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Avatar universal

GERD nausea last 10 months ?

I ended up vomiting from what I thought as bad food back in January. I had persistent nausea mild nausea for about a month ended taking aciphex which subsided the symptoms but not eliminate them.  After having some burning sensation in my stomach it was recommended I have all GI tests done endoscopy, upper GI, barium, abdominal CT  scan which all turned up negative.  The only thing then that came out of the tests was acid reflux. Well after 10 months the mild nausea is there still.  I tried everything prilosec maalox dlg prevacid zantac and nothing seems to really help with the issue though I do feel slightly better after taking the above medications except for prevacid.  I have taken the prevpac and prevacid both seem to cause additional issues or make matters worst.  Two questions one is it normal to have slight nausea with acid reflux and two after diet sleep change etc is there anything else I can do to help.  Went to see a GI specialist last week he seems to think its all mental I have been under a little pressure at home and work and was wondering if anyone out there can concur.  The symptoms have been around the last 10 months and I am just trying to find something that works.  
5 Responses
Avatar universal
One other thing I noticed has been mucus in my stool something I have not noticed before.  
1728693 tn?1332168862
Have you tried Gravol (Dramamine, Driminate, Gravol, Gravamin, Vomex, and Vertirosan) for the nausea?

From medicinenet -

Nausea is uncommon in GERD. In some patients, however, it may be frequent or severe and may result in vomiting. In fact, in patients with unexplained nausea and/or vomiting, GERD is one of the first conditions to be considered. It is not clear why some patients with GERD develop mainly heartburn and others develop mainly nausea.

What is a reasonable approach to the management of GERD?

There are several ways to approach the evaluation and management of GERD. The approach depends primarily on the frequency and severity of symptoms, the adequacy of the response to treatment, and the presence of complications.

For infrequent heartburn, the most common symptom of GERD, life-style changes and an occasional antacid may be all that is necessary. If heartburn is frequent, daily non-prescription-strength (over-the-counter) H2 antagonists may be adequate. A foam barrier also can be used with the antacid or H2 antagonist.

If life-style changes and antacids, non-prescription H2 antagonists, and a foam barrier do not adequately relieve heartburn, it is time to see a physician for further evaluation and to consider prescription-strength drugs. The evaluation by the physician should include an assessment for possible complications of GERD based on the presence of such symptoms or findings as:

    cough,

    asthma,

    hoarseness,

    sore throat,

    difficulty swallowing,

    unexplained lung infections, or

    anemia (due to bleeding from esophageal inflammation or ulceration).

Clues to the presence of diseases that may mimic GERD, such as gastric or duodenal ulcers and esophageal motility disorders, should be sought.

If there are no symptoms or signs of complications and no suspicion of other diseases, a therapeutic trial of acid suppression with H2 antagonists often is used. If H2 antagonists are not adequately effective, a second trial, with the more potent PPIs, can be given. Sometimes, a trial of treatment begins with a PPI and skips the H2 antagonist. If treatment relieves the symptoms completely, no further evaluation may be necessary and the effective drug, the H2 antagonist or PPI, is continued. As discussed previously, however, there are potential problems with this commonly used approach, and some physicians would recommend a further evaluation for almost all patients they see.

If at the time of evaluation, there are symptoms or signs that suggest complicated GERD or a disease other than GERD or if the relief of symptoms with H2 antagonists or PPIs is not satisfactory, a further evaluation by endoscopy (EGD) definitely should be done.

There are several possible results of endoscopy and each requires a different approach to treatment. If the esophagus is normal and no other diseases are found, the goal of treatment simply is to relieve symptoms. Therefore, prescription strength H2 antagonists or PPIs are appropriate. If damage to the esophagus (esophagitis or ulceration) is found, the goal of treatment is healing the damage. In this case, PPIs are preferred over H2 antagonists because they are more effective for healing.

