strange heartburn problem

Aciphex is a medication used to treat gestational acid reflux disease (GERD) and ulcers. Buy cheap aciphex and feel better today!

Question:

I’ve had bad heartburn-like pain in my chest for the past 5 months at varying levels of intensity.  At its worst, I’ve gone to the emergency room.  Sometimes it is almost tolerable.  This started after 10 days on doxycycline, so the initial thought was that caused irritation to the esophagus or stomach.  Accordingly, my Prevacid dose was upped and the theory was that after a few weeks of extra acid suppression, I would heal, and could go back to the 15 mg every other day dose of Prevacid I was taking originally.  Well, 5 months later, and there is really no improvement in symptoms.  In fact, I’m now on 30 mg twice a day and it’s no better: I still get excrutiating attacks ever few weeks, and the pain is always present if sometimes almost tolerable. I even switched to Aciphex for 3 weeks, but it wasn’t better than Prevacid and made me feel "strange" so I went back to Prevacid.  Now, 4 months ago an endoscopy revealed that my esophagus was fine, but there was some "slight irritation" of the stomach lining itself.  I have yet to get another endoscopy to see if it looks worse, but probably will. So, my question is why the heck am I not healing? BTW, there seems to be almost no correspondence between the level of pain and what food I eat, but I eat cautiously anyway.  Also, I never drink alcohol, I don’t smoke, and I’m under weight if anything.  I would describe the pain as not so much burning as a tightness/fullness/achiness, mostly under the sternum, but often also under the right breast area.  The later pain is a poser because I didn’t think anything but lung was over there! Thanks for any insight. John.

Response:

– Hide quoted text — Show quoted text -> I’ve had bad heartburn-like pain in my chest for the past 5 months at > varying levels of intensity.  At its worst, I’ve gone to the emergency > room.  Sometimes it is almost tolerable.  This started after 10 days > on doxycycline, so the initial thought was that caused irritation to > the esophagus or stomach.  Accordingly, my Prevacid dose was upped and > the theory was that after a few weeks of extra acid suppression, I > would heal, and could go back to the 15 mg every other day dose of > Prevacid I was taking originally.  Well, 5 months later, and there is > really no improvement in symptoms.  In fact, I’m now on 30 mg twice a > day and it’s no better: I still get excrutiating attacks ever few > weeks, and the pain is always present if sometimes almost tolerable. > I even switched to Aciphex for 3 weeks, but it wasn’t better than > Prevacid and made me feel "strange" so I went back to Prevacid.  Now, > 4 months ago an endoscopy revealed that my esophagus was fine, but > there was some "slight irritation" of the stomach lining itself.  I > have yet to get another endoscopy to see if it looks worse, but > probably will. > So, my question is why the heck am I not healing? > BTW, there seems to be almost no correspondence between the level of > pain and what food I eat, but I eat cautiously anyway.  Also, I never > drink alcohol, I don’t smoke, and I’m under weight if anything.  I > would describe the pain as not so much burning as a > tightness/fullness/achiness, mostly under the sternum, but often also > under the right breast area.  The later pain is a poser because I > didn’t think anything but lung was over there!

Not enough info here to do anything but take a wild guess. You need another EGD, plus ambulatory pH testing and esophageal manometry. HMc

Response:

Just a couple of thoughts. Have you been checked for Heliobactor Pilori infection in your stomach?  The pain you describe sounds similar to that which I had when infected. Re the pain under the right breast, I think your gall bladder is on the RHS, in behind the lower ribs.  Gall stones can cause anything from a dull ache to sharp pains in this area. Andrew. – Hide quoted text — Show quoted text -> I’ve had bad heartburn-like pain in my chest for the past 5 months at > varying levels of intensity.  At its worst, I’ve gone to the emergency > room.  Sometimes it is almost tolerable.  This started after 10 days > on doxycycline, so the initial thought was that caused irritation to > the esophagus or stomach.  Accordingly, my Prevacid dose was upped and > the theory was that after a few weeks of extra acid suppression, I > would heal, and could go back to the 15 mg every other day dose of > Prevacid I was taking originally.  Well, 5 months later, and there is > really no improvement in symptoms.  In fact, I’m now on 30 mg twice a > day and it’s no better: I still get excrutiating attacks ever few > weeks, and the pain is always present if sometimes almost tolerable. > I even switched to Aciphex for 3 weeks, but it wasn’t better than > Prevacid and made me feel "strange" so I went back to Prevacid.  Now, > 4 months ago an endoscopy revealed that my esophagus was fine, but > there was some "slight irritation" of the stomach lining itself.  I > have yet to get another endoscopy to see if it looks worse, but > probably will. > So, my question is why the heck am I not healing? > BTW, there seems to be almost no correspondence between the level of > pain and what food I eat, but I eat cautiously anyway.  Also, I never > drink alcohol, I don’t smoke, and I’m under weight if anything.  I > would describe the pain as not so much burning as a > tightness/fullness/achiness, mostly under the sternum, but often also > under the right breast area.  The later pain is a poser because I > didn’t think anything but lung was over there! > Thanks for any insight. > John.

— Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com).

