Chronic Gastritis and Acid Reflux

[Nervous Stomach]

I have acid reflux and chronic gastrtis.  The gastritis was diagnosed last summer with an endoscopy.  I tested negative for an h. pylori infection.  I eat healthy, and don't drink.  I used to drink socially, but now if I have more than one or two drinks the the next day my stomach feels extremely nervous, I am hoarse (probably from increased reflux), and I get fatigued.  These symptoms last for a couple days to a week depending on who much I drink.  I get similar symptoms with other common irritants - caffine, spicy food etc.  I have cut alcohol almost completely out of my diet (maybe 1-2 drinks per month) and I don't drink caffine.  I also avoid spicy foods.  I am taking nexium, which helps keep heartburn away, but I am still hoarse all the time and my stomach always has a slight feeling of butterflies to mild indigestion.

I DO NOT have any of the following symptoms:  pain, diareea, nausea, blood in stool.  

My last doctor finally tried to give me prozac.  I think he probably had good reasons for trying that approach,  but I sincerely don not believe that I have a mental disorder.  I took last summer off and just relaxed and now I am in my first year of law school.  My symptoms are neither better nor worse now than they were last summer. It is frustrating to give up any sort of drinking, caffine and spicy food and still just feel "ok".  I would give up more If I new what was causing this.  Moreover, I am concerned that this chronic gastritis and acid reflux may increase my risk of cancer or lead to other more serious problems.  Thanks ANY advice or speculation you may have.

[Kevin Pho, MD]

Chronic acid reflux can lead to a change of the cells in the esophagus - known as Barrett's esophagus.  Barrett's esophagus is linked with esophageal cancer.  If you have chronic symptoms, you may want to consider further evaluation - an upper endoscopy would be the best test to see if you have Barrett's.  

If the diagnosis of reflux is still in question, you may also want to consider a 24-hr pH study to determine how severe the reflux is.  If anti-reflux medications are not improving the GERD, surgical intervention may be necessary.  

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.

Thanks,
Kevin, M.D.

[PAJ]

I speculate you have a yeast infection , yeast infections are endemic in fact specialist doctors blame  yeast for much of the illness that plagues the western world , I would agree having suffered for years [I know now] from the condition. Read my posts below

[yoshi]

fatigue and hoarseness,may be you should see a regular doctor.

[tessa0825]

Many times horseness is a symptom of reflux disease..It is usually associated with LPR (laryngopharengeal reflux). It usually occurs when you are refluxing all the way into your throat and vocal cords...It takes higher doses of PPIs to treat and for a longer time period than when you have reflux without LPR..There is a test to diagnose it, it is a 24 hr ph probe but instead of the usual one tube test it requires two tubes, one checking specifically for LPR...Standard GERD diets include giving up all caffeine, chocolate, citrus fruits, fried and fatty foods, mints, pepper, carbonated beverages, alcohol, smoking, all aspirins, and NSAIDS..I know alot of people who have also had to give up dairy products...The general rule is if you try something and it bothers you then try to stay away from it.....Tessa

[teresab]

About two years ago, I started having extreme horseness. It started developing into bronchial infections and frequent colds. I complained to my internist who suggested that I may be having anxiety. He suggested that because I have a stressful job (divorce lawyer) that this is how I deal with stress. While I agree that the job is stressful, this was not a high stress time. He suggested i try an anti-anxiety. I was furious. I called a friend of mine who is a pulmonologist who basically said anxiety does not cause horseness.............. We found out that I developed a severe type of GERDS and the acid was contaminating my airways. I started on Nexium, and Advair (inhaler). Go see a GI doctor right away. I developed asthma from my problem and wish I would have got on the ball sooner. Sadly, I too experience a nervous stomach and have developed IBS and am still battling the horrible symptoms of GERDS. I am not a candidate for the GI surgery but you might be. I can't get teh surgery because of my IBS. Good luck

[PAJ]

Here’s more evidence on yeast causing IBS…don’t you find it strange that the forum gastro doctor never mentions the possibility.




According to Professor Jonathan Brostoff (consultant physician, Middlesex hospital, London), there was evidence that "yeast" was involved in some cases of IBS, and some patients had reduced numbers of lactobacilli and bifidobacteria (so-called "friendly" bacteria) in their guts. Indirect evidence came from the use of tetracyclines, which, when added to a standard stool population, increased yeast production and reduced counts of lactobacilli and bifidobacteria.
Lactobacilli might induce immunological hormones, which could alter mucosal response in the gut, and there was some evidence that different grains, such as wheat, oats and rice, altered the gut flora to varying extents.

Colonic fermentation
Dr John Hunter (consultant gastroenterologist, Addenbrooke's hospital, Cambridge) said that there was evidence of abnormal colonic fermentation in IBS, which could be associated with food intolerance. A trial at Addenbrooke's had shown that colonic hydrogen production was higher in patients with IBS than controls, and the use of an exclusion diet reduced both gas production and symptoms. Future developments in the management of IBS might therefore be related to modification of gut flora and there was much interest in the potential role of prebiotics and probiotics in this area. However, a trial of oligofructose (a prebiotic) at Addenbrooke's had shown no therapeutic value in patients with IBS, he said.

