Symptom help

Question:

A few months back I had tightness in my chest and what felt like heart palpitations. So I went to the doc and they run an ECG and find high voltage spikes or something to that effect. So they do an echocardiogram (sp?) to check for an enlarged heart, but find nothing. The problem has continued for months since then, mostly at night when I sleep on my back. I’ve also had back pain and what feels like swelling of the adams apple (difficulty swallowing) and when it’s real bad, then urge to throw up. I’ve also started to notice this during exercise. I’ve never had "classic heartburn" symptoms though. So I go back to the doc and they saddle me up with a 24 hr monitor to rule out heart problems. So now he prescribes an antacid, without doing any gastric tests. Everything is stress with this guy. From what little I’ve read in this group, this can be a complex problem, anything from Acid Reflux to GERD or spasms of the esophagus. Apart from finding a new doctor, what else can I do to narrow this down?

Response:

– Hide quoted text — Show quoted text -> A few months back I had tightness in my chest and what felt like heart > palpitations. So I went to the doc and they run an ECG and find high > voltage spikes or something to that effect. So they do an > echocardiogram (sp?) to check for an enlarged heart, but find nothing. > The problem has continued for months since then, mostly at night when I > sleep on my back. I’ve also had back pain and what feels like swelling > of the adams apple (difficulty swallowing) and when it’s real bad, then > urge to throw up. I’ve also started to notice this during exercise. > I’ve never had "classic heartburn" symptoms though. > So I go back to the doc and they saddle me up with a 24 hr monitor to > rule out heart problems. So now he prescribes an antacid, without doing > any gastric tests. Everything is stress with this guy. From what little > I’ve read in this group, this can be a complex problem, anything from > Acid Reflux to GERD or spasms of the esophagus. Apart from finding a > new doctor, what else can I do to narrow this down?

See a gastroenterologist or surgeon. You need an upper GI endoscopy (EGD) and 48-hours ambulatory pH testing to rule out GERD. HMc

Response:

GERD incidence rates for various countries?

Esomeprazole is a medication used to treat gestational acid reflux disease (GERD). Buy esomeprazole tablets and feel better today!

Question:

> Mark, everbody is completely well, right up until the day they get sick… > The mechanism behind TILESR’s is that the LES inappropriately get a signal > to relax. There are several things that can initiate this. Most frequent is > simply a full stomach. There are some foods/substances that can cause this > such as nicotine, alcohol, caffiene, and some spices. There is some > speculation that it can be induced by stress, but this link has not been > demonstrated. > The cause? It just happens. Some people are genetically prone to it. In your > case, I would suspect that GERD runs in the family. > HMc

Thanks again. It seems your suspicions could be correct… I just spoke with my father and found out that he has had GERD for a while. I always remembered him popping a lot of Antacids when I was a kid but I never made the connection. thanks for the insight. Mark

Response:

> It seems your suspicions could be correct… > I just spoke with my father and found out that he has had GERD for a > while. > I always remembered him popping a lot of Antacids when I was a kid but > I never made the connection.

Indeed, like a lot of medical conditions, people may have had problems in your family for years, but it was never diagnosed.  While nobody in my family had ever had heard of "GERD", quite a few of my relatives have had chronic "heartburn." That, and sometimes people don’t talk about their medical problems, even to relatives.  A friend of mine came down with Crohn’s disease, and only after the diagnosis and surgery did she discover that her father and grandfather both had the same disease (although neither of them had required surgery).  And I didn’t find out that red-green colorblindness ran in my mother’s family (or that I had it myself) until I had my medical exam for the Naval Academy, which rather put a damper on things… (yes, you can get quite far in life before you realize that you are red-green colorblind). — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

– Hide quoted text — Show quoted text -> Thanks for the reply. I had not considered the link between obesity > and Gerd as I am not overweight (probably closer to underweight) > So what originally causes the lower esophageal sphincter to not > function correctly? > It seems strange to me that all of a sudden one’s LES can stop working > correctly (as was the case with me…out of the blue one day a year > ago) > In my case, I am not overweight. I am realtively young(23). I do not > smoke or drink. I never eat fast food, or fatty foods. I dont eat > chocolate…or candy…etc The only meats that I eat are chicken and > fish. > but…I have had problems with stress in the past. > Is it possible for stress alone  to cause the LES to not function > correctly?

Mark, everbody is completely well, right up until the day they get sick… The mechanism behind TILESR’s is that the LES inappropriately get a signal to relax. There are several things that can initiate this. Most frequent is simply a full stomach. There are some foods/substances that can cause this such as nicotine, alcohol, caffiene, and some spices. There is some speculation that it can be induced by stress, but this link has not been demonstrated. The cause? It just happens. Some people are genetically prone to it. In your case, I would suspect that GERD runs in the family. HMc

Response:

– Hide quoted text — Show quoted text ->The mechanism behind TILESR’s is that the LES inappropriately get a signal >to relax. There are several things that can initiate this. Most frequent is >simply a full stomach. There are some foods/substances that can cause this >such as nicotine, alcohol, caffiene, and some spices. There is some >speculation that it can be induced by stress, but this link has not been >demonstrated. >The cause? It just happens. Some people are genetically prone to it. In your >case, I would suspect that GERD runs in the family. > A hiatal hernia will exaggerate them, also.

Actually, a hiatus hernia would affect LES resting pressure, but usually wouldn’t contribute to inappropriate LES relaxation. The latter are neurally mediated. Here are the basics: The LES is the barrier between the stomach and esophagus. Reflux occurs when intragastric pressure exceeds intraesophageal pressure, and when that pressure gradient is greater than the pressure of the LES. Therefore, anything that increases that gradient might promote reflux. Also, anything that causes lower pressure in the LES would facilitate reflux (at lower pressure gradients). Obese people (and pregnant people) have higher intrabdominal pressure due to the intrabdominal fat (baby), so that gradient is greater, more likely to exceed the LES pressure and cause reflux. That intrabdominal pressure goes even higher when that person bends over. When lying down, gravity now has no contribution to the pressure gradient. So reflux is more common when lying down, or when bending over. Additionally, some people (fat or thin) have a low LES resting pressure, so that pressure gradient between stomach and esophagus needs to be less for reflux to occur. And, some people have more active transient LES relaxation in response to full stomach, nicotine, alcohol etc. So, you could be a thin person, but have a low LES resting pressure (such as with hiatus hernia), or very active TLESR’s and get bad reflux. It is more common in obese people because of their higher intrabdominal pressure. And, it’s also true that the intrabdominal fat can push upward and aggravate a tendency to hiatus hernia, which in turn can lead to lower LES pressure, which in turn can lead to reflux. So, how do we cure GERD? (CURE, not just treat the symptoms with prilosec). We either have to lower intrabdominal pressure, increase LES pressure, or stop the TLESR’s. Or any combination of the three. If an obese person with GERD loses a lot of weight, their intrabdominal pressure goes down and their GERD will very likely go away. This is one reason why obesity surgery cures GERD. If a person with GERD has a Nissen fundoplication, that will increase the resting LES pressure and splint its relaxations, and GERD is cured. If a person with GERD has a Stretta procedure, that will increase LES pressure, AND it will ablate afferent nerve fibers that contribute to TLESR’s, and the GERD is cured. Medical antisecretory treatment only decreases the amount of acid present in the stomach. It doesn’t stop the reflux. In fact, reflux still occurs, but the refluxate is highly alkaline. This alkaline reflux doesn’t cause symptoms, but still has the capacity to severely damage the esophagus over time (Barrett’s esophagus). Medical treatment may very well not do anything to lower the risk of esophageal cancer. As I have said before, symptom management with antisecretory medication may be entirely appropriate if it   a) controls the symptoms to the patient’s satisfaction, and     b) there is not evidence of  Barrett’s esophagus. HMc