Response:

losec too high dose

Question:

I am taking 60 mg. of losec for acid reflux.  My family doctor said 8 months ago that this was okay despite my telling her the drug manuels don’t state this high of a dose for gerd.  I recently had an endoscopy in which my gastro. informed me to get down to 20 mg. of losec as 60 was a toxic dose. I didn’t have the heart to tell her that my doctor said it was okay.  20 or 40 mg. of losec just does not work for me and now I don’t know what to do.  Anyone find anything similiar here.? Regards Cecelia

Response:

How long were you on 60mg? – Hide quoted text — Show quoted text -> I am taking 60 mg. of losec for acid reflux.  My family doctor said > 8 months ago that this was okay despite my telling her the drug manuels > don’t state this high of a dose for gerd.  I recently had an endoscopy in > which my gastro. informed me to get down to 20 mg. of losec as 60 was a > toxic dose. I didn’t have the heart to tell her that my doctor said it was > okay.  20 or 40 mg. of losec just does not work for me and now I don’t > know what to do.  Anyone find anything similiar here.? > Regards > Cecelia

Before you buy.

Response:

Are these symptoms Common?

Question:

> I sleep fine, feel ok about an hour after breakfast I start feeling > pressure in my esophagus. This continues throughout the day & usually > subsides at night. > I have been reading about GERD & related matters trying to figure out > what is ailing me. Anybody having this same combination of symptoms?

Could be GERD.  My symptoms follow a similar timing pattern: they worsen about an hour after meals.  Wish I had a solution to suggest, but I’ve not found one myself yet either.

Response:

I’m a 39 yr old male,in good shape with no history of gastro-related problems. Before Thanksgiving I started burping a lot, no heartburn but felt pressure in my esophagus. I went to my doctor who prescribed Zantac 150. A few days later I began to feel gas in my stomach & was experiencing soft stools but not full blown Diarrea. Went back & received a prescription for Dicyclonine. I was told to come back in a month. I sleep fine, feel ok about an hour after breakfast I start feeling pressure in my esophagus. This continues throughout the day & usually subsides at night. I have been reading about GERD & related matters trying to figure out what is ailing me. Anybody having this same combination of symptoms? I’ve been more stressed than usual for the last couple of months both at home & work. Before you buy.

Response:

Hi… have you had any type of tests?  Upper GI or endoscopy??? If not, why not.  If so, what were the outcomes. After my husband’s diagnosis of Esophageal Adenocarcinoma… I strongly recommend finding a competent gastroenterologist and having tests. Antacids do NOT stop cancer … better safe than sorry. Just because someone has no history of a disease of some sort doesn’t mean a person can never get it. Gentle as you go, Marny – Hide quoted text — Show quoted text – > I’m a 39 yr old male,in good shape with no history of gastro-related > problems. > Before Thanksgiving I started burping a lot, no heartburn but felt > pressure in my esophagus. > I went to my doctor who prescribed Zantac 150. > A few days later I began to feel gas in my stomach & was experiencing > soft stools but not full blown Diarrea. > Went back & received a prescription for Dicyclonine. I was told to come > back in a month. > I sleep fine, feel ok about an hour after breakfast I start feeling > pressure in my esophagus. This continues throughout the day & usually > subsides at night. > I have been reading about GERD & related matters trying to figure out > what is ailing me. Anybody having this same combination of symptoms? > I’ve been more stressed than usual for the last couple of months both > at home & work. > Before you buy.

Response:

Nitro

Question:

This may seem like an odd question to ask this group, but has anyone ever heard of a Nitro relieving Gerd  pain? Thanks for any in site any of you may have–Beryl W.

Response:

Nitro is prescribed to relieve esophageal spasms which can be very painful. Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

I have coronary artery disease (bigtime), and I carry nitro with me everywhere. I have taken nitro for chest pain, and felt relief, but subsequent angiograms revealed no further progression of the CAD. GERD was suspected at the time, but other than these occasional angina-like symptoms there was no real sign of it… ..until recently, when an endoscopy revealed the presence of Barrett’s Esophagus, which is apparently a de facto sign of long-term, persistent GERD. But I’m one of those people who doesn’t experience the reflux as "heartburn" or anything like it. So it is entirely possible that sometimes when I think I’m experiencing angina, it’s really reflux, and the nitro I take does relieve it anyway. I’m on Prilosec again (I’ve been on and off it before with no apparent effect, but that was before this endoscopy), so it’ll be interesting to see if from now on all my chest pains are angina. RichC – Hide quoted text — Show quoted text – > This may seem like an odd question to ask this group, but has anyone > ever heard of a Nitro relieving Gerd  pain? Thanks for any in site any > of you may have–Beryl W.

Response:

> I am looking for info. on Nitro Bass Boats. I would appreciate any comments on > this line of boats.

Try Skeeter instead;  far more boat for the same money! WW

Response:

I am looking for info. on Nitro Bass Boats. I would appreciate any comments on this line of boats.

Response:

Rich, > I am looking for info on Nitro Bass Boats.  I would appreciate any comments on > this line of boats.

