Hiatel Hernia & Prevacid

[Dana__0__0]

  28 yr old female in generally good health - started having severe acid reflux and heartburn at age 18 - had an upper GI at age 20 showing hietal hernia - put on then prescription Tagamet but could not afford so treated with over the counter antacids - problems have varied in intensity over the years but been manageable - within the past year symptoms have greatly intensified - have gone through 3 individual month long therapies for assumed ulcer using 30 mg Prevacid - during therapy all pain and discomfort allieviated but symptoms return within a month or so after stopping the Prevacid - just finished a second upper GI and show no ulcers - just a small hietal hernia and a small amount of reflux - when not on the Prevacid I have been taking over the counter Tagamet and Mylanta - up to 800 mg of Tagamet and 8oz. Maximum strength Mylanta per day and still not having total releif - is their any danger to using Prevacid for long term treatment? - any other disorders to check or tests that can be performed? - have fought this for 10 yrs and really would like a permanent allievation of symptoms - thank you for any imput
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Dear Dana,
In view of the persistence of symptoms and the poor response to treatment, I would suggest that you have an upper endoscopy with esophageal biopsy to verify the extent of esophageal damage and to exclude Barrett's esophagus.  Additionally, an esophageal motility study with 24 hour pH probe study will confirm that your symptoms are related to acid reflux and will quantify the sverity of reflux.  If   you do have acid reflux as the cause of your symptoms, surgery would be suggested.  A laparoscopic fundoplication should improve your symptoms. Any medical therapy would be a lifetime committment because symptoms would recur when medication is stopped. I would also suggest that you try lifestyle modifications (diet, stop alcohol etc)as has been suggested in other letters related to the treatment of esophageal reflux.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical concerns.
We would be happy to see you in the GI clinic if you would like a second opinion.  Dr. Zonca of the Division of Gastroenterology would be happy to review your records and to arrange the tests suggested above.  You can arrange an appointment by calling [phone]
HFHSM.D.-rf
*keywords: esophageal reflux
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