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Dear Doc, My Daughter ,44 Yrs Is Diagnosed With Gerd

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Posted on Mon, 16 Dec 2019
Question: Dear Doc, my daughter ,44 yrs is diagnosed with gerd & Lppr(silent relux) feels dizzy often .2 yrs back her ECG showed left bundle block but Docs. now find the heart is functioning ok & suggest she goes for a brain MRI. Plse Advice , Thanks
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Follow up: Dr. Ramesh Kumar (0 minute later)
Dear Doc, my daughter ,44 yrs is diagnosed with gerd & Lppr(silent relux) feels dizzy often .2 yrs back her ECG showed left bundle block but Docs. now find the heart is functioning ok & suggest she goes for a brain MRI. Plse Advice , Thanks
doctor
Answered by Dr. Ramesh Kumar (7 hours later)
Brief Answer:
MRI not required.

Detailed Answer:
Hello and thanks for choosing "Ask a Doctor " service for your query,
Have seen your details,
Acid reflux is the cause of nausea.
LBBB is a different thing but has no relation with nausea or acid reflux. In case 2d echo is normal then LBBB has no significance.
As per as reflux is concerned ask you doctor to add domperidon.
It prevent the reflux of acid back into the mouth.
Omeprazole etc just prevent the secretion if excessive acid.
What's the need of MRI brain.
Acid reflux nor LBBB is a indication of MRI scan of brain.
Unless and otherwise any other condition is associated MRI is not required.
Just add you doctor to add a prokinetic drug like domperidon.
Hope I was helpful.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
MRI not required.

Detailed Answer:
Hello and thanks for choosing "Ask a Doctor " service for your query,
Have seen your details,
Acid reflux is the cause of nausea.
LBBB is a different thing but has no relation with nausea or acid reflux. In case 2d echo is normal then LBBB has no significance.
As per as reflux is concerned ask you doctor to add domperidon.
It prevent the reflux of acid back into the mouth.
Omeprazole etc just prevent the secretion if excessive acid.
What's the need of MRI brain.
Acid reflux nor LBBB is a indication of MRI scan of brain.
Unless and otherwise any other condition is associated MRI is not required.
Just add you doctor to add a prokinetic drug like domperidon.
Hope I was helpful.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (4 hours later)
Dear Dr XXXXXXX XXXXXXX , Thank you for this prompt response Appreciate if you could advice as what medicines or procedures need be taken for below symptoms:-
1. her esophagus constricts and feeling (globus)
2. chest pain -constant ball stuck in chest
3 Sore throat ,mucus forms in throat.
4. burning sensation in nose & throat post nasal drip.
5. constant dizzy spells ( doctors say this related to cardio or neuro)
6. Jaw lock ( Doc's feel related to arthritis)
7. ENT confirmed Lppr(silent reflux) last month.
8. Bowel movement - delayed 4 to 6 days.
Fiy- she is on soft diet mainly soup, vegetables & fruits ,totally off carbs,caffeine ,etc . both endoscopy & colonoscopy done.
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Follow up: Dr. Ramesh Kumar (0 minute later)
Dear Dr XXXXXXX XXXXXXX , Thank you for this prompt response Appreciate if you could advice as what medicines or procedures need be taken for below symptoms:-
1. her esophagus constricts and feeling (globus)
2. chest pain -constant ball stuck in chest
3 Sore throat ,mucus forms in throat.
4. burning sensation in nose & throat post nasal drip.
5. constant dizzy spells ( doctors say this related to cardio or neuro)
6. Jaw lock ( Doc's feel related to arthritis)
7. ENT confirmed Lppr(silent reflux) last month.
8. Bowel movement - delayed 4 to 6 days.
Fiy- she is on soft diet mainly soup, vegetables & fruits ,totally off carbs,caffeine ,etc . both endoscopy & colonoscopy done.
doctor
Answered by Dr. Ramesh Kumar (37 minutes later)
Brief Answer:
Ask doctor to add prokinetic drug to prevent reflux.

Detailed Answer:
Hello again,
1)As endoscopy is normal patient should be examined for esophageal spasm.Esophageal spasm means that contractions of the esophagus are irregular, uncoordinated, and sometimes powerful. This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach.
2)Reflux of acid presents with the same symptom.Chest pain ,heaviness etc.
3)Acid reflux to mouth and throat irritates the cells in mouth causing them to secrete mucous to protect them.
4)Touch a drop of acid and you would feel severe burning .In GERD acid and bolus is constantly being refluxed into mouth causing pain burning etc.
5)Dizzines and nausea are inter related.A person with acid regurgitation in mouth feels constant nausea which may be associated with dizziness.Ask the doctor to try baseline medicines first inspite of doing tests after test.
6)Why she is off carbohydrates?
7)Yes but the treatment is incomplete.Only given for acid supresion but not for regurgitation of acid back into esophagus and mouth.
SILENT REFUX-Medicine is given to control excessive acid formation but where is the medicine to control its reflux?Question your doctor sir.
8) When she is on soft diet most of the food gets digested and nothing is left to form bolus of stools thats why bowels are irregular.

Hope i was clear and XXXXXXX
Follow ups are welcome.
Thanks
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Ask doctor to add prokinetic drug to prevent reflux.