My first boat was a little Nitro 160 TF with a 50 hp Force motor.  I thought it was a good little boat for the money.  The major drawbacks were the shallow Vee hull which made it difficult to trailer or approach a dock and the wet ride (spray in the face) once on plane.  I can’t comment on the reliability because I only had it about six months before I traded it in on a bigger boat.  One of the things that was a real disappointment was the trailer.  It could best be described as a total disaster – very poor quality control – no, make that, no quality control.  In hind sight, I still think it was a good boat for the money.  And if I had a bigger garage, I’d still have it.  However, I wouldn’t go with the Force motor and I would have the biggest motor the transom would hold. Richard

Response:

- Hide quoted text — Show quoted text – > Rich, > I am looking for info on Nitro Bass Boats.  I would appreciate any comments on > this line of boats. > My first boat was a little Nitro 160 TF with a 50 hp Force motor.  I > thought it was a good little boat for the money.  The major drawbacks > were the shallow Vee hull which made it difficult to trailer or approach > a dock and the wet ride (spray in the face) once on plane.  I can’t > comment on the reliability because I only had it about six months before > I traded it in on a bigger boat.  One of the things that was a real > disappointment was the trailer.  It could best be described as a total > disaster – very poor quality control – no, make that, no quality > control.  In hind sight, I still think it was a good boat for the > money.  And if I had a bigger garage, I’d still have it.  However, I > wouldn’t go with the Force motor and I would have the biggest motor the > transom would hold.

I have a 1993 Nitro 180TF with a 115HP Evinrude….  I couldn’t agree more with Richard’s analysis of the trailer and motor size,  but I can’t really say on the Force Outboard… The boat spray doesn’t really seem to be too much of a problem in my 180….and overall,  the boat fishes real well…to bad they scrimped so bad on the trailer.  Does anyone else seem to have as much problem with their trailers as we Nitro owners have????  Have they improved them at all??? — "He who knows not, and knows not that he knows not, is a fool. Shun him. He who knows not, and knows that he knows not, is a child. Teach him. He who knows, and knows not that he knows, is asleep. Wake him. He who knows, and knows that he knows, is wise. Follow him."—Author unkown

Response:

got test results today…

Question:

went to the doctors today and he told me the results of my endoscopy that I had done 2 weeks ago. He says I have a hital hernia and possible stones in my pancreas ….so now they up’d my daily dosage of prilosec to 40mg a day and I will have a ultrasound done next week to rule out the stones……does anyone know about this hital hernia stuff?

Response:

>does anyone know about this hital hernia stuff?<

Go to www.heartburn-help.com and click on ‘Heartburn Web Sites’ then scroll down to: (All about Hialtal Hernia, Heartburn and Gerd.) Hiatal Hernia is caused by an opening in the diaphragm, a flat muscle that separates the lungs from the abdomen. When this occurs, the top of the stomach slips through the enlarged hiatal hernia or opening in the diaphragm and allows the stomach to bulge into the chest cavity. A lot people have this condition to some degree or another. Many suffer no symptoms at all. Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

can you tell me what they do for a hital hernia? do they just treat it with prilosec or what? also I have heard some people talk about changing eating habits and elevating the head when sleeping….I have done all these things….but my problem is not what I eat it is when I don;t eat anything at all……I get heartburn really bad when I don;t eat anything at all or I go to long in between meals with nothing to eat. anyone have any idea;s about this? Lisa

– Hide quoted text — Show quoted text -> One thing I learned years ago is to ask for a copy of the written > report from any medical test.  The first time I did it I felt funny > (as if the doctor might think I didn’t trust him), but after that it > is like 2nd nature to me. > I’m amazed at how much more I learn from the written material than > from what the doctor tells me. > I’ve never been asked by the doctor or the assistants why I want the > copies, but if asked, I would just say I keep copies of everything as > a complete medical history. > Good luck. > Jer >went to the doctors today and he told me the results of my endoscopy that I >had done 2 weeks ago. He says I have a hital hernia and possible stones in >my pancreas ….so now they up’d my daily dosage of prilosec to 40mg a day >and I will have a ultrasound done next week to rule out the stones……does >anyone know about this hital hernia stuff?

Response:

> can you tell me what they do for a hital hernia? do they just treat it with > prilosec or what? also I have heard some people talk about changing eating > habits and elevating the head when sleeping….I have done all these > things….but my problem is not what I eat it is when I don;t eat anything > at all……I get heartburn really bad when I don;t eat anything at all or I > go to long in between meals with nothing to eat. anyone have any idea;s > about this?

