Hiatal Hernia and Acid Reflux???

I was diagnosed, almost a month ago, with a hiatal hernia and acid reflux based on symptoms alone (no tests). I was prescribed Carafate 4x per day for 3 weeks and told to take Prilosec OTC once a day. After 2 weeks and no improvement my doctor prescribed Nexium which I've been taking for 2 weeks and still nothing has changed.

My symptoms are my abdomen is tender to the touch from my breastbone down to my belly button. My chest aches and I feel like I can't completely take a deep breath. I have some tenderness on the right side below my ribs. Also, I burp all the time and often have a hiccup then burp, it's weird. I hadn't had heartburn but after taking the medicine I've been feeling a slight burning sensation in my chest and a sense of warmness up to my throat.

I've been having stomach issues since August of last year after somewhat drastically changing my eating habits. I gave up fastfood, soft drinks, and sweets. Prior to this I'd probably been eating fast food 5 times a week if not more.  Since June of last year I've lost almost 50 pounds only to start having problems.

October to November I had 3, what I know question if they were, gallbladder attacks. It was the most intense pain I had ever experienced in my life and each time I was at the point of about going to the hospital. I thought one of the times that I was for sure going to die and had the phone about to call for an ambulance. The pain was from my breast bone area to an inch or two above my belly button and radiated to my back and I had right side tenderness. An ultra sound revealed one small gallstone so I ended up having my gallbladder removed in December and yet I'm still having problems.

How long does it take to see improvement when starting to take a PPI?
Do my symptoms sound like they could be related to reflux?
Could my change in diet and the weight loss somehow triggered this problem?
Could it not have been my gallbladder but acid reflux causing the attacks I had?

[Elliot R Goodman, MD]

PPIs should work in 2-3 days
These symptoms could be reflux - esp if they go away with PPIs
Endoscopy, pH and manometry could clinch reflux diagnosis
Dietary changes and weight loss should help GERD
Quite possible GERD was the villain all along
Good luck