Response:

- Hide quoted text — Show quoted text – > Obesity is a very substantial contributing factor to GERD. Since obesity is > so rampantly epidemic here in the US, it’s not surprising that GERD is too. > Likewise, there is some correlation between lower incidence of GERD and > lower incidence of obesity in countries where the amount and type of food is > less obesity-inducing. > Diet does not cause GERD. GERD is caused by a dysfunctional lower esophageal > sphincter. That dysfunction causing reflux symptoms is exacerbated by the > increased intraabdominal pressure associated with obesity. > So, to the extent that diet contributes to obesity, GERD is indeed > diet -associated, and the classic American diet definitely makes it more > common in the US. > HMc

Thanks for the reply. I had not considered the link between obesity and Gerd as I am not overweight (probably closer to underweight) So what originally causes the lower esophageal sphincter to not function correctly? It seems strange to me that all of a sudden one’s LES can stop working correctly (as was the case with me…out of the blue one day a year ago) In my case, I am not overweight. I am realtively young(23). I do not smoke or drink. I never eat fast food, or fatty foods. I dont eat chocolate…or candy…etc The only meats that I eat are chicken and fish. but…I have had problems with stress in the past. Is it possible for stress alone  to cause the LES to not function correctly? thanks, Mark

Response:

Does anyone have any info on what countries have what incidence rates for GERD (not sure if I am wording this correctly). I remember reading somewhere that in Africa for instance GERD is pretty rare… It would be interesting to take a look at countries where GERD is relatively rare, and see if the native diet has anything to do with it… Mark

Response:

> Does anyone have any info on what countries have what incidence rates > for GERD (not sure if I am wording this correctly). I remember reading > somewhere that in Africa for instance GERD is pretty rare… > It would be interesting to take a look at countries where GERD is > relatively rare, and see if the native diet has anything to do with > it…

Obesity is a very substantial contributing factor to GERD. Since obesity is so rampantly epidemic here in the US, it’s not surprising that GERD is too. Likewise, there is some correlation between lower incidence of GERD and lower incidence of obesity in countries where the amount and type of food is less obesity-inducing. Diet does not cause GERD. GERD is caused by a dysfunctional lower esophageal sphincter. That dysfunction causing reflux symptoms is exacerbated by the increased intraabdominal pressure associated with obesity. So, to the extent that diet contributes to obesity, GERD is indeed diet -associated, and the classic American diet definitely makes it more common in the US. HMc

Response:

Moderate Hiatal Hernia

Question:

Howard…. could you please explain what is meant by moderate? It’s been a month since my EGD and I’m not feeling much relief from the Nexium. How long should I wait for a return visit with my doctor? Any help would be greatly appreciated.

Response:

> Howard…. could you please explain what is meant by moderate? It’s been a > month since my EGD and I’m not feeling much relief from the Nexium. How long > should I wait for a return visit with my doctor? Any help would be greatly > appreciated.

A hiatus hernia is where the upper part of the stomach can slip or has slipped up into the chest. The part that slips includes the gastroesophageal junction and the lower esophageal sphincter. A "moderate" hiatus hernia is one where the gastroesophageal junction is displaced about 2-3 centimeters upward into the chest. It is a common misconception, even among doctors, that a hiatus hernia and acid reflux are the same thing. "Doctor, I have terrible heartburn"…."Yes, you must have a hiatus hernia."    Baloney. Many people with hiatus hernia have no acid reflux, and many people with acid reflux have no hiatus hernia. The causative factor in GERD is dysfunction of the lower esophageal sphincter. In about 40% of cases, the main reason for LES dysfunction is low resting pressure. In SOME of those cases, hiatus hernia contributes to that low resting pressure, therefore, hiatus hernia might contribute to GERD in some cases. The erroneous belief in the relationship of hiatus hernia severity to GERD severity is a holdover from the old days when doctors thought, erroneously, that low LES pressure was the cause of GERD. However, in over 60% of cases of acid reflux, the main cause is transient lower esophageal sphincter relaxation. The cause of these TLESR’s are primarily such things as nicotine, alcohol, caffiene, full stomach, and some foods such as tomatoes and other spices. It’s amazing to me how few doctors understand this concept. I guess it’s just easier to tell the patient "Oh, it’s just your hiatus hernia acting up…take these pills" So, whether or not someone has a hiatus hernia is pretty much irrelevant to GERD. The problem is the function of the LES, which is the root cause of GERD. If you have acid reflux, the place to start is lifestyle modification (diet, weight loss, smaller meals etc etc….these will help control your LES dysfunction. You can also take anti-secretory medication. These meds will not fix your LES dysfunction, nor will they do anything for your hiatus hernia, but they will decrease the amount of acid in the stuff that you reflux thereby moderating your symptoms. Maybe…unless the LES dysfunction is too severe. If these things don’t work, then the function of your Lower Esophageal Sphincter needs to be addressed surgically. Bottom line….don’t worry about your hiatus hernia, worry about controlling your acid reflux. Just because you have one doesn’t imply anything about the severity of your GERD. A high DeMeester score (>14.7) or refluxing more than about 3% of the time on 48 hour pH testing, that means something. A LES resting pressure less than 10 mmHg on manometry, that means something. An EGD that shows erosive esophagitis, stricture, or Barrett’s esophagus, that means something. All of these things allow us to draw real conclusions about your reflux disease. The presence or absence of a hiatus hernia tells us virtually nothing. If you haven’t had 48 hour ambulatory pH testing or esophageal manometry, and if all the doctor saw at EGD was a "moderate" hiatus hernia, then we still have virtually no objective information about whether or not you have GERD. HMc

Response:

Acid Reflux – Coffee, Beer and Wine

Question:

I’ve been on Nexium for a couple months now after being diagnosed with Acid Reflux.  I really miss my 2 cups of coffee on the morning & an occasional beer or glass of wine.  I’ve heard Kona or Sumatra Coffee might be less aggravating to reflux symptoms & plan to try them.  I haven’t even attempted to drink Wine or Beer since starting the Nexium.  Anyone with Acid Reflux find any wine or beer that doesn’t cause aggravation?