Lisa,      First wanted to say Hi.   I’ve been checking here periodically and was beginning to wonder what happened to you.   I’m really glad to see your posts.     Was really glad to hear that nothing "serious" was found from your tests.   I know that is easy for me to say.    But considering all of the possible things they could have found,  I think you got pretty good news.       As several people have already pointed out,  a hiatal hernia is a condition where a small portion of the stomach can work its way up through the diaphragm.    In doing so,  the sphincter muscle that normally keeps acid from refluxing can sometimes be stretched open, causing continued heartburn.     I went to the web site that Hawk has been promoting and there is a pretty good and thorough explanation of the condition there.        The good news is,  this is generally a benign condition, in terms of any harm being done to your body.  Of course, the downside of that is,  if the heartburn continues over a long time period because of it,   problems secondary to the acid can develop over time.   However no need to worry over that at this time.        As for treatment,  I am not an expert on hiatal hernias,  but I can give you a few generalities.    A lot of what happens with such a condition will depend on the exact reason for the hernia and also on the degree that the stomach protrudes through the diaphragm.         Sometimes,  this condition corrects itself.    Other times,  it will very in severity as the stomach will change position.   So you could find that over time,  things will just return to a more normal state, with some occasional flare ups.          In the mean time,  it is very wise to minimize as much stomach acid production (and reflux) as possible.  Raising the dosage of Prilosec will reduce the amount of acid so you definitely should follow through on that.    I also still stand by my previous recommendations of some OTC Gaviscon.  It has a component called Alginic Acid which helps form a "barrier" between the stomach and esophagus.   It can further reduce acidity of the stomach as well as help prevent more reflux.  It is a good, and very safe antacid, and Can be taken with Prilosec.          You will need to discuss this with your doctor but there are also a few medications that will increase the LES (Lower Esophageal Sphincter) pressure. In other words,  there are medications that can help "force" the sphincter muscle to close more forcefully.   Obviously by doing this,  there is less chance of acid refluxing upwards.         Finally,  there are also medications which can help increase the motility of the stomach.   By taking these medications,  it causes the stomach to empty more quickly which causes less internal  pressure and just leaves less materials and acid  in the stomach to "back up".        There have been many advances in this area of pharmacology recently.  Not having a hiatal hernia myself, I haven’t been following these drug developments too closely.   I’m sorry but I don’t know the names of any of these particular drugs.   You’ll have to ask your doctor about them.         –   Keeping the head of the bed up is good,  if you can stand it.  (I was always sliding down off the bed or something.  :->).   Also, you might want to simply watch the position you normally sleep in.  Because of normal anatomical issues,  it is known that the esophagus is more "open" when laying on the left side.  That is why,  they had you on your left side when you had your endo.  That wasn’t by chance.   Try lying on your right side.  See if that makes things different in the AM and during the day.        -  Depending on who you talk to,  some folks will recommend  surgery for this.   However,  I believe that is usually left as a last ditch effort. Sometimes it is necessary but I wouldn’t worry about that just yet.    There are a lot of other techniques to be tried first.   Make sure you discuss ALL the options with your doctor and don’t let yourself be pushed into something complex unless he/she can give you a VERY solid reason for it.      As for the heartburn between meals.    I’ve had it.   There is no one, simple good answer for it.   If you do get on higher doses of Prilosec and some of the other medications for a while you may very well find this will settle down as well.  The Gaviscon will help too.    Eating smaller meals, more often is the other simple solution.    Of course,  small snacks can help as well. (The only down side to that is potential weight gain.)       Also,  you still may want to watch what you eat to some extent.   High fat foods,  carbonated and caffeinated beverages, and spicy foods are still serious culprits.    Even if they don’t seem to bother you right after eating,  they still could cause some of the between meal reflux.  So,  do keep an eye on that.   See if you find any patterns.       Finally, hang in there until they finish evaluating the pancreas stuff. If you have some type of irritation or inflammation going on,  that could be feeding into your symptoms too.   I’m not really sure how they figured that out via an endoscopy but let them do the remainder of the tests,  then have a long, assertive chat with your doctor and ask about all your options.       I know most all of this is "old news".    I hope it helps a little.   Have patience a little longer and try the Gaviscon and other eating tricks until you see the doctor again.    In the mean time,    please don’t worry and please continue to keep us posted.    As I’ve said before,  my e-mail box is always open.   I hope you’ll keep in touch.  Take care. John

Response:

Pancreatiz enzymes high (re-post)

Question:

I’m not sure what happened to the original of this post. It seems to have disappeared. (If I am off topic, my apologies….otherwise, I could use some help.) Hello, folks. I have been lurking on this group for quite a while, but a recent bout of trouble with…well, my doctor isn’t really sure what is wrong at this point, even though there has been a lot of blood drawn, a couple of CT scans and an endoscopy. "We’re" looking at the other end as soon as it can be scheduled. I’m so excited I could just…well…never mind. Here’s my situation: Starting in 1982 (I was nearly 26), I began having regular bouts of heartburn. For a few years, I could control it with Tums, Rolaids, etc. I was eventually diagnosed with a hiatal hernia (recently reported to be "small"). In the past couple of years, I have been taking prescription strength Tagamet. Last winter, my family doctor put me in Prevacid, initially at 60mg per day. It worked wonders. The reason I had been in to see the doctor was because of tenderness in my abdomen. We never did determine what that was all about before it went away, but it placed us on a diagnostic path that seems to lead nowhere. My pancreatic enzymes are high (I don’t know the actual score), but there is no evidence of any problems with my pancreas. Over the past ten years, I have monitored my diet and weight in order to understand what triggers my heartburn episodes. While there are things I can point to that cause problems more than others (garlic, chocolate, alcohol), I can never predict when I am going to have real trouble until it hits. Unless, of course, I drink the least bit of brandy or eat it in foods. That will do it every time. Haven’t had it in years because of that. Oh, yeah, almost forgot. I belch a lot. Pretty melodic sometimes. It doesn’t matter if I have had anything to eat or drink in a while. In fact, one just snuck up on me and I haven’t ingested anything (except a few ounces of water with my Prevacid 2 hours ago) in 10 1/2 hours. Half the time I don’t even notice any more. I am taking 30mg of Prevacid per day and my gastroenterologist (did I get that right?) tells me "no one should have heartburn at that dose…" He, my family physician and I are equally puzzled. I am writing because I woke up at 3am with a stomach ache and couldn’t get back to sleep. Ticks me off when that happens. I have watched a number of thoughtful comments and conversations on this group. Any thoughts, observations or ideas on my situation? Anything I’ve left out of my story? TIA — Steven Kopischke Green Bay, WI