If complications of GERD, such as stricture or Barrett's esophagus are found, treatment with PPIs also is more appropriate. However, the adequacy of the PPI treatment probably should be evaluated with a 24-hour pH study during treatment with the PPI. (With PPIs, although the amount of acid reflux may be reduced enough to control symptoms, it may still be abnormally high. Therefore, judging the adequacy of suppression of acid reflux by only the response of symptoms to treatment is not satisfactory.) Strictures may also need to be treated by endoscopic dilatation (widening) of the esophageal narrowing. With Barrett's esophagus, periodic endoscopic examination should be done to identify pre-malignant changes in the esophagus.

If symptoms of GERD do not respond to maximum doses of PPI, there are two options for management. The first is to perform 24-hour pH testing to determine whether the PPI is ineffective or if a disease other than GERD is likely to be present. If the PPI is ineffective, a higher dose of PPI may be tried. The second option is to go ahead without 24 hour pH testing and to increase the dose of PPI. Another alternative is to add another drug to the PPI that works in a way that is different from the PPI, for example, a pro-motility drug or a foam barrier. If necessary, all three types of drugs can be used. If there is not a satisfactory response to this maximal treatment, 24 hour pH testing should be done.

Who should consider surgery or, perhaps, an endoscopic treatment trial for GERD? (As mentioned previously, the effectiveness of the recently developed endoscopic treatments remains to be determined.) Patients should consider surgery if they have regurgitation that cannot be controlled with drugs. This recommendation is particularly important if the regurgitation results in infections in the lungs or occurs at night when aspiration into the lungs is more likely. Patients also should consider surgery if they require large doses of PPI or multiple drugs to control their reflux. Still, it is debated whether or not a desire to be free of the need to take life-long drugs to prevent symptoms of GERD is by itself a satisfactory reason for having surgery.

Some physicians—primarily surgeons—recommend that all patients with Barrett's esophagus should have surgery. This recommendation is based on the belief that surgery is more effective than treatment with drugs in preventing both the reflux and the cancerous changes in the esophagus. There are no studies, however, demonstrating the superiority of surgery over drugs for the treatment of GERD and its complications. Moreover, the effectiveness of drug treatment can be monitored with 24 hour pH testing.
Avatar universal
I looked at this article about 10000 times over the last 10 months wondering if I had associated symptoms.  At one point or another iI have had the symptoms but my biggest issue has been the constant very mild nausea and burning sensation.  To be honest I have had a few hours relief when drinking smoothies or slushy iced drinks.  I have meet with a gi doctor besides having all the other tests and they believe its stress related.  Any other advice is more then welcomed.

Thanks
Avatar universal
I also have Acid reflux with my primary symptom being nausea.  This has been going on over a year.  All my tests came up clean. I am doing much better than I was last year.  Diet change has helped me the most. What kind of diet changes have you made?
Avatar universal
I have cut out drinking which was something I did frequently and went over board during the weekends.  I used to be an avid coffee drinker 2 cups a day sometimes more all depending on what type of mode I am.  My coffee consumption now is about once a week and on those days the symptoms are definitely more.  My primary diet is chicken and or fish with red meat maybe once a week.  Lots more fruits and vegetables the fruit that makes me feel the best is watermelon, also for some reason cold drinks such as a slushy or fruit smoothies pretty much eliminates the symptoms for a couple hours after consumption.  I did go over board a little last week and this week and paid the price heavily last week.  Just lost I normally do not feel like this and just trying to find a cause.  I have been on so many forums boards looking for answers and think its crazy that so many people are in a similar situation.  I have an appointment schedule with another gi in   November just for him to see what he thinks.  From all the tests that I have done and each being negative besides showing the acid reflux in one everyone says its in my head, also a friend of the family thats a physician said that based on the tests you should be fine.  A friend of the family said they had a similar situation and found they had a food allergy.  I do find that low carbs make me feel better.  Just lost for thought and wondering if any one can provide a solution.

thanks
Thanks,
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