Response:

> I’ve been on Nexium for a couple months now after being diagnosed with > Acid Reflux.  I really miss my 2 cups of coffee on the morning & an > occasional beer or glass of wine.  I’ve heard Kona or Sumatra Coffee > might be less aggravating to reflux symptoms & plan to try them.  I > haven’t even attempted to drink Wine or Beer since starting the > Nexium.  Anyone with Acid Reflux find any wine or beer that doesn’t > cause aggravation?

Although I find that *any* beer or wine aggravate my GERD, smooth dark beers seem to aggravate it the least.  For example, Guinness draught. — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

Surgery for GERD

Esomeprazole is a medication used to treat gestational acid reflux disease (GERD). Buy esomeprazole drug and feel better today!

Question:

> I just recently switch doctors (about 6 months ago) over the last 5 years I > have been switch from one drug to the other, now nothing is working and I am > continually having heartburn.  My current doctor placed me back on Aciphex > and sugested that I give it a try for 3-4 weeks and if I do not get relief > then I should start to consider surgery.  I am currenlty not only > experiancing the heartburn but get acid and food backup whenever I bend > over, anytime…….  I am only 38 years old, slightly overwight (+20 lbs),

In my case, I found that the "lose some weight, even a few pounds" advice from my MD was also advice that helped a *lot*.  Losing 5lbs greatly reduced my GERD problems (and I was not, and am not, even close to being overweight: 5′10" and 160 lbs). — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

Not had it done myself but know of someone that has had the fundoplication procedure done and is very happy with the results e.g. eats what she wants when she wants. I think everyone has a different way of dealing with GERD, for me it was to loose some weight, watch my diet, try to get a handle on what I can eat and what I can’t and  get some type of regular exercise. I still have events but they  are minor and can be controlled with a little Mylanta. (well most times). I am on 1x 40mg of Somac (pantoprazole) / day. If you don’t have a motility problem and at 38 y/o it sound like you are a good candidate for for surgery. Have you had a Acid PH and Motilty study done? Casey

Response:

I have not had the PH test nor the Motility tests done, I understand what the PH test does but I am not quite sure what the motility test does?  Now that I think about it, awhile ago I went in and had several tests taken where I drank some stuff and they took pictures as I swallowed, then I drank some fizzy stuff and they took more pictures to see the reflux.  They also took pictures of my upper GI.  I have never had any problems swallowing or have never had any feeling of unswallowed food, quite the opposite, if I even bend over slightly after eating I will reflux my meal back into my throat and mouth.  I would like to be able to exercise without that fear! Thanks Rob

– Hide quoted text — Show quoted text -> Not had it done myself but know of someone that has had the fundoplication > procedure done and is very happy with the results e.g. eats what she wants > when she wants. > I think everyone has a different way of dealing with GERD, for me it was to > loose some weight, watch my diet, try to get a handle on what I can eat and > what I can’t and  get some type of regular exercise. > I still have events but they  are minor and can be controlled with a little > Mylanta. (well most times). > I am on 1x 40mg of Somac (pantoprazole) / day. > If you don’t have a motility problem and at 38 y/o it sound like you are a > good candidate for for surgery. > Have you had a Acid PH and Motilty study done? > Casey

Response:

Hi Rob Sound like you had a Barium Swallow and X-rays done. PH and Motility study requires a small tube down the throat into the oesophagus area (via the nose). The first is the Motility and you are required to swallow water and the motility is recorded on a machine. The second tube, PH (fitted straight after the first is removed) is left there for 24 hours and has a monitor attached to you belt (or on a harness). You are able to do all you normal activities in this time (within reason of course). The monitor has an "event" button on it so that if you have some reflux and or regurgitating you the press this button and the event is "flagged" as need to be looked at. This monitor record the whole 24 hours (not just the events) and is removed after that. I had no trouble with this procedure at all and only felt a little discomfort. The motility study is required if you oft for the surgery (determines the amount of tightness they set the sphincter).  Hope this is some help. Cheers Casey P.S. Motility is the natural rhythm of the oesophagus to move food down to the stomach. <snip>

– Hide quoted text — Show quoted text -> I have not had the PH test nor the Motility tests done, I understand what

Response:

When was the last time you have had a total checkup and especially a check internally.  I have not had the surgery, but have heard that if it is needed it is needed.  Dumb statement but true.

– Hide quoted text — Show quoted text -> Just wondering if anyone has undergone the surgery to correct GERD.  I have > been on medication for numerous years and they have all stopped working. If > anyone has undergone the surgery could you post your experiances?? > Thanks > Rob

Response:

I just recently switch doctors (about 6 months ago) over the last 5 years I have been switch from one drug to the other, now nothing is working and I am continually having heartburn.  My current doctor placed me back on Aciphex and sugested that I give it a try for 3-4 weeks and if I do not get relief then I should start to consider surgery.  I am currenlty not only experiancing the heartburn but get acid and food backup whenever I bend over, anytime…….  I am only 38 years old, slightly overwight (+20 lbs), have migranes and glaucoma. I have been on: Priolosec, Previced, Aciphex, Nexium……. Thanks Rob

– Hide quoted text — Show quoted text -> When was the last time you have had a total checkup and especially a check > internally.  I have not had the surgery, but have heard that if it is needed > it is needed.  Dumb statement but true. > Just wondering if anyone has undergone the surgery to correct GERD.  I > have > been on medication for numerous years and they have all stopped working. > If > anyone has undergone the surgery could you post your experiances?? > Thanks > Rob

Response:

Just wondering if anyone has undergone the surgery to correct GERD.  I have been on medication for numerous years and they have all stopped working.  If anyone has undergone the surgery could you post your experiances?? Thanks Rob

Response:

> Just wondering if anyone has undergone the surgery to correct GERD.  I have > been on medication for numerous years and they have all stopped working.  If > anyone has undergone the surgery could you post your experiances??