Response:

Moses here: First the disclaimer, I am not a Doc ( if you have lurked you know this) so I have my limits.  My comments mixed in below with yours. – Hide quoted text — Show quoted text -> I’m not sure what happened to the original of this post. It seems to have > disappeared. (If I am off topic, my apologies….otherwise, I could use some > help.) > Hello, folks. > I have been lurking on this group for quite a while, but a recent bout of > trouble with…well, my doctor isn’t really sure what is wrong at this > point, even though there has been a lot of blood drawn, a couple of CT scans > and an endoscopy. "We’re" looking at the other end as soon as it can be > scheduled. I’m so excited I could just…well…never mind. > Here’s my situation: > Starting in 1982 (I was nearly 26), I began having regular bouts of > heartburn. For a few years, I could control it with Tums, Rolaids, etc. I > was eventually diagnosed with a hiatal hernia (recently reported to be > "small").

Yeah, small ones seem to be enough to help the LES to fail, my wife had a "small one". In the past couple of years, I have been taking prescription > strength Tagamet. Last winter, my family doctor put me in Prevacid, > initially at 60mg per day. It worked wonders. The reason I had been in > to

 Well that tells you there is some dose that works. I’d say 40 milligrams of Prilosec would be more effective the 30 milligrams Prevacid, and yes 40 milligrams of Prevacid would be more likely to help also. It’s just I am not aware of the Prevacid capsule makers producing a 40 mg capsule. The comparison studies that I’ve seen the abstracts to on medline are a little stupid; in that, they compare different size doses of the drugs. Yes, I know the drug companies would say that each drug has a somewhat different activity, but the two different drug molecules are rather similiar IMHO. The 40 milligram capsule of Prilosec, the Merck company drug is about another 50 dollars a month than the 30 milligram Prevacid and the 20 milligram Prilosec. > see the doctor was because of tenderness in my abdomen. We never did > determine what that was all about before it went away, but it placed us on a > diagnostic path that seems to > lead nowhere. > My pancreatic enzymes are high (I don’t know the actual score), but there is > no evidence of any problems with my pancreas.

By this I assume you mean, the serum levels of the enzymes. This is quite worrisome. The two enzymes that my books mention are amylase and lipase. Both exist in the blood and are also excreted by the kidneys. They also are secreted in the the duodenum to digest starch and fats, respectively. Elevated levels of these enzymes can point to a number of ills. If it lasts a week or ten days, it may mean the patient has acute pancreatitis. According to the diagnostic algorithm chart, this condition is likely also marked with abdominal pain. A gall stone can be the cause of this problem. For persistent elevation of serum amylase, the chart lists three conditions, pancreatic pseudocyst, pancreatic abcess, and pancreatic ascites on this branch of the chart. On another related branch of the algorithm that includes abdominal pain, there is a  chance of malignancy of the pancreas, ovary, and colon. On the "no abdominal pain branch of the algorithm chart there is listed under the "chronic elevation" is the following macroamylasemia, S-type hyperamylasemia, renal failure, and prostate disease. > Over the past ten years, I have monitored my diet and weight in order to > understand what triggers my heartburn episodes. While there are things I can > point to that cause problems more than others (garlic, chocolate, alcohol), > I can never predict when I am going to have real trouble until it hits. > Unless, of course, I drink the least bit of brandy or eat it in foods. That > will do it every time. Haven’t had it in years because of that. > Oh, yeah, almost forgot. I belch a lot. Pretty melodic sometimes. It

doesn’t Yes, the belch goes with the failed LES (lower esophageal sphinter). If you get your acid completely suppressed, you won’t notice it much. Or so I am told by a workmate with the condition. He take 40 mgs of Prilosec per day. – Hide quoted text — Show quoted text -> matter if I have had anything to eat or drink in a while. In fact, one just > snuck up on me and I haven’t ingested anything (except a few ounces of water > with my Prevacid 2 hours ago) in 10 1/2 hours. Half the time I don’t even > notice any more. > I am taking 30mg of Prevacid per day and my gastroenterologist (did I get > that right?) tells me "no one should have heartburn at that dose…" He, my > family physician and I are equally puzzled. > I am writing because I woke up at 3am with a stomach ache and couldn’t get > back to sleep. Ticks me off when that happens.

