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GERD or stomach ulcer or acid reflux?

   Hello, and future thanks to anyone who will be replying to my post. I wrote down all i have been feeling yesterday, and it was a solid 2-3 pages, so i will do my best to quickly summarize how i have been feeling. A future thanks to anyone reading this, i know it's a lot more writing than you are probably used to reading, but i am absolutely miserable, and want to give as much information as possible to in the end, help you help me.

   A few months ago i woke from a dead sleep at 5 in the morning feeling very nauseas. I began to feel very shaky as well, and within a few minutes i was going through almost violent spasms of shakes while feeling nauseas. I took some ant-acids and waited to vomit, however that never happened. I eventually went back to bed. The next morning i was awoken again, however this time it was a severe burning sensation in my stomach and my back, directly behind my stomach. Immediately, i made an appointment to see my doctor.

   My doctor told me there were a few things it might be, the first being severe acid reflux that i had gotten literally overnight. Another would be the development of an ulcer, which would explain the burning in my stomach and back. The doctor gave me Protonix(Pantoprazole 40g) and told me to take one once a day. I decided to take it at night, to reduce my chances of waking up in the middle of the night again.

   I took this medication every night for 10 days straight, and eventually strayed from taking this medication religiously as i had been doing, as i was beginning to feel better. Since then i have woken up every so often to feeling the way i did the first night i woke up. Very nauseas with burning sensations, violent shakes, and in the end, never vomiting.

   This past few days have been very rough. My stomach has felt very gaseous, it feels like it's on fire, and i have a constant burning sensation in my mid-lower esophagus. I am also still very nauseas. It's very difficult for me to eat, and I have been eating very little at all. However i force myself to eat when i can, thinking that may be one of the main reasons i feel so awful, having eaten so little. Unfortunately, even after eating i feel the same way, if not worse.

   I am in a lot of pain/discomfort and it is a Saturday afternoon. My doctor is not open to see, and i do not feel that i need to go to the emergency room. I have the number for a gastrologist i will be calling to arrange an appointment with on Monday, to hopefully have my stomach probed via cameras down my throat so i can finally figure out what's going on. However, i would very much appreciate it if someone reading this post could relate with me, or even more so have a doctor or nurse tell me what they think. I've had a few panic attacks, not knowing whats wrong with me, and feeling on my own with no doctor office nearby being open.

A few things to note:

I am absolutely terrified of vomiting. I know many people dislike it, but i feel i may have a phobia of it. This is to note because i wonder if this is why i violently shake? Because i'm panicking that i am going to puke? I just thought i would mention it.

What i feel may be the most important part of this is that i have "waves" of nausea. It's difficult to explain, but basically i feel nauseas, it goes away, and the comes back and i feel more nauseas, then goes away again. This continues until i hit a "peak" in which i have cleaned the toilet and am waiting to vomit, so sure i will, and suddenly, the waves begin to calm down. I still have waves of nausea but instead of getting worse, they're becoming less until all i am left with is a burning in my throat and stomach, and "tiny" waves of nausea, as i call them. That being the same thing as i described above, however my nausea does not worsen, it comes and goes and is more annoying than anything else.

Finally, i am now taking 3 Protonix 40g a day. Two in the afternoon, one at night.

Again, i know this is a lot and i'm supposed to keep this post relatively short and to the point, however i feel a little bit of background history was important to understand what it is i am feeling, and hopefully help a doctor reach out to me and explain what it is i am feeling!

Thank you so, so very much.
4 Responses
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875426 tn?1325528416
Ah- a search using specific words- didn't even think of that! :0)
So, you may have a complex problem- low blood sugar and the burning pain from eating both?  Have you gotten a glucose monitor from the store and tested your blood sugar when you have an episode like this?

Did your doctor prescribe for you to take it three times daily, as that is more than the normally recommended dose, even for someone with Zollinger-Ellison syndrome from what I can see?  If not, I hope you are not compounding the nausea problem by taking too much medication.  You are right that pepto-bismol can make your stools black (and give a black coating on your tongue too) as well as taking iron supplements.  But if you are doing neither of these, it would be good to get occult blood stool testing.

Regarding the food recommendations, you are on the right track about bland foods.  Avoid dairy (except you might try activia yogurt or equivalent), spicy foods (obviously), fried foods and fruits and their juice that cause you to have an acidic burning reaction.  

For example, I have a problem with burning often with bananas, but pears seem a good choice.  I have interstitial cystitis (IC) in addition to GERD & was found to have some esophagitis and gastritis with an endoscopy study.   Some of the recommendations overlap for the two.  Pears are allowed on the IC diet and I think tends to be better with my GERD.  However, blueberries and honeydew melon, both allowed on the IC diet  have caused a flare in the burning acid in my stomach for me.  If I put the blueberries in vanilla Activia or eat them close together in timing, this helps with that one.  Sometimes I indulge in jarred peaches or even a white peach (which is less acidic than the yellow peach).  Rice is supposed to be easy to digest, so you might try some jasmine rice.  I use rice dream- vanilla flavored on my cereal now instead of soy milk or lactaid milk.  It didn't take long to get used to the change in flavor.  