Sure, I had a Nissen Fundoplication done in ‘01.  Here’s the short version: 1. Prior to the surgery, I was almsot completely unresponsive to medication (including Zantac, Prevacid, and Prilosec), and was recommended for a Nissen. 2. Had the nissen, which went fairly well except for a rather nasty bout of crepitus (trapped air under the skin) after surgery. 3. For about 3 weeks after the surgery, I couldn’t swallow anything solid, but then regained the ability to swallow.  Alas, at that time my GERD symptoms reappeared. 4. However, post-Nissen I have been a *lot* more responsive to medication, and am currently taking Nexium 2x a day, and an occasional Zantac prior to going to bed, and have regained a more or less normal life. — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

Weaning off prilosec?

Question:

I’ve been on Prilosec since 2000. It started when I was 400lbs., ate horrible and had a horrible lifestyle. The horrible GERD I began to suffer from (so bad it felt like a heart attack on a number of occassions and caused months of almost constant nausea and lots of dry heaving) caused me to reevaluate my life. Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and by exercising regularly; cycling 10-20 miles a day. Everything is going pretty well. Cholesterol is way down, far below normal. My heart is great and overall my health is great. I’d like to kick Prilosec, though. Part of this process of getting healthier, has been to take charge of my life and to fix my problems by doing things the right way. Eating the right foods, exercising, etc. Thus I’d like to get off Prilosec if I can, because I don’t want to take any medication that isn’t necessary. Problem is, when I tried to take pills only sporadically about 7 months ago, I had REALLY had heartburn. So my question is this. #1 – Is it possible that being on Prilosec can make you MORE susceptible to heartburn if you quit it? I hope that makes sense. Essentially is there a weaning period of some kind? Does Prilosec somehow interfere with my body’s natural ability to regulate acid production? #2 – Are there any drugs that can be taken if I want to wean myself. Right now I take 20mg of Prilosec daily. Is there anything that’s effective that would help this process? Zantac? Thanks for any help or advice. Preston

Response:

> #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production?

That’s *exactly* what it is doing, which in general means that if you go off it, you’ll have some difficulty with acid levels, since the regulatory mechanisms are all fouled up. I’ve been trying to wean myself off Nexium for similar reasons.  I’m a very healthy individual, and right now it takes a combination of Nexium and careful diet to keep my acid level under control.  I’m slowly trying to get to the point where I’m not popping pills all the time, and since I’ve found that Nexium, Prilosec, Prevacid, and Zantac all give me intestinal indigestion. > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac?

The only thing I’ve really been able to do is substitute one med for another.  I can take Zantac instead of Nexium, for example, but the doses are huge[1], and talking with my GI specialist he believes that Nexium is probably causing less problems in the long run than Zantac. I’d be *very* careful with antacids.  While I was undergoing pre-surgical screening for my Nissen I had to go completely off acid control meds, and had to take large amounts of antacid to function. As I discovered, too much tums taken habitually can really mess you up, too. (I won’t complain, I’m *way* better off than a year ago, when I had *bad* GERD starting after a car accident.  After a Nissen with Hiatal Hernia repair, the acid isn’t eroding my esophagus any more, but I still have problems with high acid levels and gastritis and the occasional bout of heartburn.  But each month is an improvement) It sounds like you’re on the right track, you’ve got your lifestyle changed for the better.  Just take it slowly, and talk with specialists if you can. [1] As an aside, at least generic Zantac is *cheap* now.  I can get 120 75 mg tablets at the local walmart for $9.50, so when I was taking that I didn’t even both with my insurance. — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

I’ve been on Prevacid since July of 1999.  And I figure that I am hooked forever.  When I began to have horrible heartburn, the doctor recommened Zantac 75.  It helped slightly, but I felt that my mind was in a fog.  When I returned to the doctor in several weeks, he prescribed Prevacid.  Suddenly, the fog lifted and the heartburn was not nearly so terrible.  Almost three years later, my heartburn is pretty well under control, but if I skip a pill, I am totally miserable.  I’ve tried Prilosec, Nexium, Protonix – but I’m dependent on Prevacid.  The doctor said I’d probably be on that pill forever. Even before my heartburn, I was in excellent shape, thin, ate a very, very healthy diet, exercised very regularly.  Now I am even in better shape.  The point is – life style changes DO help.  But they don’t always eliminate GERD. They may make GERD a lot more manageable. – Hide quoted text — Show quoted text – > I’ve been on Prilosec since 2000. It started when I was 400lbs., ate > horrible and had a horrible lifestyle. The horrible GERD I began to suffer > from (so bad it felt like a heart attack on a number of occassions and > caused months of almost constant nausea and lots of dry heaving) caused me > to reevaluate my life. > Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and > by exercising regularly; cycling 10-20 miles a day. Everything is going > pretty well. Cholesterol is way down, far below normal. My heart is great > and overall my health is great. > I’d like to kick Prilosec, though. Part of this process of getting > healthier, has been to take charge of my life and to fix my problems by > doing things the right way. Eating the right foods, exercising, etc. Thus > I’d like to get off Prilosec if I can, because I don’t want to take any > medication that isn’t necessary. > Problem is, when I tried to take pills only sporadically about 7 months > ago, I had REALLY had heartburn. So my question is this. > #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production? > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac? > Thanks for any help or advice. > Preston

Response:

Im on Nexium  no problems…I was on Prilosec.but it was affecting my Coumadin levels in my blood….Nexium has cause no evil with me and y GERD is well under control. I love it. Barbara Behan

– Hide quoted text — Show quoted text -> I’ve been on Prevacid since July of 1999.  And I figure that I am hooked > forever.  When I began to have horrible heartburn, the doctor recommened > Zantac 75.  It helped slightly, but I felt that my mind was in a fog. When I > returned to the doctor in several weeks, he prescribed Prevacid. Suddenly, > the fog lifted and the heartburn was not nearly so terrible.  Almost three > years later, my heartburn is pretty well under control, but if I skip a pill, > I am totally miserable.  I’ve tried Prilosec, Nexium, Protonix – but I’m > dependent on Prevacid.  The doctor said I’d probably be on that pill forever. > Even before my heartburn, I was in excellent shape, thin, ate a very, very > healthy diet, exercised very regularly.  Now I am even in better shape. The > point is – life style changes DO help.  But they don’t always eliminate GERD. > They may make GERD a lot more manageable. > I’ve been on Prilosec since 2000. It started when I was 400lbs., ate > horrible and had a horrible lifestyle. The horrible GERD I began to suffer > from (so bad it felt like a heart attack on a number of occassions and > caused months of almost constant nausea and lots of dry heaving) caused me > to reevaluate my life. > Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and > by exercising regularly; cycling 10-20 miles a day. Everything is going > pretty well. Cholesterol is way down, far below normal. My heart is great > and overall my health is great. > I’d like to kick Prilosec, though. Part of this process of getting > healthier, has been to take charge of my life and to fix my problems by > doing things the right way. Eating the right foods, exercising, etc. Thus > I’d like to get off Prilosec if I can, because I don’t want to take any > medication that isn’t necessary. > Problem is, when I tried to take pills only sporadically about 7 months > ago, I had REALLY had heartburn. So my question is this. > #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production? > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac? > Thanks for any help or advice. > Preston

Response:

Weaning off prilosec?