The other thing to be aware of when taking acid suppressors is that one is more vulnerable to bacteria like the toxic form of E. coli. Small children are more vulnerable to E. coli at least in part from the fact that their stomachs make less acid than an adult. Eating out is thus a bit more risky for you now. Best Wishes Moses Clarke > I have watched a number of thoughtful comments and conversations on this > group. Any thoughts, observations or ideas on my situation? Anything I’ve > left out of my story? > TIA > — > Steven Kopischke > Green Bay, WI

Share what you know. Learn what you don’t.

Response:

   Well dont believe a doctor when he speaks in absolutes,, I had Heartburn at 30 mg prevacid 2 times daily. And my doctor said, he could give me as high a dose as worked, its all about finding the dosage that works for you.    So ask your doctor to knock you up a notch,, maybe 45mg 2 times daily. I personally take a 30 and a 15  two times daily..   Also get checked for gastric emptying speed, maybe food sits in your stomach for a long period of time.. Ask your doctor if you might need a Motility drug in conjunction with the Proton pump inhibiting Prevacid…

Response:

Pancreatic enzymes high

Question:

Hello, folks. I have been lurking on this group for quite a while, but a recent bout of trouble with…well, my doctor isn’t really sure what is wrong at this point, even though there has been a lot of blood drawn, a couple of CT scans and an endoscopy. "We’re" looking at the other end as soon as it can be scheduled. I’m so excited I could just sleep. Here’s my situation: Starting in 1982 (I was nearly 26), I began having regular bouts of heartburn. For a few years, I could control it with Tums, Rolaids, etc. I was eventually diagnosed with a hiatal hernia (recently reported to be "small"). In the past couple of years, I have been taking prescription strength Tagamet and one other which name escapes me (begins with an "H"?). Last winter, my family doctor put me in Prevacid, initially at 60mg per day. It worked wonders. The reason I had been in to see the doctor was because of tenderness in my abdomen. We never did determine what that was all about before it went away, but it placed us on a diagnostic path that seems to lead nowhere. My pancreatic enzymes are high (I don’t know the actual score), but there is no evidence of any problems with my pancreas. Over the past ten years, I have monitored my diet and weight in order to understand what triggers my heartburn episodes. While there are things I can point to that cause problems more than others (garlic, chocolate, alcohol), I can never predict when I am going to have real trouble until it hits. Unless, of course, I drink the least bit of brandy. That will do it every time. Haven’t had it in years because of that. Oh, yeah, almost forgot. I belch a lot. Pretty melodic sometimes. It doesn’t matter if I have had anything to eat or drink in a while. In fact, one just snuck up on me and I haven’t ingested anything (except a few ounces of water with my Prevacid 2 hours ago) in 10 1/2 hours. Half the time I don’t even notice any more. I am taking 30mg of Prevacid per day and my gastroenterologist (did I get that right?) tells me "no one should have heartburn at that dose…" He, my family physician and I are equally puzzled. I am writing because I woke up at 3am with a stomach ache and couldn’t get back to sleep. Ticks me off when that happens. I have watched a number of thoughtful comments and conversations on this group. Any thoughts, observations or ideas on my situation? Anything I’ve left out of my story? TIA — Steven Kopischke Green Bay, WI

Response:

Moses here: A friend of mind claims that Prilosec is the more effective drug. He tried both for a month each. Have your Doc prescribe a 40 milligram once daily dose. There was something on Medline that supported this view, but I didn’t keep track of it. The burping is likely the weaken LES allowing "backflow." My wife before her surgury complained about having a feeling like this. I’d avoid booze, coffee, and chocolate. The last two cause a weaken LES to relax even more as drug effect. Some people metabolize the PPI drugs at different rate and yeah, there is an abstract on Medline I saw on this topic. Albeit, it did not discuss an clinical ramifications at least in the abstract version. That is if I recall correctly. And if you have about $15000, you can have the surgury. But then it doesn’t always last. When look at my wife and reflect on her surgury, I think so far so good. Several years and one pregnancy down the road. However, I know others (OK one other who is complete failure and another who is a mixed case) who’ve had the surgury and it has failed over time. Sorry about repeating myself since this sounds like my earlier posts. Hopefully someone else will make some comments. Hope you get to feeling better. Sincerely Moses Clarke – Hide quoted text — Show quoted text -> Hello, folks. > I have been lurking on this group for quite a while, but a recent bout of > trouble with…well, my doctor isn’t really sure what is wrong at this > point, even though there has been a lot of blood drawn, a couple of CT scans > and an endoscopy. "We’re" looking at the other end as soon as it can be > scheduled. I’m so excited I could just sleep. > Here’s my situation: > Starting in 1982 (I was nearly 26), I began having regular bouts of > heartburn. For a few years, I could control it with Tums, Rolaids, etc. I > was eventually diagnosed with a hiatal hernia (recently reported to be > "small"). In the past couple of years, I have been taking prescription > strength Tagamet and one other which name escapes me (begins with an "H"?). > Last winter, my family doctor put me in Prevacid, initially at 60mg per day. > It worked wonders. The reason I had been in to see the doctor was because of > tenderness in my abdomen. We never did determine what that was all about > before it went away, but it placed us on a diagnostic path that seems to > lead nowhere. > My pancreatic enzymes are high (I don’t know the actual score), but there is > no evidence of any problems with my pancreas. > Over the past ten years, I have monitored my diet and weight in order to > understand what triggers my heartburn episodes. While there are things I can > point to that cause problems more than others (garlic, chocolate, alcohol), > I can never predict when I am going to have real trouble until it hits. > Unless, of course, I drink the least bit of brandy. That will do it every > time. Haven’t had it in years because of that. > Oh, yeah, almost forgot. I belch a lot. Pretty melodic sometimes. It doesn’t > matter if I have had anything to eat or drink in a while. In fact, one just > snuck up on me and I haven’t ingested anything (except a few ounces of water > with my Prevacid 2 hours ago) in 10 1/2 hours. Half the time I don’t even > notice any more. > I am taking 30mg of Prevacid per day and my gastroenterologist (did I get > that right?) tells me "no one should have heartburn at that dose…" He, my > family physician and I are equally puzzled. > I am writing because I woke up at 3am with a stomach ache and couldn’t get > back to sleep. Ticks me off when that happens. > I have watched a number of thoughtful comments and conversations on this > group. Any thoughts, observations or ideas on my situation? Anything I’ve > left out of my story? > TIA > — > Steven Kopischke > Green Bay, WI

