Digestive Disorders / Gastroenterology Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

GERD Chronic Reflux

I am a 32-year-old male diagnosed with Acid-reflux and reflux related asthma in June 2004.  The medicine I take for Asthma is Advair (250/50) once every 12 hours and Aciphex 20mg for my reflux.   I cannot get my reflux under control.  In addition to refluxing in my lungs, I experience tightness in my throat right around my Adam
32 Responses
233190 tn?1278553401
Long term acid reflux can lead to what's known as Barrett's esophagus - which is a risk factor for esophageal cancer.

You can consider a 24-hr pH study to quantify the degree of reflux.  If medications like Aciphex are not helping, an upper endoscopy or upper GI series can be done to determine if there has been any damage to the upper GI tract, or if Barrett's esophagus is developing.

Surgical options (i.e. a Nissen fundoplication) can be considered if conservative measures are not working.  A referral to a GI specialist, or surgeon, can be considered for further discussion.

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.

Kevin, M.D.
Avatar universal
There is a surgical intervention for GERD that you may want to discuss with your gastroenterologist. It is called Nissen Fundoplication, and can be done laparoscopically these days, which lessens pain and recovery time, and precludes the need for the 9 inch incision from your sternum to your navel that open nissen fundoplication involves.

It usually takes a while for GERD to lead to Barrett's Esophagus, if at all, and from there to Dysplasia or esophageal cancer, which are even less common maladies. You should have time to work with your Primary Care Physician and Gastroenterologist to explore your options thoroughly before committing to surgery.

Good luck,
Chicken Soup
Avatar universal
I can certainly relate to your misery. Fasting was a good idea. What kind of a fast was it? Acid reflux does not disappear overnite and many medicines do not work and sometimes cause more problems. You need to find the cause of your acid reflux. Systemic yeast is often a problem for reflux sufferers. I would suggest you start with your colon by doing a good colon detox. Drink lots of pure water and make sure your bowels move frequently. I would also suggest a good yeast fungal detox, Garden of Life Fungal Defense is excellent and it only takes 2 weeks. Digestive food enzymes are essential for those of us who are reflux sufferers. You must have acid and enzymes to digest your food. Chiropractic is also a good idea. You may have an entrapped nerve leading to your digestive tract.Start with one thing at a time. You must be patient and let your body heal naturally. Check out your local herb shop or GNC for help. Good luck.
Avatar universal
Please be very careful about entrusting a clerk at GNC that is paid $7/hour with your health, as suggested above.  The "detox" and GI cleansing remedies some recommend have been around for a while as part of "alternative medicine".  You can generally read more about them on Quackwatch.com.
Avatar universal
I would consider switching therapies, if I were your physician.  I think you should definately consider this option.

Have you tried any other PPI therapies?  I'd try Nexium -- 2x/day if necessary to alleviate the symptoms.  It should take no more than 5 days to reach maximum efficacy with any PPI therapy.

Partial fundoplication could also be an option -- but usually insurance companies never like to pay for this procedure.  
Avatar universal
Well, if I was taking a bunch of medication that wasn't working I think I'd go for a harmless detox. Tell Dr. Dan Colbert he's a quack since he's helped so many with his "Toxic Relief" books. Just because traditional medicine doesn't recognize detoxification as valid doesn't mean it isn't. As soon as doctors and pharmaceutical companies start curing people with their drugs then maybe I'll sing a different song. I have been in the same boat as everyone on this forum with gastro problems, so I speak from experience. I never suggested you take your health into a store clerks hands, your health should be in your hands making an informed decision about everything you do. I suggest to everyone what has worked for me. Whether you decide to try it is up to you, but name calling isn't necessary. I am far from being a quack as you suggested, just someone who doesn't suffer from acid reflux anymore.
Avatar universal
Hey astros18,

first and foremost, i'd like to say that as a practioner that i'm more than willing to learn about any type of medicine that is willing to cure any patient that might have an ailment.  one of the problems (that maybe you can help me with) - is that it's very hard to find conclusive, peer-reviewed scientific studies that support the use of alternative therapies.  additionally, the FDA no longer regulates the labels that are placed on "supplement" products - thus allowing supplement companies to print whatever they'd like without the support of any body of peer-reviewed scientific evidence.  that said, i can clearly say that in some cases alternative medicines are truly the best form of therapy.  if there is anything that i've learned in my years of practice - it's that there isn't a therapy that works for everyone and for everything.  any clinical trial that's published has a percentage of people that are cured by placebo ... this is a powerful mechanism and a true testament to the healing power of the body itself.

that said ...

specifically in terms of GERD ... refluxation is usually caused by a weakness in the lower esophogael sphincter that relaxes allowing acid from the stomach to push into the esophogus.  when patients are given a ppi therapy -- they are still refluxing, but with the therapy they are not damaging their esophogus (which, as you know, can lead to many diseases including adenocarcinoma) as the pH in the stomach is neutralized (additionally, the symptoms are relieved). when patients do not receive adequate relief from ppi therapy -- a procedure such as a nassin fundoplication could help.  sometimes not even that works.  sometimes reflux can be caused by stress, anxiety, and/or depression.  it's a very gray area -- but i can say that of all of the patients that i've treated, that there are very few who have not benefitted from ppi therapy, h.pylori eradication with ppi maintenance therapy, or ppi + h2 blocker therapy.
Avatar universal
Thank you for your thoughtful response, and for moving the discussion back in to the 21st century.

