So really there is no point worrying about Barrett's as it could affect someone with no gerd symptoms or severe symptoms?
Brief Answer:
Yes, no need to worry about it.
Detailed Answer:
Hello,
Yes, there is no point in worrying about Barrett's esophagus, preventing reflux is the way out.Regards.
Yes, no need to worry about it.
Detailed Answer:
Hello,
Yes, there is no point in worrying about Barrett's esophagus, preventing reflux is the way out.Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Prasad
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