Share what you know. Learn what you don’t.

Response:

too much acid??

Question:

Is there such thing as producing too much acid??  That is the feeling that I have lately.  I was diagnosed with a hiatal hernia about three years ago.  I was put on 1 prilosec (20mg) per day.  That completely took away the heartburn.  Within the last 3 or 4 months, the condition has gotten so much worse!!  I had an endoscopy about 2 or 3 months ago and my doctor found inflammation of my stomach and inflammation and erosion of my esophagus.  I was put on 2 prilosec per day for 6+ weeks.  When I went back down to 1 per day, I started getting slight heartburn, so was put back on 2 and then 1 and then 2 and so on…..I am so frustrated!!  I feel like my stomach is producing more acid now or something.  I am so strict with my diet and everything.  I guess my question is why, for so long, did 1 prilosec work (without even watching my diet) and now 2 per day (while watching my diet) doesn’t work?  Is it possible that prilosec stops working after being on it for a long time?  Could my stomach be producing more acid?  Is there a way to test for this?  If that is the case, how do they treat it?  Does prevacid work better than prilosec for some people?  I have never tried prevacid.  I know I am asking a lot of questions but I am just desparate for answers and I am starting to get frustrated with my doctor, since nothing is helping.   Can anyone help?

Response:

Yes, you can produce too much stomach acid. Some people find that the medication works for a while and then they have to increase the dose. This could be caused by an increase in stomach acid or other factors such as the Lower Esophageal Sphincter is relaxing more. Sometimes Prevacid will work where Prilosec does not and the other way around as well. Prevacid is a little stronger in crossover studies. There are a couple of tests..The 24hr PH probe is the gold standard for measuring reflux. Another measures Lower Esophageal Sphincter pressure. These tests are described on the heartburn-help.com web site. Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

Please Help!!

Question:

I am starting to get so discouraged.  Here’s the situation…I was diagnosed with a hiatal hernia over 2 years ago.  I was put on prilosec 20 mg 1 time per day.  That took care of the heartburn problem.  Recently, I started getting the heartburn back really bad and the acid was moving into my throat.  I was having some trouble swallowing, etc.  Anyways, my doctor did another endoscopy and found inflammation and erosion of my esphagus. He doubled my dosage of prilosec (1 in the am and 1 in the pm).  That in combination with watching my diet really seemed to help.  He told me to do this for 6 weeks, which I did.  Last week I went back on 1 per day according to his direction.  The heartburn is back and am starting to get burning in my throat.  I thought one dose of prilosec was suppose to help most people.  Why not me?  What else can I do??  The other problem is that I want to have more children someday.  Is my body ever going to be able to tolerate a pregnancy with this heartburn problem??  It is not safe to take prilosec during a pregnancy.  Does anyone have any answers for me???

Response:

>I thought one dose of prilosec was suppose to help most people.<

Some people require 40mg or higher. Others have switched to Prevacid and found that it works better. The reverse is true as well. >What else can I do??<

I am sure you are not smoking and really watching what you eat but I am saying it anyway for the others that will be reading this. >The other problem is that I want to have more children someday.  Is my body

ever going to be able to tolerate a pregnancy with this heartburn problem??  It is not safe to take prilosec during a pregnancy.< It is not recomemded to take Prilosec or Prevacid when pregnant. One person I know stopped taking the Prilosec and remained relativly heartburn free the whole time she was pregnant. After giving birth she had to start taking the Prilosec again. It could be that your doctor might reccomend an h2 blocker such as Ranitidine (Zantac) There have been no adequate studies on pregnant mothers to date but animal studies using  up 160 times the human dose showed no impaired fertility or damage to the fetus. The makers of Zantac also state:  "Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.." The other course of action would be fundoplication surgery. I hope this helps…I know it is not an easy thing to live with, especially when you would like to have children. Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