Best regards,
Chicken Soup
Avatar universal
Thank you all very much for you time and thoughtful responses, I do appreciate your help.  My father passed away almost two years ago from bladder cancer.  It was a very traumatic experience for me.  He suffered a great deal and I helped my mom in taking care of him.  I took two months off from work because, I had Plantar Fasciitis and she needed help with taking care of my father.  It was during that time around May 2003 I started to develop a cough.  I first noticed I would cough when I spoke to my mother on the phone then it seemed to progress to coughing in the morning to coughing after meals and bowel movements.  I experienced bouts of constipation were I felt bloated and a little nauseous after bowel movements.  At times, I would experience anxiety while trying having a bowel movement and I would not be able to bear down and push my stool out.  I would experience a sensation of having to move my bowels, then when sitting I would feel the sensation of losing my grip on the stool.   Since that time my gastro doctor put me on a high fiber diet including benefiber three times a day.  It helps a great deal.  I occasional have difficulty with the constipation I described but I think it has gotten much better.  I work with a physiologist twice a week that has helped me thought a great deal of stress I have experienced in these past years.  I have known myself to be a sensitive individual with a sensitive body.  I know I also have a great deal of anxiety I deal with on a day-to-day basis.  I have a tendency to over focus on my ailments and it will make the symptoms worse.  At times alternative therapy has helped when it came to insomnia.  I was addicted to prescription sleeping pills and sedatives for over five years and I was able to stop several months ago.   I now will use valerian to sleep and breathing exercises to relax.   This morning I tried Nexium and it seems to work better.  I have to add that the 1st response from Chicken Soup seems to ease some of my anxiety.    I had a gastric empting test in Jan 2005, conclusion, and a very slight delay in empting.  An endoscopy around that time that concluded, gastritis, esophagitis, Duodenitis.  I had an incomplete colonoscopy because I experienced an intestinal spasm, which caused a lot of pain.  They did find one pre-cancerous polyp in the rectum.  I am going to get a full colonoscopy in September so they can check the right side of the large intestine.  I tried the 24-hour monitoring device but I was unsuccessful.  The tube that they use to insert in the nose caused me to gag and dry heave so they had to removed it within minutes of pulling it in.  The doctor did not think it was a good idea to use the other device that they attach during an endoscopy due to how sensitive I was.  To answer the question about the fast, it was a juice fast recommended my Dr. Andrew Weil.   Thank you all again.
Avatar universal
I really feel for you.  Losing the weight and the work out is so frustrated and it freaked me out.  In addition to changing my gastro doctor and switching to Nexium, I have found a good source on-line that I found for alternative health, Dr Andrew Weil.  Since you were into lifting what sounds like heavy weights you should inquire with you doctor about a Hiatal hernia.  It is a difficult hernia to diagnose, but it may be worth your time to check it out.  
Avatar universal
Thanks, I have suspected a hiatal hernia since the beginning, as I have many of the symptoms/complaints related, but it seems like my Upper GI didn't show anything in June, so I don't have one.  These doctors act like these tests are bulletproof in diagnosing, and conversely, ruling out, diseases and conditions.  Also, my condition seems to have changed since June, mutated if you will.  I didn't have pancreatitis back in June, but now I do, or "mildly elevated" enzyme levels.  Like since nothing is standing out, only watching and waiting will do for these doctors.

Good luck in your treatment
Avatar universal
Are you my long-lost twin?  You sound exactly like me.  I'm 31/m whos been working out since I was 16.  I got up to 175 and muscular.  In June I was hit with reflux, bad-woke up gagging one morning from the reflux.  Since June I've had just about every test you can have.  Still no solid conclusion.  Now I have a constant gnawing pain in my upper center abdomen, below sternum.  Doctor told me today that since the tests don't show anything, to just come back in 3 months.  I'm concerned that something is wrong and to wait is just letting it get worse.

Historically, I would workout and do heavy deadlifts, 420lbs+.  Felt great emotionally, but I think something eventually "broke".  In the recent year, I would do them and it would feel like something was coming up into my throat.  After lifting, the water I drank would go down very slowly, like something was blocking it.  The doctors I've been to haven't even acted like they heard what I said about this, and I'm thinking I need a sports medicine doctor?

I'm now down to 130lbs and struggling to maintain that.  I haven't been able to workout because of this.  I'm just praying that I have to let it run it's course and I'll be back to my healthy ways.  

Don't eat right before going to bed, as I did!
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Learn which OTC medications can help relieve your digestive troubles.
Is a gluten-free diet right for you?
Discover common causes of and remedies for heartburn.
This common yet mysterious bowel condition plagues millions of Americans
Don't get burned again. Banish nighttime heartburn with these quick tips
Get answers to your top questions about this pervasive digestive problem