You might keep a food diary of sorts for a while, writing down what you ate before you had another acidic flare so you can have a list of foods to avoid.  

You might also consider whether the anxiety itself is fueling your GERD and your nausea.  I was told by a dr. that anxiety can cause GERD to be worse.  I know it can also cause nausea.  I hope you will get your thyroid function tested to make sure a hyperthyroid isn't adding fuel to your panic attacks.

   Also, you may want to ask your GI doctor to test your blood for your gastrin level to try to rule out Zollinger Ellison syndrome, caused by a tumor that emits too much gastrin.  Rare and not a problem you'd want to have, you still will want to rule it out with their work up- at least I did.  But this would involve, I believe going off the medicine you are taking for quite a while for an accurate reading, so check with your doctor about doing the gastrin test or not.

Turned out my own gastrin was on the low end of normal- makes you think they still don't know or aren't explaining it well to patients all the ins and outs of GERD, since it is thought that acid is causing so much problem.  Why then does a person have enough acid to cause gastritis and esophagitis without much stimulation from the gastrin hormone?

By the way, I have an immediate relative with that phobia of throwing up who didn't do it for decades.  I don't have the phobia, though I don't think any normal person enjoys it!
Helpful - 0
Avatar universal
it seems someone is is having the same problem, I have been going out of my head for the past 5 days I have had the worse acid in my stomach feeling and its making me miserable.  I am on nexium and now the doc gave me another one to try, but this truly makes your life miserable, I hope I will be clear of it soon its never been this bad, I keep feeling I am having a heart attack but they assure me that its just anxiety.  I too suffer from emetophobia (fear of vomiting).  This will help with that  http://gutreaction.myfreeforum.org/    I hate this feeling it gets me so down :'((
Helpful - 0
Avatar universal
   Thanks for the reply. About the shakiness, I have only woken up to it a few times, and it's not usually the first thing i wake up to, it usually develops a few minutes into feeling extremely nauseas, which is why i am more inclined to thinking it is a panic attack. However i thought i would mention it in the post because maybe it's related to the other things i am feeling.

   And about the low blood sugar, i'm sure that's entirely what i'm feeling, however my illness has gone from: Feel nauseas -> Eat -> Feel better, to Feel Nauseas -> Eat -> Feel just as bad if not worse. I understand i should be eating multiple smaller meals throughout the day, are there any foods you would recommend in addition to basic bland foods? Such as toast and saltine crackers?

   I had not thought about pancreitis either, that's a very good point and thank you for bringing it up, i intend to do a bit more research on it more so than i already know. And to clarify, my stools are black however i'm not sure about tarry. I never really considered that could reflect as a symptom because i figured that was the medication making my stools a different color. Like Pepto Bismol does. I am currently taking Protonix 40mg 3 times a day. Specifically two pills in the afternoon, and one as close to 12 hours later as possible.

Finally, i put my search title as "GERD or stomach ulcer or acid reflux" because i figure anyone looking on this site would be using the computer function of control+f to open the find feature and people may either be typing in GERD or Acid reflux as i have heard different people interchange the two.
Helpful - 0
875426 tn?1325528416
First off, I'm not a doctor and I believe this was not a professional forum, but a community one, so you mightn't get a doctor's reply here.  But I'd like to share as a lay person with some nurse's training in my background.

Regarding your title- GERD stands for gastroesophageal reflux disease and means a person is having acid reflux, but you may just be trying to clue people in by saying "or acid reflux" in case they weren't aware of this?

While the shakiness can come from panic attacks, you might also get ruled out low blood sugar (hypoglycemia) which can make a person shaky, hyperactive thyroid (thyroid function testing) which can cause nervousness and tremor, and iron deficiency anemia, which can cause weak shaky muscles from lack of oxygen to them (ferritin, which are your iron stores is the best test for this).   Your almost violent spasms of shakes that happened after waking from a sound sleep description makes me think perhaps you also should have a neurologist test you to make sure you have not developed seizure activity in your brain.  And you might want to check your blood pressure when this happens to see if is normal as well.

Nausea too can come from panic attacks, but it can also be a symptom of GERD, what your doctor thought you might have.  Nausea and nervousness can be symptoms of low blood sugar.  I just saw something in an article that says nausea is because your body need sodium bicarbonate.  

I know I've had burning in the past where it hurt to eat and I was diagnosed with gastritis and told to be on a clear liquid diet for so many hours- I think 72.  I have since been diagnoses with GERD, but no ulcers were found with testing.  Your burning behind your stomach makes me wonder about pancreatitis, since the pancreas is located behind your stomach.

Re: a clue of whether you might have an ulcer while you are waiting for the GI doctor's diagnostic testing- are your stools black and tarry?  You aren't saying you are taking 40 of protonix times three are you?
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