pH monitoring

I went to a new GI specialist yesterday, doubled Nexium to 80 mg daily, and 20 mg of baclofen to control cough.  The other option that was suggested was to repeat an endoscopy and do pH monitoring.  I was on info. overload and should have slowed the dr. down, but opted for another try at meds instead of the scope.  If I have not responded to drug therapy to control reflux during the past 3 or more months is there reason to believe that this will work?  Does anyone else use baclofen for similar reasons and with any success?

[boron]

What is your original problem? Acid reflux?

If you aspirate acid into lungs, and then take baclofen to control cough, this is a gross mistake, since this only masks the original problem - aspiration.

But you should explain the history of your problems a bit.

[giupset]

The original problem is acid reflux with a hiatal hernia.  This was diagnosed about 2 months ago with an endoscopy.  The doctor performing the endo. suggested that bile reflux was probably the cause of most of my discomfort.  The GI specialist spent lots of time listening to my lungs before prescribing baclofen.

[boron]

Are you coughing, do you have problems with breathing? I don't see the reason for baclofen. If you aspirate acid into lungs, tthen reflux should be treated, I personally don't see the reason for backlofen, well, he is GI, and I'm not.

[Lori707]

Seriously...Get yourself to another doctor for a second opinion now. AND..get that scope. You don't feel it because you're put out. Once, many years ago I was awake and it didn't bother me. They sprayed something in my throat which numbed it and gave me dedatives by I.V.

[giupset]

Thanks for the info.  I have coughing spells a couple of times a day that are severe.  They cause me to leave meetings and sometimes my classroom (I teach).  Today was not great because I was outside with kids all day in the cool air and wind.  My dr. explained that the baclofen is an antispasmodic med. and that my cough is easily triggered by a current state of hypersensitivity.  Even though he said it wouldn't make me feel drowsy, it is.  I'm not afraid of another scope, first one went well, had endo. and colon. done at same time.  I was just looking for less time lost from work and a quick start on treatment that might make a difference.

[boron]

Eventual hypersensitivity should be determined by allergiologist or a lung specialist. You either have an asthma, or an allergy to CERTAIN substance, pollen, drug, food. It is usually one substance, one drug..., you can have skin tests for each suspicious substance. But I'd say you have problems with aspiration of acid. You maybe need a bronchoscopy to check this. Again - I think baclofen is only masking your problem with acid, you should solve this aspiration.

In ongoing problems with hiatus hernia /reflux /lungs, an operation of hernia is an optiuon.

[giupset]

Thanks.  I cut the baclofen to 10mg before bed because it was making me too drowsy.  This of course causes me to cough more during the day.  I woke up a few times during the night choking even though I was sleeping almost upright.  I plan to call the dr. to let him know that I have concerns about the baclofen.

[boron]

There was nothing said about Helycobacter pylori here. This is the most common cause of gastritis, so you should have a breath test for H. pylori. H. pylori infection is the main reason why anti-acid drugs fail.

I'm not against baclofen just like that. Question is what is an original problem here, and I suspect it is aspiration of acid into your lungs. Especially, if your cough is worse at night, when you're lying down.

Your basic concern should be how to control acid reflux and especially this acid aspiration.

So, have a breath test for H. pylori; if positive you get antibiotics.