Question:

I’ve been on Prilosec since 2000. It started when I was 400lbs., ate horrible and had a horrible lifestyle. The horrible GERD I began to suffer from (so bad it felt like a heart attack on a number of occassions and caused months of almost constant nausea and lots of dry heaving) caused me to reevaluate my life. Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and by exercising regularly; cycling 10-20 miles a day. Everything is going pretty well. Cholesterol is way down, far below normal. My heart is great and overall my health is great. I’d like to kick Prilosec, though. Part of this process of getting healthier, has been to take charge of my life and to fix my problems by doing things the right way. Eating the right foods, exercising, etc. Thus I’d like to get off Prilosec if I can, because I don’t want to take any medication that isn’t necessary. Problem is, when I tried to take pills only sporadically about 7 months ago, I had REALLY had heartburn. So my question is this. #1 – Is it possible that being on Prilosec can make you MORE susceptible to heartburn if you quit it? I hope that makes sense. Essentially is there a weaning period of some kind? Does Prilosec somehow interfere with my body’s natural ability to regulate acid production? #2 – Are there any drugs that can be taken if I want to wean myself. Right now I take 20mg of Prilosec daily. Is there anything that’s effective that would help this process? Zantac? Thanks for any help or advice. Preston

Response:

> #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production?

That’s *exactly* what it is doing, which in general means that if you go off it, you’ll have some difficulty with acid levels, since the regulatory mechanisms are all fouled up. I’ve been trying to wean myself off Nexium for similar reasons.  I’m a very healthy individual, and right now it takes a combination of Nexium and careful diet to keep my acid level under control.  I’m slowly trying to get to the point where I’m not popping pills all the time, and since I’ve found that Nexium, Prilosec, Prevacid, and Zantac all give me intestinal indigestion. > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac?

The only thing I’ve really been able to do is substitute one med for another.  I can take Zantac instead of Nexium, for example, but the doses are huge[1], and talking with my GI specialist he believes that Nexium is probably causing less problems in the long run than Zantac. I’d be *very* careful with antacids.  While I was undergoing pre-surgical screening for my Nissen I had to go completely off acid control meds, and had to take large amounts of antacid to function. As I discovered, too much tums taken habitually can really mess you up, too. (I won’t complain, I’m *way* better off than a year ago, when I had *bad* GERD starting after a car accident.  After a Nissen with Hiatal Hernia repair, the acid isn’t eroding my esophagus any more, but I still have problems with high acid levels and gastritis and the occasional bout of heartburn.  But each month is an improvement) It sounds like you’re on the right track, you’ve got your lifestyle changed for the better.  Just take it slowly, and talk with specialists if you can. [1] As an aside, at least generic Zantac is *cheap* now.  I can get 120 75 mg tablets at the local walmart for $9.50, so when I was taking that I didn’t even both with my insurance. — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

I’ve been on Prevacid since July of 1999.  And I figure that I am hooked forever.  When I began to have horrible heartburn, the doctor recommened Zantac 75.  It helped slightly, but I felt that my mind was in a fog.  When I returned to the doctor in several weeks, he prescribed Prevacid.  Suddenly, the fog lifted and the heartburn was not nearly so terrible.  Almost three years later, my heartburn is pretty well under control, but if I skip a pill, I am totally miserable.  I’ve tried Prilosec, Nexium, Protonix – but I’m dependent on Prevacid.  The doctor said I’d probably be on that pill forever. Even before my heartburn, I was in excellent shape, thin, ate a very, very healthy diet, exercised very regularly.  Now I am even in better shape.  The point is – life style changes DO help.  But they don’t always eliminate GERD. They may make GERD a lot more manageable. – Hide quoted text — Show quoted text – > I’ve been on Prilosec since 2000. It started when I was 400lbs., ate > horrible and had a horrible lifestyle. The horrible GERD I began to suffer > from (so bad it felt like a heart attack on a number of occassions and > caused months of almost constant nausea and lots of dry heaving) caused me > to reevaluate my life. > Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and > by exercising regularly; cycling 10-20 miles a day. Everything is going > pretty well. Cholesterol is way down, far below normal. My heart is great > and overall my health is great. > I’d like to kick Prilosec, though. Part of this process of getting > healthier, has been to take charge of my life and to fix my problems by > doing things the right way. Eating the right foods, exercising, etc. Thus > I’d like to get off Prilosec if I can, because I don’t want to take any > medication that isn’t necessary. > Problem is, when I tried to take pills only sporadically about 7 months > ago, I had REALLY had heartburn. So my question is this. > #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production? > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac? > Thanks for any help or advice. > Preston

Response:

Im on Nexium  no problems…I was on Prilosec.but it was affecting my Coumadin levels in my blood….Nexium has cause no evil with me and y GERD is well under control. I love it. Barbara Behan

