Can GERD/GERD remedies cause digestive problems?

[tunibell1974]

I am a 34 year old female in good health. About four months ago, just a few weeks after the birth of my second child, I started experiencing a dull, gnawing ache in my upper abdomen, in the triangular area formed by the rib cage. The pain would sometimes feel like someone was squeezing my lower chest, and sometimes there was a mild burning sensation behind the lower portion of my ribs. I also felt as though something was stuck in my chest. These symptoms generally showed up between meals, in the late afternoon or early evening, and were on/off for approximately 6 weeks before I sought medical help. My PCP diagnosed the problem as GERD and recommended Prilosec. After two weeks, I wasn't really feeling much better, so he added Zantac in the evening. I also decided to alter my diet - I removed all dairy, caffeine, chocolate, tomato products, citrus, alcohol etc. I also had a CBC panel run (normal except for elevated eosinophils) and tested negative for H. pylori. Since beginning the medication (and changing my diet), I've had some changes in my bowel habits. For the most part, my stool looks normal, but I have had a few episodes of loose stools, and a few "bumpy" stools that looked like they contained undigested food and a little mucous. I have also issues with painful gas, particularly in the evenings. I often have the feeling that I might have diarrhea, but it is always either gas or a reasonably normal bowel movement. Sometimes I feel as though areas of my abdomen are mildly inflammed. I have also lost approximately 10 pounds in the past 6 weeks (which may be explained by the changes to the diet and round-the-clock breastfeeding). In addition to the acid reducers, I am also taking 150 mg of Zoloft for anxiety (which has been increased from 100 mg since the birth of my child.) I was fairly confident in the diagnosis before the bowel issues started; now I'm not so sure. Can GERD (or it's treatment) cause intestinal issues?

[Kevin Pho, MD]

GERD is certainly a possibility, but if the symptoms continue, more tests can be done to exclude other causes.

These can include an ulcer, inflammation of the upper digestive tract, gastroparesis, or liver or gallbladder issues.

I agree that the Zantac and elimination diet that you are doing is effective GERD treatment.  I would also consider an upper endoscopy and/or imaging the abdomen with an ultrasound or CT scan to further evaluate the symptoms.

These options can be discussed with your personal physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd

[tunibell1974]

Just thought I'd update this discussion. Turns out I have celiac disease (diagnosed via blood work and endoscopy/biopsy).