Bloated and heartburn are driving me to the edge!

[Tracy__0__0]

  I'm a 35 year old female with a history of chronic heartburn (for
  the past 2 years or so).  At first, rolaids and the like would keep
  the symptoms down, but in the past few months nothing seemed to help.
  I finally was able to see a doctor (I had no insurance for a long
  time).  He prescribed Prilosec for a month and had me check my stool
  for blood.  When I saw him again, he prescribed the Prilosec for
  another month and told me there was some blood in my stool.  (I took
  3 tests and two were positive for blood)  I'm a week away from my
  next appointment and once again doing the tests for blood. (been off
  the medication for 5 days now) My symptoms have all come back, except
  now I'm exhausted all the time.  I get heart burn that lasts all day,
  abdominal pain, diarreah, bloating and I belch almost constantly.  I read
   on the internet that they can't test for h-pylori unless you've been off
  Prilosec for 30 days.  Does this mean I'll be miserable like this for a month?
   This is all getting very depressing.  Any suggestions?
____________
dear tracy,
Your symptoms are very suggestive of esophageal reflux.  We know that this is a chronic problem that responds to acid-suppressant treatment but can recur when the medication is stopped.  Given the persistence and recurrence of symptoms, I agree that it is a good idea to see a gastroenterologist and to exclude other possible causes for your symptom.  I would NOT check you for H. pylori unless you have or have had an ulcer.  The NIH recommendations do not support treatment for all people who have H. pylori infection, only specific subsets of which the most frequent is those with ulcers.  
I think that you need an endoscopy to confirm the diagnosis of esophagitis.  Also, I would restart your acid suppressant therapy once the diagnosis has been confirmed.  Your physician may also consider adding a prokinetic agent.
HFHSM.D.-rf
*keywords: esophageal reflux, H. pylori
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