– Hide quoted text — Show quoted text -> I’ve been on Prevacid since July of 1999.  And I figure that I am hooked > forever.  When I began to have horrible heartburn, the doctor recommened > Zantac 75.  It helped slightly, but I felt that my mind was in a fog. When I > returned to the doctor in several weeks, he prescribed Prevacid. Suddenly, > the fog lifted and the heartburn was not nearly so terrible.  Almost three > years later, my heartburn is pretty well under control, but if I skip a pill, > I am totally miserable.  I’ve tried Prilosec, Nexium, Protonix – but I’m > dependent on Prevacid.  The doctor said I’d probably be on that pill forever. > Even before my heartburn, I was in excellent shape, thin, ate a very, very > healthy diet, exercised very regularly.  Now I am even in better shape. The > point is – life style changes DO help.  But they don’t always eliminate GERD. > They may make GERD a lot more manageable. > I’ve been on Prilosec since 2000. It started when I was 400lbs., ate > horrible and had a horrible lifestyle. The horrible GERD I began to suffer > from (so bad it felt like a heart attack on a number of occassions and > caused months of almost constant nausea and lots of dry heaving) caused me > to reevaluate my life. > Since that time I’ve gotten down to 250lbs. by becoming a vegetarian and > by exercising regularly; cycling 10-20 miles a day. Everything is going > pretty well. Cholesterol is way down, far below normal. My heart is great > and overall my health is great. > I’d like to kick Prilosec, though. Part of this process of getting > healthier, has been to take charge of my life and to fix my problems by > doing things the right way. Eating the right foods, exercising, etc. Thus > I’d like to get off Prilosec if I can, because I don’t want to take any > medication that isn’t necessary. > Problem is, when I tried to take pills only sporadically about 7 months > ago, I had REALLY had heartburn. So my question is this. > #1 – Is it possible that being on Prilosec can make you MORE susceptible > to heartburn if you quit it? I hope that makes sense. Essentially is there > a weaning period of some kind? Does Prilosec somehow interfere with my > body’s natural ability to regulate acid production? > #2 – Are there any drugs that can be taken if I want to wean myself. Right > now I take 20mg of Prilosec daily. Is there anything that’s effective that > would help this process? Zantac? > Thanks for any help or advice. > Preston

Response:

Heartburn-help.com

Question:

http://www.heartburn-help.com has a very active message board for heartburn and Gastro Esophageal Reflux Disease. Several people posting on the board have had corrective surgery for Gerd and are answering questions.

Response:

>http://www.heartburn-help.com has a very active message board for heartburn >and Gastro Esophageal Reflux Disease. >Several people posting on the board have had corrective surgery for Gerd and >are answering questions.

is it possible to merge it  with this newsgroup ?

Response:

I’m hoping to be able to post in this group as I have had corrective surgery however have had complications with the surgery and now have to have another operation and have alot of indigestion and heartburn. — Rose I pray for our Future – Children with Strong, Healthy Minds, Bodies and Future. "Stop Child Abuse"

– Hide quoted text — Show quoted text -> http://www.heartburn-help.com has a very active message board for heartburn > and Gastro Esophageal Reflux Disease. > Several people posting on the board have had corrective surgery for Gerd and > are answering questions.

Response:

Hi Rose Sorry to hear your not doing well. What was the surgery for and what went wrong? Casey

– Hide quoted text — Show quoted text -> I’m hoping to be able to post in this group as I have had corrective surgery > however have had complications with the surgery and now have to have another > operation and have alot of indigestion and heartburn. > — > Rose > I pray for our Future – Children with Strong, Healthy Minds, Bodies and > Future. > "Stop Child Abuse"

Response:

Hi Casey, I had a Nissan Fundoplication done to help with my GERD.  I had a few ulcers on my oesophagus and the valve that shuts off the oesophagus to the stomach was actually totally burnt out.  So a wrap was made from my stomach to rebuild the valve. It was fantastic for the first year but then something just didn’t feel right.  As a mother, my kids always go to doctors when they have the sniffles but me… well I put it off for a while, so when I went back to see the surgeon and he did an endoscopy again he found that the wrap has come away and has risen into the chest wall.  My diaphragm has ripped and it all needs to be repaired again. So the heartburn, constant reflux is back and on the 20th May I will have to undergo the operation again and repair the diaphragm too but this time it will be open and not laparoscopic.  The incision will be from my breast bone to my bellybutton so I am scared.  I have no choice but to have it as it is a mess in there. I see you are in the land of Oz as I am too.  I live in WA.  So do you suffer heartburn?  I am a 33 year old mum of 2 kids, 9 & 11 y/o — Rose I pray for our Future – Children with Strong, Healthy Minds, Bodies and Future. "Stop Child Abuse"

– Hide quoted text — Show quoted text -> Hi Rose > Sorry to hear your not doing well. > What was the surgery for and what went wrong? > Casey > I’m hoping to be able to post in this group as I have had corrective > surgery > however have had complications with the surgery and now have to have > another > operation and have alot of indigestion and heartburn. > — > Rose > I pray for our Future – Children with Strong, Healthy Minds, Bodies and > Future. > "Stop Child Abuse"

Response:

Hi Rose Yep I have been suffering this pathetic disease for about 15 years now. You must be feeling very uncomfortable at the moment. I have been putting off having the operation for some time now but I think it is inevitable that I have it done. I hope and pray all goes well for you and that the op is a complete success, please keep us informed. Bye for now Casey – Hide quoted text — Show quoted text -> Hi Casey, > I had a Nissan Fundoplication done to help with my GERD.  I had a few ulcers > on my oesophagus and the valve that shuts off the oesophagus to the stomach > was actually totally burnt out.  So a wrap was made from my stomach to > rebuild the valve. > It was fantastic for the first year but then something just didn’t feel > right.  As a mother, my kids always go to doctors when they have the > sniffles but me… well I put it off for a while, so when I went back to see > the surgeon and he did an endoscopy again he found that the wrap has come > away and has risen into the chest wall.  My diaphragm has ripped and it all > needs to be repaired again. > So the heartburn, constant reflux is back and on the 20th May I will have to > undergo the operation again and repair the diaphragm too but this time it > will be open and not laparoscopic.  The incision will be from my breast bone > to my bellybutton so I am scared.  I have no choice but to have it as it is > a mess in there. > I see you are in the land of Oz as I am too.  I live in WA.  So do you > suffer heartburn?  I am a 33 year old mum of 2 kids, 9 & 11 y/o > — > Rose > I pray for our Future – Children with Strong, Healthy Minds, Bodies and > Future. > "Stop Child Abuse" > Hi Rose > Sorry to hear your not doing well. > What was the surgery for and what went wrong? > Casey > > I’m hoping to be able to post in this group as I have had corrective > surgery > > however have had complications with the surgery and now have to have > another > > operation and have alot of indigestion and heartburn. > > — > > Rose > > I pray for our Future – Children with Strong, Healthy Minds, Bodies and > > Future. > > "Stop Child Abuse"

Response:

If you are in WA Casey, the best surgeon for this procedure is Professor Fletcher at Kaleeya hospital & Fremantle Hospital.  He trained with the guy that invented the procedure. — Rose I pray for our Future – Children with Strong, Healthy Minds, Bodies and Future. "Stop Child Abuse"