Detailed Answer:
Hello again,
1)As endoscopy is normal patient should be examined for esophageal spasm.Esophageal spasm means that contractions of the esophagus are irregular, uncoordinated, and sometimes powerful. This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach.
2)Reflux of acid presents with the same symptom.Chest pain ,heaviness etc.
3)Acid reflux to mouth and throat irritates the cells in mouth causing them to secrete mucous to protect them.
4)Touch a drop of acid and you would feel severe burning .In GERD acid and bolus is constantly being refluxed into mouth causing pain burning etc.
5)Dizzines and nausea are inter related.A person with acid regurgitation in mouth feels constant nausea which may be associated with dizziness.Ask the doctor to try baseline medicines first inspite of doing tests after test.
6)Why she is off carbohydrates?
7)Yes but the treatment is incomplete.Only given for acid supresion but not for regurgitation of acid back into esophagus and mouth.
SILENT REFUX-Medicine is given to control excessive acid formation but where is the medicine to control its reflux?Question your doctor sir.
8) When she is on soft diet most of the food gets digested and nothing is left to form bolus of stools thats why bowels are irregular.

Hope i was clear and XXXXXXX
Follow ups are welcome.
Thanks
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar (11 hours later)
Thanks Doctor for this quick response. Your reply is succinct . Appreciate very much . Based on your diagnosis can you prescribe the medications to be taken with the time frame. Her next appt at the hospital is in late February 2020 & she need not have to wait & suffer. Are these medicines available over the counter at the pharmacies or do we need a doctor's prescription . Thanks
& Best Regards, XXXXXXX XXXXXXX
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Follow up: Dr. Ramesh Kumar (0 minute later)
Thanks Doctor for this quick response. Your reply is succinct . Appreciate very much . Based on your diagnosis can you prescribe the medications to be taken with the time frame. Her next appt at the hospital is in late February 2020 & she need not have to wait & suffer. Are these medicines available over the counter at the pharmacies or do we need a doctor's prescription . Thanks
& Best Regards, XXXXXXX XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Follow up.

Detailed Answer:
Hello and thanks for follow up,
Tablet Pantoprazole 40 mg twice (over the counter).
Tab Domperidon 10 mg thrice( prescription required).
Syrup Antacid(Magnesium and aluminium hydroxide) over the counter.
Tab Acotiamide 100 mg thrice ( if in u.s.a it's not available can get it online from Mexico. Available in Europe and other countries.
Try this for minimum 14 days and write back to me.
No tests required at present rather proper medication is required.
Minimum 2 weeks trial should be given.
Food-
Vegetarian home cooked food.
Lots of yoogurt and curd.
Avoid meat.
No smoking or alcohol or beverages.
food should be less oily.
Lots of non citrus fruits( sweet).
Lots of vegetable salad.

One glass of chilled milk ice cold in morning.
Follow up after 14 days of taking medication.
Target-40-50% relief.
Thank you.
Do rate the answer sir.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Hello and thanks for follow up,
Tablet Pantoprazole 40 mg twice (over the counter).
Tab Domperidon 10 mg thrice( prescription required).
Syrup Antacid(Magnesium and aluminium hydroxide) over the counter.
Tab Acotiamide 100 mg thrice ( if in u.s.a it's not available can get it online from Mexico. Available in Europe and other countries.
Try this for minimum 14 days and write back to me.
No tests required at present rather proper medication is required.
Minimum 2 weeks trial should be given.
Food-
Vegetarian home cooked food.
Lots of yoogurt and curd.
Avoid meat.
No smoking or alcohol or beverages.
food should be less oily.
Lots of non citrus fruits( sweet).
Lots of vegetable salad.

One glass of chilled milk ice cold in morning.
Follow up after 14 days of taking medication.
Target-40-50% relief.
Thank you.
Do rate the answer sir.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar (3 hours later)
Thanks again for this comprehensive & speedy response,
my daughter tells me that she is unable to take curd/yoghurt ,dairy & carbs as it gives her lot of problems besides the antacid syrup used is of magnesium trisilicate without aluminium . Is it ok if she skips the dairy perhaps due to lactose intolerance . Plse advice. Best Regards,
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Follow up: Dr. Ramesh Kumar (0 minute later)
Thanks again for this comprehensive & speedy response,
my daughter tells me that she is unable to take curd/yoghurt ,dairy & carbs as it gives her lot of problems besides the antacid syrup used is of magnesium trisilicate without aluminium . Is it ok if she skips the dairy perhaps due to lactose intolerance . Plse advice. Best Regards,
doctor
Answered by Dr. Ramesh Kumar (1 hour later)
Brief Answer:
Follow up.

Detailed Answer:
Hello there,
Absolutely yes If she is lactose intolerant avoid all forms of dairy.
Instead give Pantoprazole 80 mg in morning and 40 mg in evening.
Yes you can give the antacid you have with you.
You can follow up on this direct link sir.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660
Thank you.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Hello there,
Absolutely yes If she is lactose intolerant avoid all forms of dairy.
Instead give Pantoprazole 80 mg in morning and 40 mg in evening.
Yes you can give the antacid you have with you.
You can follow up on this direct link sir.
http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660
Thank you.
Note: For further follow up on digestive issues share your reports here and Click here.

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

Gastroenterologist

Practicing since :1986

Answered : 2911 Questions

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Dear Doc, My Daughter ,44 Yrs Is Diagnosed With Gerd

Dear Doc, my daughter ,44 yrs is diagnosed with gerd & Lppr(silent relux) feels dizzy often .2 yrs back her ECG showed left bundle block but Docs. now find the heart is functioning ok & suggest she goes for a brain MRI. Plse Advice , Thanks