Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Subject: Re: Chronic Esophagitis
Forum: The Gastroenterology and Liver Diseases Forum
Topic Area: Reflux Esophagitis
Posted by HFHSM.D.-rf on September 20, 1998 at 08:08:33:
In Reply to: Chronic Esophagitis posted by Sue on September 17, 1998 at 03:38:33:


I am a 47 year old female.
As a result of severe reaction to chemotherapy for breast cancer
3 years ago, I now suffer from chronic esophagitis. I have been
taking Losec (20mg) for two and a half years now and am interested
to know what the longterm prognosis is with this type of
condition. I take one tablet per day. I have tried to wean myself
off the medication only to find that I suffer severe reflux.

Is it likely that I will have to take medication long term? Are
there any longterm side effects with Losec?

Thank you.

Dear Sue,
Reflux esophagitis ( inflammation of the esophagus due to acid entering the esophagus) is a chronic condition. The severity of symptoms can vary but most people will have intermittent discomfort or ongoing problems. It is unusual to have only 1 episode of symptoms. The backbone of therapy is lifestyle modifications. Recommendations include:
a) eat 3 meals only; do not snack
b) do not lie down for 3-4 hours after eating
c) sleep with the head of your bed elevated approx 6 inches
d) do not smoke or drink alcohol
e) avoid fatty foods, chocolate peppermints. coffeee, tea, carbonated beverages
f) during the day chew gum or suck candies to increase saliva production

If these lifestyle manipulations do not work, then medical therapy is added. Some physicians use a proton pump inhibitor. like prevacid, whereas others use an H2 receptor antagonist. If you are symptom free on the prevacid, you could ask your doctor to try an H2 receptor antagonist. If symptoms recur, then you would have to stay on the prevacid indefinitely.

At the present time, we believe that long term use of prevacid is safe. I often suggest to my patients that they stop the prevacid every 8 weeks and for several days just use tagamet. This recommendation allows the stomach to make a small amount of acid and removes the continuous suppression.

This information is presented for educational purposes only. Always consult your personal physician for specific medical questions.

HFHSM.D.-rf
*keywords: esophageal reflux, prevacid
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