[yoshi]

what about smoker and drinkers??

[teresab]

I am still searching for the Primal defense and can't find it around here. I am wondering whether it might have another name. My doctor told me that if you have yeast it shows on the colonoscopy and other than 2 polyps mine was normal. Did your test show yeast. If you did have a positive test what tests did you have. Thanks in advance for anwsering .

[PAJ]

Primal defence can be purchased off the internet ,that’s not an endorsement for the stuff ,I’ve never tried it. Yeast dosnt always show on a colonoscopy exam , red patches usually show. It’s thought that yeast being diamophic changes and literary digs in .
Due to the disgusting lack of support from the medical profession that is with the exception of my very much appreciated GP . I’ve been forced to diagnose and treat myself, unfortunately that’s normal with the condition. I’m symptom free after 18 months of Rx antifungal drugs  I’m left fighting a co-bacterial infection that looks like it’s a normal progression with long term yeast.
The biggest problem in proving the existence of Candida Related Complex in non-immune compromised people is that until very recently, there were no good tests for the condition. Everyone has Candida in his or her system and in small amounts it is harmless. It is only in larger amounts that Candida is harmful.
Therefore it is tricky to test for Candida. Simply showing that Candida is present in a person's system is useless. What are needed are tests that show how much is present in the system.
The IgA, IgG, and IgM are three tests which are somewhat reliable separately, and together have a good degree of reliability. The candida immune complexes test is even more reliable.

http://www.aal.xohost.com/candidacontent.htm
Organic acid testing [looking for metabolites of fungi]
http://www.greatplainslaboratory.com/test1.html

Keep this in mind it’s very much worthwhile taking this test.
,Over time it’s now known that we produce a lessening response to candida antigen.This is called an Anergy . There is a test called  Hypersensitivity allergy test It’s a medical fact that a healthy person will react allegically to Candida albicans,. Using a clinical test for normal immunity, the doctor injects a small amount of Candida yeast extract under the skin and observes for a raised, red allergic reaction. If that reaction does not occur, the patient is diagnosed as "anergic," meaning that the immune system is not functioning. In other words, the body will always react allergically to Candida yeast unless immunity has become paralysed or stressed-out. That fact proves that the presence of yeast in the body creates stress to immunity.
As an alternative to clinical testing you could try a trail course of Nystatin .I’t’s a very safe drug ,it will tell you if yeast is your problem although onlone it dosnt offer a cure . doses of 4 million units a day for a couple of weeks are not uncommon. [see the nystan trail article ]


"WITH THERAPEUTIC USE 1. Toxicity from orally administered nystatin is extremely low. Dermal application or ingestion of even large quantities should produce only minor GI symptoms. Treatment is usually unnecessary.".........."Laboratory: Nystatin is not well absorbed orally. Unless GI inflammation is present, blood levels should not be detectable. Therapeutic or toxic blood levels have not been established."........"Toxicity due to nystatin is negligible. Even when large amounts have been ingested, ensuing symptoms have been minor. Charcoal, emesis and cathartic should not be necessary."......."ABSORPTION...FROM GI TRACT IS NEGLIGIBLE, & DRUG APPEARS IN FECES. WHEN DOSES OF 8 MILLION UNITS OR MORE ARE GIVEN, INDIVIDUALS WITH NORMAL RENAL FUNCTION MAY HAVE PLASMA CONCN OF ONLY 1-2.5 UG/ML. ... NYSTATIN IS NOT ABSORBED FROM SKIN OR MUCOUS MEMBRANES. [Goodman, L.S., and A. Gilman. (eds.) The Pharmacological Basis of Therapeutics. 5th ed. New York: Macmillan Publishing Co., Inc., 1975. 1236]**QC REVIEWED**" http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~AAAnTaaFg:1

[kwag]

Primal defense can be found at health food stores probably not a GNC.  Go on the web at www.gardenoflifeusa.com.  You can order it.  I take it and I know many others that do to and It has been very useful.  It works better if you use the green superdood also and you have to have a good diet.  You ought to get the book Patient Heal Thyself and follow it.  It has excellent nutrition advice.

[ohio2]

I have had acid reflux and gastritis for over a year now.  I have used antacids, H2 blockers, and all the PPIs (protonix, prevacid, and now nexium).  I continued to have off-and-on bouts with heartburn and abdominal pain throughout this last year.  I even had an upper GI and an endoscopy in January which was negative for ulcers and negative for h. pylori.

However, just last week I went to the doctor for a different problem.  I had a pinkish rash on my shoulder, neck, and tailbone  (I had had the rash once before years ago).  Dr. said it was a fungal skin infection and prescribed Diflucan.  Since taking the Diflucan, my skin cleared immediately, but surprisingly, all my heartburn and abdominal symptoms have disappeared.

I am curious as to whether my GERD and abdominal pain were caused by fungus.  I have read that candida can cause gastritis in immunosuppressed individuals (I am not immunosuppressed, very healthy aside from GERD). If fungus can cause GERD and gastritis, why did no doctor of mine ever check or even consider fungal infection?