– Hide quoted text — Show quoted text -> Hi Rose > Yep I have been suffering this pathetic disease for about 15 years now. > You must be feeling very uncomfortable at the moment. > I have been putting off having the operation for some time now but I think > it is inevitable that I have it done. > I hope and pray all goes well for you and that the op is a complete success, > please keep us informed. > Bye for now > Casey > Hi Casey, > I had a Nissan Fundoplication done to help with my GERD.  I had a few > ulcers > on my oesophagus and the valve that shuts off the oesophagus to the > stomach > was actually totally burnt out.  So a wrap was made from my stomach to > rebuild the valve. > It was fantastic for the first year but then something just didn’t feel > right.  As a mother, my kids always go to doctors when they have the > sniffles but me… well I put it off for a while, so when I went back to > see > the surgeon and he did an endoscopy again he found that the wrap has come > away and has risen into the chest wall.  My diaphragm has ripped and it > all > needs to be repaired again. > So the heartburn, constant reflux is back and on the 20th May I will have > to > undergo the operation again and repair the diaphragm too but this time it > will be open and not laparoscopic.  The incision will be from my breast > bone > to my bellybutton so I am scared.  I have no choice but to have it as it > is > a mess in there. > I see you are in the land of Oz as I am too.  I live in WA.  So do you > suffer heartburn?  I am a 33 year old mum of 2 kids, 9 & 11 y/o > — > Rose > I pray for our Future – Children with Strong, Healthy Minds, Bodies and > Future. > "Stop Child Abuse" > > Hi Rose > > Sorry to hear your not doing well. > > What was the surgery for and what went wrong? > > Casey > > > I’m hoping to be able to post in this group as I have had corrective > > surgery > > > however have had complications with the surgery and now have to have > > another > > > operation and have alot of indigestion and heartburn. > > > — > > > Rose

– Hide quoted text — Show quoted text -> > > I pray for our Future – Children with Strong, Healthy Minds, Bodies > and > > > Future. > > > "Stop Child Abuse"

Response:

GERD without heartburn

Question:

Hi Jennifer, I had a Nissan fundoplication done 18 months ago and enjoyed my first coffee after 5 years of agony if I did have one.  I had ulcers on my oesophagus also so the burning was incredible.  Coffee was the worst that would give me so much pain.  If I avoided coffee the heartburn would ease but even a decaff would give me heartburn.  I hadn’t had oranges or orange juice for about 10 years because that was the worst for me.  I stopped eating tomatoes and putting vinegar on my salad both of which were my favourite things. Well there were alot of things… wine, pizza, any take away actually, pickled things… oh heaps the list was endless. I had the luxury of having all these things once the surgery was done.  It was absolutely fantastic!!  Now for the past 2 months the heartburn has returned because the wrap has slipped up into my chest wall and my diaphragm needs repair.  So in 4 weeks time I will be cut from my breast bone down to my navel to repair the diaphragm.  I had keyhole surgery before but now they cant do the repair by keyhole.  This is a real bummer as I held off having the fundoplication for 2 years waiting for them to get the keyhole procedure successful and now I have to be cut open anyway. I wish I could have avoided these problems earlier on. — Rose I pray for our Future – Children with Strong, Healthy Minds, Bodies and Future. "Stop Child Abuse"

> I’m assuming it’s OK to post a follow-up to one’s own query > Is there any possible connection between GERD and frequent nosebleeds?

– Hide quoted text — Show quoted text -> > Yes it is possible and reasonably common.  I had a good article on this > > topic, I think you can find it at www.bgsm.edu/voice/reflux_voice.html > > Phlegm in the back of the throat is often "post nasal drip" and can be > > associated with GERD aggravating the mucous lining of the throat/sinus area. > > > Does anyone know if it is possible to have diagnosed GERD without any > > > heartburn?  My father (73-year-old white male) was diagnosed with GERD > > > about two years ago, underwent bronchoscopy and pH monitoring and > > > motility study, which all turned out to be negative with the exception > > > of (I believe) mild gastritis along with a slight hernia right at the > > > base of the esophagus not significant enough to warrant surgery. His > > > primary complaint is, and always has been, heavy phlegm at the base of > > > his throat which causes him to constantly be clearing his throat. He > > > has been through the entire gamut of GERD medications and, I believe, > > > is currently taking Nexium.  He denies suffering from heartburn — > > > granted he is on Nexium — and DOES NOT abide by any kind of dietary > > > restrictions; he drinks a considerable amount of coffee. > > > Any information or opinions would be greatly appreciated. > GOD BLESS your dad I would give ANYTHING for a cup of coffee, but > heartburn is totally NORMAL. This is the doctors way of saying you > have TOO much ACID going on. This is why he has gastritis! And trust > me, it will NEVER get better as long as he’s drinking coffee! No > matter WHAT antacid he takes. Coffee is the BIGGEST acid producing > beverage known to man. EVEN if it’s decaf! How I found out that I had > gastritis was whenever I drink coffee and it was alot, I would get > this AWFUL pain in the pit of my stomach as well as burning in the pit > area. After endoscopy, I was told it’s gastritis. Because H-Pylori > (which causes gastritis and ulcers) was treated, the name given for > the reason I had gastritis was GERD. Simply put, TOO much acid. > Heartburn only occurs when the acid starts to RISE up through the > esophagus. His acid might not be that severe. Thank god!  But trust > me, ask the doctor. If he’s drinking coffee….it will NEVER get > better!!!! Never. He also needs to watch what he eats. Plenty of > water, and bland foods and with the antacid, it will get better in > time. It’s hard sticking with the diet, I’m 27 and it’s hard, so at > 70, it’s going to be even harder. And the reason the nexium isn’t > working, is BECAUSE…. of the coffee! It all comes down to that. > -Jenniefr

Response:

- Hide quoted text — Show quoted text – > I’m assuming it’s OK to post a follow-up to one’s own query > Is there any possible connection between GERD and frequent nosebleeds? > Yes it is possible and reasonably common.  I had a good article on this > topic, I think you can find it at www.bgsm.edu/voice/reflux_voice.html > Phlegm in the back of the throat is often "post nasal drip" and can be > associated with GERD aggravating the mucous lining of the throat/sinus area. > > Does anyone know if it is possible to have diagnosed GERD without any > > heartburn?  My father (73-year-old white male) was diagnosed with GERD > > about two years ago, underwent bronchoscopy and pH monitoring and > > motility study, which all turned out to be negative with the exception > > of (I believe) mild gastritis along with a slight hernia right at the > > base of the esophagus not significant enough to warrant surgery.  His > > primary complaint is, and always has been, heavy phlegm at the base of > > his throat which causes him to constantly be clearing his throat.  He > > has been through the entire gamut of GERD medications and, I believe, > > is currently taking Nexium.  He denies suffering from heartburn — > > granted he is on Nexium — and DOES NOT abide by any kind of dietary > > restrictions; he drinks a considerable amount of coffee. > > Any information or opinions would be greatly appreciated.

