Burning / Gnawing sensation in upper stomach and chest

[jj9500]

Im going on month 3 of a terrible gnawing/burning sensation in my high upper abdomen (where the rib cage meets) and sometimes in my chest area.  By the sternum.  Im really not refluxing food or anything.  It's just a terrible burning sensation like someone has a hot poker sitting there.  This sensation comes and goes throughout the day.  Some days worse than others.  Bad at night where it was waking me up at night.  Started out with 1 Priolosec, moved to 2 Prilosec per day.  Doc then add a 300mg Zantac at night, still not much relief so she sent me to a GI Specialist last week who persccribed Kapidex 60 mg.  Just started that yesterday.  He also ordered a Upper Endoscopy and a Esophageal Manmomentary (I seem to have ALOT of stuff draining/clogged in my throat..like a post nasal drip thing).  Im having these tests doe next week.  I've been dealing with GERD symptoms for about 8 years so taking PPIs off an on as needed.  But, this bout of whatever it is..is ruining my daily activities.  The frustrating part is I can't pinpoint whats causing it.  And not much seems to relieve it.  Im a very anxious person as well...worry about every little thing and I know that doesn't help.  I just worry about cancers, and the worse.  Looking back at med records I went througha point 5 years ago with same exact situation and symptoms during the same time of year.  Somehow after I went through a serious of tests (upper scope, colonoscopy, CT of the abdomen, MRI of Ab, ENT visit, Allergy Test, and barium swallow test) things went away.  The barium swallow did show a slow contracting esophagus at that time.  No reflux (I was on protonix at the time).  Has anyone experience this burning sensation I'm referring to?  Can it just be severe GERD, or some other digestive disease.  The GI doc did mention possible Sphinter of Oddi Dysfunction.

[LazyMoose]

"Im going on month 3 of a terrible gnawing/burning sensation in my high upper abdomen (where the rib cage meets) and sometimes in my chest area.  By the sternum"

- that is what is meant by heartburn, a sympym of GERD itself. With GERD you dont have to feel it coming up, but it dose.

Many years, you need a plan besides meds!

Cant just rely on the meds. You dont say if you adapted to a gerd diet or not. No mention on alkalizing your body by quitting acidic foods (learn about the ph scale and saliva). Get ph test paper strips at a health food place.

Gerd can be a symptom of other causes. I answed a post with causes today, look for it. Gastroenteritis can be very close minded and do not look for the cause, just push drugs.

[jj9500]

I went for my endoscopy one week ago today and the gi doc talked to my husband and I (from what I can remember - pretty loopy yet from the meds0.  Anyways, he said I have Bile Reflux.  Could see alot of green stuff in the esophagus and stomach in the photos.  He perscribed carafte 4x/day and told me to continue with the Kapidex 60 mg 1x/in am.  He said bile reflux has to be controlled differently than acid reflux.  PPIs alone won't work.  Hence, the reason why I wasn't having any relief for 3 months I imagine.  He did take biopsies, but I haven't head back on those.  It's been one week.  Im assuming they were fine otherwise I would think I would have heard something by now.  The burning sensation is just now starting to subside some after a full week on the meds.  Im also scheduled for an esophageal manometry to measure the contraction in my esophagus.  That is next week.  I really laid off all my coffee, no spicy foods, prop my bed up 6-8 inches at the headboard, no sodas, no tomato products, no fried foods.  Pretty much follow the diet stuff.  

How do you work with the ph papers?  I think I will go to the local health food store and pick some up today.  Will the papers also show bile and acids?

[LazyMoose]

Well, your doc must be half decent if he notice the bile! You might want to read up on the bile.  Remember bile is for digesting fats, so maybe layoff fatty red meat and opt for chicken and fish? At least test it out to see the difference. Did he say anything about the pyloric valve (the opposite of LES valve, at end of stomach) having any ulcers on / nearby? That would be a case for it not shutting. Do you still have a gallbladder? How does your liver checkout on your last physical. There is allways a reason things happen, although some drugs work well, its nice to find the cause.

PH paper comes in a small roll and is only about 3/8 wide. Remember testing PH of water in science class? PH is just a numbered scale with acid (low PH like 2) on one side and alkaline (high PH like 10) on the other side. Neutral is in the middle. Anyhow, you are what you eat and all food has a PH number. In some foods the PH changes when introduced to stomach acid. You can find chart on the net that group foods on a PH scale, google alkalizing your body also. PH paper changes color when it wet from whatever liquid your testing. Can test saliva since its related to your stomach. Do this in the morning. I think saliva PH is supposed to be around 7. Point is, if your allways below 6, you can make it go up by eating less acidic foods. Some people test urine too. You can find the specifics on this at a health food store.

Some people just feel better getting their PH 7 to 8. They have alkalizing (cheater) liquid drops too.

An acidic diet will lead to an overall acidic body. Increased fat and all sugar lower the PH to acidic levels - not good although common from western diet. This reflects on blood PH as well. In acidic blood, the cells stick to each other and will not be drawn into tissue and muscles as easily as non acidic blood, thus body parts get less oxygen. Low body PH contributes to heart disease too. Some people claim they feel great when upping their body PH. I ate a boatload of veggies and stayed clear of red meat for 3 months, then my saliva PH went to 7- 7.5 in the morning, was around 5.5-6 before. My stomach felt better, and those boring veggies started to taste better. If you can deal with a diet change for 3 months, there could be interesting results. You really cant do this eating at restaurants though. After the three months I occasionally enjoy red meat in moderation and offset it with veggies. Gave up most sweet stuff, its just bad for the body. Its like coffee, after you eliminate it, the desire can go away. A candy bar might be more convenient than fruit, but is a silent killer in the long run.

Time for me to stop babbling. Try the PH thing, it can be fun in an interesting sort of way.

[jj9500]

Thanks for the response.  In answer to some of your questions.  No on the gallbladder, it was removed four years ago.  When I aksed the doc about any ulcers after the endoscopy and he said he seen no ulcers.  Could he have seen one by the Pyloric Valve in an endoscopy test or is there another test for that.  To me it makes sense that something is wrong with that Pyloric valve to leak the bile into my stomach.  The Endoscopy biopsy diagnosed Reflux Esophagitis (GERD).  No barretts or anything like that.  I did have a liver panel done a couple weeks before endoscopy;  
TOTAL PROTEIN 7.5  
ALBUMIN 4.4 Normal Range 3.6-4.7 GM/DL
BILIRUBIN, TOTAL 0.7 Normal Range 0.3-1.0 MG/DL
BILIRUBIN,DIR 0.0 Normal Range 0.0-0.3 MG/DL
ALK PHOSPHATASE 72 Normal Range 30-120 U/L
SGOT/AST 40 Noramal Range 10-38 U/L (This is mildly elevated, suggested to recheck in 1 month)  Not sure what this suggests!
SGPT/ALT 21  Normal Range 10-50 U/L
Also had this bloodwork done:
AMYLASE 105  Normal range 30-110 U/L
LIPASE 58  Normal range 23-300 U/L
I had an esophagel manometry done yesterday.  The doc called me back himself when I got home after work that evening and said everything looked good with that!  The fact that he called himseld impressed me!
I guess I'll jsut continue with the meds to see what happens>  But still curious of how I can stop the bile from getting into my stomach and esophagus.  To me it states that something is wrong with the LES and Pyloric valve.  You would think they could see that in the manometry test I had done yesterday, especially with the LES.  

He said the carfate 4 x/day could take 4-6 weeks to really take affect.  Ive been on it for two weeks and notice just a notice a slight difference.  To continue with that and 1/ 60 mg Kapidex and follow wp with him in December when my follow up is scheduled.

[LazyMoose]

Playing the waiting game is no fun. We all have to do it sooner or later.

Hopefully things will settle down soon. In the meantime, I hope you record every meal and rate your GERD level accorrdingly (1-10).

Leaving out specific foods for several days at a time might lead to a patern in helping you heal. With bile reflux, I would start with eliminating ALL fats, greasy foods and see how you feel. This means the only meat is low fat fish (not salmon) and chicken breast. No pork or beef at all. Obviously this means what you eat will be different then what people around you eat - make sure they understand.

This is easier said than done for some people, but I gurgled acid nightly, so the choice was clear for me. I eat meat again, but limit beef. The only pork I ever eat is ham. Bacon is a silent killer no matter how you look at it.

It seems that once one of the digestive 'valves' gets weak, you have to baby it back to health with what ever your body thinks is a bland diet. Every bit helps.