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Gastroenterology  (Expert Forum)
 | 
Chronic Gastritis and Acid Reflux
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

Chronic Gastritis and Acid Reflux

by Nervous Stomach, Feb 27, 2004 12:00AM
I have acid reflux and chronic gastrtis.  The gastritis was diagnosed last summer with an endoscopy.  I tested negative for an h. pylori infection.  I eat healthy, and don't drink.  I used to drink socially, but now if I have more than one or two drinks the the next day my stomach feels extremely nervous, I am hoarse (probably from increased reflux), and I get fatigued.  These symptoms last for a couple days to a week depending on who much I drink.  I get similar symptoms with other common irritants - caffine, spicy food etc.  I have cut alcohol almost completely out of my diet (maybe 1-2 drinks per month) and I don't drink caffine.  I also avoid spicy foods.  I am taking nexium, which helps keep heartburn away, but I am still hoarse all the time and my stomach always has a slight feeling of butterflies to mild indigestion.



I DO NOT have any of the following symptoms:  pain, diareea, nausea, blood in stool.  



My last doctor finally tried to give me prozac.  I think he probably had good reasons for trying that approach,  but I sincerely don not believe that I have a mental disorder.  I took last summer off and just relaxed and now I am in my first year of law school.  My symptoms are neither better nor worse now than they were last summer. It is frustrating to give up any sort of drinking, caffine and spicy food and still just feel "ok".  I would give up more If I new what was causing this.  Moreover, I am concerned that this chronic gastritis and acid reflux may increase my risk of cancer or lead to other more serious problems.  Thanks ANY advice or speculation you may have.
Doctor's Answer

by Kevin Pho, MD, Feb 29, 2004 12:00AM
Chronic acid reflux can lead to a change of the cells in the esophagus - known as Barrett's esophagus.  Barrett's esophagus is linked with esophageal cancer.  If you have chronic symptoms, you may want to consider further evaluation - an upper endoscopy would be the best test to see if you have Barrett's.  



If the diagnosis of reflux is still in question, you may also want to consider a 24-hr pH study to determine how severe the reflux is.  If anti-reflux medications are not improving the GERD, surgical intervention may be necessary.  



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 (10)

by PAJ, Feb 27, 2004 12:00AM
I speculate you have a yeast infection , yeast infections are endemic in fact specialist doctors blame  yeast for much of the illness that plagues the western world , I would agree having suffered for years [I know now] from the condition. Read my posts below

by yoshi, Feb 27, 2004 12:00AM
fatigue and hoarseness,may be you should see a regular doctor.

by tessa0825, Feb 27, 2004 12:00AM
Many times horseness is a symptom of reflux disease..It is usually associated with LPR (laryngopharengeal reflux). It usually occurs when you are refluxing all the way into your throat and vocal cords...It takes higher doses of PPIs to treat and for a longer time period than when you have reflux without LPR..There is a test to diagnose it, it is a 24 hr ph probe but instead of the usual one tube test it requires two tubes, one checking specifically for LPR...Standard GERD diets include giving up all caffeine, chocolate, citrus fruits, fried and fatty foods, mints, pepper, carbonated beverages, alcohol, smoking, all aspirins, and NSAIDS..I know alot of people who have also had to give up dairy products...The general rule is if you try something and it bothers you then try to stay away from it.....Tessa

by teresab, Feb 28, 2004 12:00AM
About two years ago, I started having extreme horseness. It started developing into bronchial infections and frequent colds. I complained to my internist who suggested that I may be having anxiety. He suggested that because I have a stressful job (divorce lawyer) that this is how I deal with stress. While I agree that the job is stressful, this was not a high stress time. He suggested i try an anti-anxiety. I was furious. I called a friend of mine who is a pulmonologist who basically said anxiety does not cause horseness.............. We found out that I developed a severe type of GERDS and the acid was contaminating my airways. I started on Nexium, and Advair (inhaler). Go see a GI doctor right away. I developed asthma from my problem and wish I would have got on the ball sooner. Sadly, I too experience a nervous stomach and have developed IBS and am still battling the horrible symptoms of GERDS. I am not a candidate for the GI surgery but you might be. I can't get teh surgery because of my IBS. Good luck

by PAJ, Feb 28, 2004 12:00AM
Here’s more evidence on yeast causing IBS…don’t you find it strange that the forum gastro doctor never mentions the possibility.









According to Professor Jonathan Brostoff (consultant physician, Middlesex hospital, London), there was evidence that "yeast" was involved in some cases of IBS, and some patients had reduced numbers of lactobacilli and bifidobacteria (so-called "friendly" bacteria) in their guts. Indirect evidence came from the use of tetracyclines, which, when added to a standard stool population, increased yeast production and reduced counts of lactobacilli and bifidobacteria.

Lactobacilli might induce immunological hormones, which could alter mucosal response in the gut, and there was some evidence that different grains, such as wheat, oats and rice, altered the gut flora to varying extents.



Colonic fermentation

Dr John Hunter (consultant gastroenterologist, Addenbrooke's hospital, Cambridge) said that there was evidence of abnormal colonic fermentation in IBS, which could be associated with food intolerance. A trial at Addenbrooke's had shown that colonic hydrogen production was higher in patients with IBS than controls, and the use of an exclusion diet reduced both gas production and symptoms. Future developments in the management of IBS might therefore be related to modification of gut flora and there was much interest in the potential role of prebiotics and probiotics in this area. However, a trial of oligofructose (a prebiotic) at Addenbrooke's had shown no therapeutic value in patients with IBS, he said.

by yoshi, Feb 28, 2004 12:00AM
what about smoker and drinkers??

by teresab, Feb 28, 2004 12:00AM
To: PAJ
I am still searching for the Primal defense and can't find it around here. I am wondering whether it might have another name. My doctor told me that if you have yeast it shows on the colonoscopy and other than 2 polyps mine was normal. Did your test show yeast. If you did have a positive test what tests did you have. Thanks in advance for anwsering .