HawkTear> The other course of action would be fundoplication surgery. How long has this procedure been performed?  What is the long term implications of the procedure.  For example, if the patient is in their 30’s, will the surgery be a permanent solution?  What other implications are there? Thanks. — Russell Senior

Response:

Heartburn is caused by a lack of tone in certain muscles. That is why pregnant women get heartburn, they can not breathe deeply when pregenat and hormones cause a weakning of thier muscles in general. Just do the following exercises: Create a vacuum in your lungs, by sucking in air through pursed lips, pretending to suck a thick liquid through a straw. Then blowing out air through the same small opening, creating pressure on your lungs by you muscles. If you do this for a while on a daily basis, your muscles will have toned up in such a way that they keep the sphincter in the esophagus closed. I had this problem for 10 years and it is gone! Good luck — Joop Kaashoek

Response:

>How long has this procedure been performed?  What is the long term >implications of the procedure.  For example, if the patient is in >their 30’s, will the surgery be a permanent solution?  What other >implications are there?

The open Nissen fundoplication started being performed about 1951. The laparoscopic Nissen fundoplication about 1991. A resent study found that 90 percent of patients undergoing the procedure are symptom-free after 10 years.  Another serious study presented at the 62nd Annual Scientific Meeting of the American College of Gastroenterology reviewed the long-term effectiveness of fundoplication and made this statement "Although this procedure is viewed as curative, as many as 64 percent of patients in this study experienced persistent reflux symptoms and significantly impaired quality of life after this surgical procedure."  There are several excelent links on the heartburn-help.com web site that will answer your questions. Click on the Surgery Button on the main page.   Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

Thanks for posting for the whole group to see. Heartburn and Gastro Esophageal Reflux web page: http://www.heartburn-help.com

Response:

I`m so sorry for your loss Kathy, I lost my first husband when I was 22, & I had a 10 month old and a 2 year old. I know how you feel, and it`s not fair. My girls were what kept me going. I wish you all the luck in the world… Take care of that little 2 yr. old. {{{{{{Hugs}}}}}} Janis  (

Fear Of Going To The Doctor

Question:

Hello, I have been having heartburn and GERD symptoms for some time, which have been becoming worse during the past few months.  One of my most worrisome symptoms is an off and on again sensation of ulcer sensations in my throat when swallowing. I have been afraid to go to the doctor because I have long believed that the above symptom can mean only one thing–throat cancer.  However, I have just now learned that this can also be a symptom of GERD. I recently went to one of these "doc in the box" places for this condition.  He prescribed me Axid, 150 mg., two times a day.  He wanted to do a complete examination–but I declined because I did not have any cancer insurance in the event that his examination did reveal cancer. The Axid does not seem to be helping very much. So, here is what I have decided to do:  (1)  I have purchased an AFLAC cancer insurance policy.  However, this means that I can not get any type of cancer screening until my 30 day preliminary period is up.  The "magic date" is December 19th.  After this date, I will be able to covered under AFLAC for cancer if it is diagnosed.  (2)  I have made an appointment for a complete physical on the date of December 30th.  This is something that I have resolved to follow through with.  Yet, I am terrified of receiving a cancer diagnosis if cancer is, indeed, present. In the meantime, I guess I will just have to wait and pray.  Any words of moral support would be appreciated.  Thanks Dennis

Response:

I too had these symptoms and was worried about throat cancer. I am a smoker. I was suffering for months and had several panic attacks as a result of this. I finally went to a throat doctor that ruled out cancer. Then I went to a gastrointestinal  doctor and had an endoscopy done. It turned out to be a hiatal hernia which was causing my GERD. I have altered my diet (I used to drink 5-10 cups of coffee and high fat foods) and took some prilosec and propulsid for a while. I almost feel normal now but I stopped panicing and am controling my symptoms. I wouldnt worry if I where you but I would definately have it check out asap. Throat cancer is one of the easier cancers of curing if caught early. Best of luck – Hide quoted text — Show quoted text – >Hello, >I have been having heartburn and GERD symptoms for some time, which have been >becoming worse during the past few months.  One of my most worrisome symptoms >is an off and on again sensation of ulcer sensations in my throat when >swallowing. >I have been afraid to go to the doctor because I have long believed that the >above symptom can mean only one thing–throat cancer.  However, I have just now >learned that this can also be a symptom of GERD. >I recently went to one of these "doc in the box" places for this condition. He >prescribed me Axid, 150 mg., two times a day.  He wanted to do a complete >examination–but I declined because I did not have any cancer insurance in the >event that his examination did reveal cancer. >The Axid does not seem to be helping very much. >So, here is what I have decided to do:  (1)  I have purchased an AFLAC cancer >insurance policy.  However, this means that I can not get any type of cancer >screening until my 30 day preliminary period is up.  The "magic date" is >December 19th.  After this date, I will be able to covered under AFLAC for >cancer if it is diagnosed.  (2)  I have made an appointment for a complete >physical on the date of December 30th.  This is something that I have resolved >to follow through with.  Yet, I am terrified of receiving a cancer diagnosis if >cancer is, indeed, present. >In the meantime, I guess I will just have to wait and pray.  Any words of moral >support would be appreciated.  Thanks >Dennis

Response: