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Gastroenterology (Expert Forum)

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Esophagitis

Answered by

Kevin Pho, MD - Internal Medicine

Kevin Pho, MD Boston - MA

This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

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MedHelp Member's Question

Esophagitis

by haddad, Feb 15, 2004 12:00AM

Tags: esophagitis, barrett's, esophagus, endoscopy, gerd, hernia, pain, prilosec, reflux, sleep, test, Barrett's Esophagus

every night I have sharp pain in the epigastric area i.e above the navel area. I have done ultrasound twice, endoscopy twice, Ct scan and (HIDA )nuclear medicine, all tests revealed negative re gallbladder, duodenum, colon and or pancreas. They found I have Hiatal Hernia and esophagitis. I was put on Prilosec but it did not help me at all. I still suffer from sharp pain every night and I am losing sleep and I am very exhausted from lack of sleep. Any other treatment suggested ??

Doctor's Answer

by Kevin Pho, MD

, Feb 16, 2004 12:00AM

I would consider testing for H Pylori.  This is a disease that is associated with inflammation of the upper GI tract.  The bacteria can be diagnosed through an endoscopy or a blood test.  Two antibiotics in addition to the Prilosec is normally needed for treatment.

I would also make sure that the esophagitis isn't Barrett's esophagus.  This is normally associated with chronic GERD and be diagnosed via the biopsy obtained during the endoscopy.  If this is present, close monitoring is needed due to its association with esophageal cancer.

Another test to consider would be a 24-hr pH study, which can comprensively diagnose GERD.  If it is present and not controlled with Prilosec, either surgery or addition of an H2 blocker may be considered.

If all negative, you may want to consider non-GI causes of the pain, including heart tests (i.e. an exercise stress test), or pulmonary causes (which can be tested with chest imaging studies).

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,

Kevin, M.D.

Member Comments (5)

by tessa0825, Feb 16, 2004 12:00AM

There are 5 PPIs available in the US..If the Prilosec isn't working maybe your Dr. would switch you to one of the others..Some people have to try several of them to find the one that works best for them...Some Drs. believe that Nexium might be better at healing esopohageal damage..I don't know why they think that but it seems to be so...You don't say, but do you sleep on a wedge? If not, they are available at most medical supply companies and online, they average in price from about 24.00-50.00...It would keep your head elevated approx. 6-8 inches thus not allowing the acid to reflux into your esophagus while you are sleeping..You could also raise the head of your bed with blocks, platform, etc. and get the same effect...Do you also follow the GERD diet and not eat for several hrs. before laying down?...you could also ask for a surgical evaluation but if you ever go that route for reflux and hernia repair, it's very important to choose a surgeon that has done many of these surgeries...Just some thoughts I had....Been there, done that....Tessa

by Bev2153, Feb 16, 2004 12:00AM

I cant believe I am reading your post. It sounds just like me. Did you ever find help?

I started with burning in the throat and pressure in my chest. Doc run light down my throat, ultra sound on my stomach, gall bladder, liver, and pancreas. That checked out ok except very small hiatal hernia.  Very little reflux.

Im taking nexium in morning pepcid at night and antacids during day by orders of Doctor. I watch my diet and I sleep with 2 pillows. Im not a doctor but it appears to be thehiatal hernia.  When I stand up or lie down it gets better. I have done all I know to do. My Doctor wants to do a 24 hour PH monitor. I just dont agree with  him on this. I dont know what to do now. Please let me know if you found help. Im desperate....

                            ***@****

by haddad, Feb 16, 2004 12:00AM

Yes, when I did the first endoscopy and biopsy they found that I have H Pylori bacteria and was treated thru triple antibiotics and later I had nuclear breath test and it was negative. I use the bed wedge with no help. My MD first put me on Nexium in the morning and Zantac in the evening but the Zantac caused me a severe abdominal pain so I stopped it, then they switched me to Prilosec in the morning and Caviscon after meals also no help at all. I do not have a throat problem or bloating nor swallowing problem, I have besides the severe pain in the upper part of my stomach I burp during the night.I am scheduled to see my MD (GI) specialist soon (5th) visit for further evaluation and I hope he will have better assesment other than prescribing pain killers.

by sportsco, Feb 17, 2004 12:00AM

Haddad,

Try Prevacid. I've been through them all and from what I understand some don't work for everybody. Prevacid has been a miracle for me.

by GATACA-16, Mar 09, 2004 12:00AM

WELL, I'VE BEEN SUFFERING FROM GERD FOR ABOUT A YEAR AND THE PPI THAT SEEMS TO WORK A LITTLE BETTER IS NEXIUM, BUT WHEN MY REFLUX GETS REALLY BAD, I TAKE TWO NEXIUMS A DAY. I HAVE ALSO FOUND OUT THAT ALTERNATIVE MEDICINE WORKS REALLY GOOD LIKE CHEWING TWO CAPLETS OF DGL BEFORE MEALS, TAKING ONE ALFALFA CAPSULE AND TWO CAPSULES OF CHAMOMILE EXTRACT WITH MEALS, AND ONE CAPSULE OF ALOEVERA AT BEDTIME HELPED ALSO A LOT. U SHOULD TRY THESE MEDICINAL HERBS, OF COURSE, THEY ARE NOT MAGICAL OK. YOU WILL HAVE TO GIVE THEM SOME TIME TO BUILD UP IN YOUR SYSTEM; I AM 100 PERCENT THAT YOU WILL FEEL BETTER. I DID NOT BELIEVE ON MEDICINAL HERBS, BUT THEY ARE GREAT. BELIEVE YOU ARE NOT ALONE, THERE ARE A LOT OF PEOPLE LIKE YOU.

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