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I Have A Question About Acid Reflux . I Have

Posted on Sat, 4 Feb 2023

Question: I have a question about acid reflux. I have been have a bad flare lately. Started around December 18, 2022. Pain in the chest and upper back. Prilosec and Nexium doesn’t seem to be doing much. I had a endoscopy in May of 2018 and was diagnosed with NERD and a 2cm hital hernia. All pathology was normal with the scope as well. I have been drinking a lot more soda and coffee before this flare popped up and really don’t remember this lasting for two weeks before. Just worried something bad has popped up since then. I have bouts over there years of this. Had a scope in 2008 and 2014 as well that was normal but had esophagitis on one. Am I worried for nothing? How long can things like this last. And then I also think what if something like cancer has formed and causing all this since 2018. Wanted to know your thoughts.

Follow up: Dr. Ramesh Kumar (1 minute later)

Something else I’m noticing now is excessive belching and feeling like I have to belch.

Answered by Dr. Ramesh Kumar (10 hours later)

Brief Answer:
Please go through detailed answer.

Detailed Answer:
Hi there,
Thank you for asking query on this forum,
Firstly you have to understand that your acid peptic disorder is because of Hiatal hernia.
So if this is corrected you would automatically get rid of the problem.
Secondly GERD is a life style problem.
Now in controlling GERD there are two parts-
1)Control excessive acid production- This part is taken care by Nexium..You have not mentioned the doses...You can try 80 mg two times a day.
2)Prevent acid reflux- Now usually doctors completely neglects it and therefore patients don't get relieved by Nexium.
You need to take Domstal 10 mg three times a day/ 30 mg slow release once a day.
Belching is because that due to long term GERD good bacteria's are dead inside intestine,Food starts to ferment and this fermented food release a lots of toxic gases causing belching.
Activated charcoal tablets can be taken for it.
If not relieved Tab Acotiamide 100 mg three times a day would also be added.
Along with it a good probiotic like VSL#3 two times a day should be taken.
Now let's come to diet part.
You need to take soft diet /Bland food for few days.
Atleast a week.
Problem is that most of the medicines are not OTC in USA.
Try to get these medicines from your G.P and you would be 80% relieved in a week.
But in case you need a prescription just inform me.
Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (8 hours later)

What about gastritis could that be an issue

Answered by Dr. Ramesh Kumar (14 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again my dear patient,
Gastritis is a part of GERD and Hiatal hernia is one of the most common cause of Gastritis.
Quoting the above answer part 1) is gastritis.
GERD has two components-
1)Gastritis
2)Reflux
1)Control excessive acid production(Gastritis)- This part is taken care by Nexium..You have not mentioned the doses...You can try 80 mg two times a day.
2)Prevent acid reflux- Now usually doctors completely neglects it and therefore patients don't get relieved by Nexium.

Hope this clears your concept.
Follow ups are welcome.
I would be happy to clear your doubts!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (2 days later)

Should I be worried about esophageal cancers etc with a clean Upper GI in 2018. I didn’t know if that’s slow growing or does it go in stages like Barrett’s first then many years later does it transform into cancer. I always think the worst

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello,
If you have a feeling that food and water remain stuck in esophagus or pain is there in that area then a check endoscopy can be done just to remove doubt from your mind.
However it's not esophageal cancer.
You try meds for a week and revert back..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (29 hours later)

Please review uploaded report. My doctor ordered one for later in the month but was able to get in today due to a cancellation. Never seen such a bare report

Answered by Dr. Ramesh Kumar (19 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi,
The reports attached by you show only small hiatal hernia except that no significant finding is there.
Why do you want to repeat endoscopy again?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (14 hours later)

I don’t I was just saying the updated report is attached. Is it common to have a gerd flare and have no finding on a scope?

Answered by Dr. Ramesh Kumar (41 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hi again,
Yes Endoscopy is usually done to find out if GERD is caused due to any thing wrong pathologically.
In your case hiatal hernia is there.
So we have a cause with us.
Now GERD consist of two things-
1)Excessive acid formation called gastritis- Which is covered by prisolec twice a day.
2) Regurgitation of acid back in esophagus - hich is usually missed by most of Doctors.
Domstal 10 ml three times takes care of it.
Secondly trying to avoid a spicy diet and rather switch to a better natural diet helps a lot.

And yes we have a finding in scope- Hiatel hernia...Most common cause of GERD.
Follow ups are welcome!

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar