Re: Reflux problem

Posted By HFHSM.D.-rf on August 23, 1998 at 19:59:07:

In Reply to: Reflux problem posted by Rodger Owens on August 23, 1998 at 11:43:29:






I am having a problem with acid reflux it usually occurs during the day and carries into the evening hours and any antacids I take do not usually work.  I have had this problem for about 2 or 3 years now and have seen many doctors about this problem but none of the doctors seem to know what is causing my reflux.  I've had endoscopy work done, but all that was found was a bit of irritation of the digestive tract. I'm not sure what to do here it is getting worse all the time and I am having problems sleeping at night. I wake up after a time and the burning is just incredibly intense. Do you think this is something that is very serious.
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Dear Roger Owens,
The first step is to characterize the cause of your discomfort and to verify that the symptoms are related to acid reflux.  You will need an esophageal motility study and 24 hour pH probe study to characterize the esophageal function.  If your symptoms are reflux-related , lifestyle modifications and treatment with drugs to inhibit acid secretion will be needed.  
Lifestyle modifications include: eating 3 meals, no snacks; not lying down for 4 hours after eating, sleeping with your head elevated approx 4-6 inches; stopping alcohol, cigarettes, coffee, tea,; avoiding fatty foods, chocolates, peppermints. Patients are encouraged to take antacids, over the counter H2 receptor antagonists and to chew gum or suck candies.  The increased salivation resulting from this activity neutralizes the acid that has refluxed into the esophagus.
If lifestyle modifications do not work, we usually start medical therapy with an H2 receptor antagonist e.g. Pepcid, Tagamet. zantac.  If you remain symtomatic, we add a second drug called a prokinetic agent (e.g. Cisapride).  If symptoms persist, we replace the H2 receptor antagonist with a more powerful inhibitro of acid secretion, the proton pump inhibitor e,g. Prevacid or Prilosec.  In some people surgery is required to control the reflux problem, although most do well with medical therapy alone.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords; esophageal reflux
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