You seem to have some similar issues to mine, though I have an atypical reflux, apparently. My only symptom was shortness of breath. Oddly, like you mention, my symptoms go away when I lie down and are not bad in the morning. It gets worse as the day goes on, water helps, etc. I do get esophageal spasms now. PPI medication helped A LOT, but it gave me terrible heart palpitations and tachycardia. I tried Nexium twice, with the same results both times (great for GERD, not so great for the heart). I guess I am only of the lucky less than 1% of people who get that side effect. So now, with no PPI medications, I'm not real sure what I can do. Chocolate darn near kills me, so I eat none. I find that spicy food doesn't bother me nearly as much as greasy food, soda or sugar.
Do you get the shortness of breath and have you found anything that works for you aside from the medications? I'm nowhere near overweight, I eat a low-fat, high fiber diet and I exercise 6 days a week. Seems I do everything they say to do and I am still having this. It's frustrating.
I'm back from the hospital after my EGD and am still slightly under the influence of the drug -- versed. The three findings, in order of importance, as relayed by me sometimes cryptic doctor: 1. It's not cancer; 2. My esophagitis is still Grade I and slightly better than the last time I was checked (three years ago), and 3. I have now developed an area of superficial hemorrhagic gastritis in my stomach. In talking with another doctor friend, he thought that this gastritis was likely due to the fact that in the last month I've taken some ibuprofen before I play basketball to help with minor tendinitis in one knee. He said a few weeks of no ibuprofen and no alcoholic beverages might cure it. So, all in all, a pretty good report. I thank you very much for advice and consul. I was really quite worried about why my PPIs were no longer working as they once had. Interestingly, the less powerful AXID seems to be doing a better job right now.
Saw my GI doc today. He wants to do another EGD before adjusting my medication -- currently AXID 150mg BID. It's scheduled for a week from Friday. I'll let everyone know what he finds and what he recommends. Symptoms today seem very minor. Right at the moment, none. We discussed, briefly, my unusual experience of having GERD symptoms leave me at night when I go to bed. He thought that day-time spasms of the LES might be a cause and that these spasms might then lessen during sleep. Would this phenomenon account for the old-time thought that GERD was related to anxiety and/or stress?
Thanks for the replies everyone. Since my intial post, a strange thing has happened. I had a reaction to the Nexium. My hands and feet got red and felt like they were swelling. They weren't actually swelling, but they felt like it. They also began to itch -- but no rash. This lasted for about an hour. I quit taking the Nexium, and I haven't had a return of this weird reaction. I'm making an appointment to see my GI, but in the meantime I switched back to 150mg Axid BID, which I had been on last summer. Amazingly, it's working much better than the PPIs. After three days, I'm having no GERD symptoms at all. I'm wondering if with the PPIs I was having some side-effect pain that I couldn't distinquish from GERD pain. I would think the PPIs were doing a better job of surpressing the actual acid production. Anyone have an explanation for what might be going on here. Maybe I'm just weird!
I doubt seriously that cardiac problems are related here. I have no signs of cardiac issues. I have normal BP, low resting heart rate, excellent cholesterol and blood lipid levels, and I exercise vigorously three days a week and keep up with folks in their 20s. I have no angina. In general what you say is a good suggestion, I just don't think it's likely to yield much in my case. I sort of wonder if I might have a functional esophagitis problem overlaying my actual GERD.
I wondered if you have had any coronary testing done? If not you might want to consider it, if for no other reason than to just rule it out as a cause of your pains. Also, I would ask for a 24 hr ph study. That test will tell how often and how much you are having acid reflux.
I would discuss this further with your gastroenterologist. Sometimes combining a PPI with an H2 blocker (i.e. Pepcid, Axid or Zantac) can help.
A 24-hr pH study can determine the severity of the reflux.
If medications cannot appropriately control the symptoms, surgical therapy can be considered (i.e. a fundoplication).
These option can be discussed with your gastroenterologist or surgeon.
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.
Kevin, M.D.
kevinmd_
P.S. I should add that about a year ago, my family physician wanted to rule out hiatal hernia. I had the wonderful barium swallow and the complete X-ray examination. The result was negative for hiatal hernia.