GOD BLESS your dad I would give ANYTHING for a cup of coffee, but heartburn is totally NORMAL. This is the doctors way of saying you have TOO much ACID going on. This is why he has gastritis! And trust me, it will NEVER get better as long as he’s drinking coffee! No matter WHAT antacid he takes. Coffee is the BIGGEST acid producing beverage known to man. EVEN if it’s decaf! How I found out that I had gastritis was whenever I drink coffee and it was alot, I would get this AWFUL pain in the pit of my stomach as well as burning in the pit area. After endoscopy, I was told it’s gastritis. Because H-Pylori (which causes gastritis and ulcers) was treated, the name given for the reason I had gastritis was GERD. Simply put, TOO much acid. Heartburn only occurs when the acid starts to RISE up through the esophagus. His acid might not be that severe. Thank god!  But trust me, ask the doctor. If he’s drinking coffee….it will NEVER get better!!!! Never. He also needs to watch what he eats. Plenty of water, and bland foods and with the antacid, it will get better in time. It’s hard sticking with the diet, I’m 27 and it’s hard, so at 70, it’s going to be even harder. And the reason the nexium isn’t working, is BECAUSE…. of the coffee! It all comes down to that. -Jenniefr

Response:

Does anyone know if it is possible to have diagnosed GERD without any heartburn?  My father (73-year-old white male) was diagnosed with GERD about two years ago, underwent bronchoscopy and pH monitoring and motility study, which all turned out to be negative with the exception of (I believe) mild gastritis along with a slight hernia right at the base of the esophagus not significant enough to warrant surgery.  His primary complaint is, and always has been, heavy phlegm at the base of his throat which causes him to constantly be clearing his throat.  He has been through the entire gamut of GERD medications and, I believe, is currently taking Nexium.  He denies suffering from heartburn — granted he is on Nexium — and DOES NOT abide by any kind of dietary restrictions; he drinks a considerable amount of coffee. Any information or opinions would be greatly appreciated.

Response:

Yes it is possible and reasonably common.  I had a good article on this topic, I think you can find it at www.bgsm.edu/voice/reflux_voice.html Phlegm in the back of the throat is often "post nasal drip" and can be associated with GERD aggravating the mucous lining of the throat/sinus area.

– Hide quoted text — Show quoted text -> Does anyone know if it is possible to have diagnosed GERD without any > heartburn?  My father (73-year-old white male) was diagnosed with GERD > about two years ago, underwent bronchoscopy and pH monitoring and > motility study, which all turned out to be negative with the exception > of (I believe) mild gastritis along with a slight hernia right at the > base of the esophagus not significant enough to warrant surgery.  His > primary complaint is, and always has been, heavy phlegm at the base of > his throat which causes him to constantly be clearing his throat.  He > has been through the entire gamut of GERD medications and, I believe, > is currently taking Nexium.  He denies suffering from heartburn — > granted he is on Nexium — and DOES NOT abide by any kind of dietary > restrictions; he drinks a considerable amount of coffee. > Any information or opinions would be greatly appreciated.

Response:

I’m assuming it’s OK to post a follow-up to one’s own query Is there any possible connection between GERD and frequent nosebleeds? – Hide quoted text — Show quoted text – > Yes it is possible and reasonably common.  I had a good article on this > topic, I think you can find it at www.bgsm.edu/voice/reflux_voice.html > Phlegm in the back of the throat is often "post nasal drip" and can be > associated with GERD aggravating the mucous lining of the throat/sinus area. > Does anyone know if it is possible to have diagnosed GERD without any > heartburn?  My father (73-year-old white male) was diagnosed with GERD > about two years ago, underwent bronchoscopy and pH monitoring and > motility study, which all turned out to be negative with the exception > of (I believe) mild gastritis along with a slight hernia right at the > base of the esophagus not significant enough to warrant surgery.  His > primary complaint is, and always has been, heavy phlegm at the base of > his throat which causes him to constantly be clearing his throat.  He > has been through the entire gamut of GERD medications and, I believe, > is currently taking Nexium.  He denies suffering from heartburn — > granted he is on Nexium — and DOES NOT abide by any kind of dietary > restrictions; he drinks a considerable amount of coffee. > Any information or opinions would be greatly appreciated.

Response:

Diabetic diet and GERD

Question:

I have been told that I am in the ‘borderline’ diabetic range after I received the last few blood tests.  My doctor had me go to diabetic counseling and she told me to stay on the diabetic diet for 3 months and then retest my blood.  I am very willing, but I also have GERD, am on Prevacid each day, and the diet frequently is very irritating to my system.  I find it difficult to eat so much at dinner without having extreme heartburn all night.  Previously, I had a very small, high carb dinner and ate nothing at all after 7:00 pm.  I definitely cannot have the recommened PM snack without being sick all night.  By the way, I am 50 years old, very thin, in extremely good physical shape(lot of exercise), and eat a very healthy diet.  I just cannot manage to spread the calories out during day without becoming extremely ill. My digestive system works a lot better when I eat more of my calories earlier in the day.  When I talked to the dietician about my problem, all she could say was that I should spread my calories evenly throughout the day. Does anyone else have a similar problem?  I’m so discouraged.  After 2 years of  barely being able to eat, I finally figured out how to control my GERD.  And now it’s back with a vengeance.  Len

Response:

You might also try posting your message on the www.heartburn-help.com web site. Just click on the blue button marked New Message Board. Hawk

– Hide quoted text — Show quoted text -> I have been told that I am in the ‘borderline’ diabetic range after I > received the last few blood tests.  My doctor had me go to diabetic > counseling and she told me to stay on the diabetic diet for 3 months and > then retest my blood.  I am very willing, but I also have GERD, am on > Prevacid each day, and the diet frequently is very irritating to my > system.  I find it difficult to eat so much at dinner without having > extreme heartburn all night.  Previously, I had a very small, high carb > dinner and ate nothing at all after 7:00 pm.  I definitely cannot have > the recommened PM snack without being sick all night.  By the way, I am > 50 years old, very thin, in extremely good physical shape(lot of > exercise), and eat a very healthy diet.  I just cannot manage to spread > the calories out during day without becoming extremely ill. My digestive > system works a lot better when I eat more of my calories > earlier in the day.  When I talked to the dietician about my problem, > all she could say was that I should spread my calories evenly throughout > the day. > Does anyone else have a similar problem?  I’m so discouraged.  After 2 > years of  barely being able to eat, I finally figured out how to control > my GERD.  And now it’s back with a vengeance.  Len

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