Really worried. In constant pain :(

[BritishBeef]

Hi there. I'm new to this forum.

I've suffered from Acid Reflux for about 10+ years now and have been on various PPI's ever since.
At the moment (and for last couple of years) I am taking 40mg Nexium (Esomeprozole) daily. Ever since my reflux started it has been welll managed by the PPI's. If it started to return, a different PPI usually worked.

Since taking the Nexium I have had little issue with Reflux apart from the odd flare up - usually caused by alcohol and spicy foods which would only last 24 hours.

The PPI's have been so effective that I have been able to eat almost what I want, when I want.

However, over the last 2/3 weeks I have been suffering from bad Heartburn. This is unusual because I normally rarely get Heatburn. Normally, if my reflux is flaring up I get regurgitation of acid into my mouth and the sting of it coming up + the lump in throat sensation - I rarely get the symptoms of heartburn. This time though, it's mainly just heartburn with the lump in throat sensation and it's constant with no let up.

Prior to these few weeks of heartburn, I had been eating very badly and drinking more than usual too (probably for a good few months). I have been extremely stressed due to having an 8 month old daughter who has been suffering from (ironically) reflux and was up all night every night with a cough. This meant that I had hardly any sleep for months and no inclination to watch what I ate and I craved comfort foods. I ate a lot of take-aways and bad foods and coffee etc. and more alcohol than usual too.

So I can see why I may have induced this flare up. However, for the last 2 weeks I have eaten only the so-called 'Reflux-safe foods and zero alcohol or coffee etc. My concern is that my symptoms have not got any better since I drastically changed my diet. If anything, they seem worse. Everything I eat makes it worse. I can't sleep at night because of it, even sitting upright in bed doesn't alleviate the discomfort. I saw the doctor 2 weeks ago and he prescribed Domperidone to be taken as well as the Nexium but that isn't helping either. I have also tried the over the counter antacids too with no joy.

I have had 3 Endoscopy's in the last 10 years. The first one showed inflammation and a Hiatus Hernia, Second one also showed inflammation. My last one (Oct 2009) showed normal so all inflammation gone.

How long does it take for the body to reduce the acid levels after changing your diet to a reflux safe one? Should I be concerned?

Any help or advice appreciated.

[BritishBeef]

Hi Flycaster,
Thanks very much for your reply.
All of my Endoscopy's show the Hernia. I do not have Barretts - the Endoscopy just showed some inflammation. I will try and see the doctor this week sometime and ask for another Endoscopy.

I normally  take my Nexium every day at about 6.30pm and usually eat at about 7.30pm. Not religiously though so that could be tightened up.

My heartburn has eased over the last 48 hours. However yesterday I had the feeling of reflux coming up near my throat and all last night/this morning I have had a scratchy sore throat. It took a long time to get to sleep due to the sore throat and coughing.

I'm interested in the surgery but I saw a consultant before about it and he was unsure if they could do it on me due to scar tissue from an operation I had as a baby in that area.

[Flycaster305]

I had a huge change in GERD symptoms after a physically and emotionally challenging event, much like you have experienced.  A couple of questions:
You have had three Endoscopy studies.  Do all three confirm a Hiatal Hernia?  Also, by inflammation, are you referring to what is called Barrett's Esophagus?  
In my case, the LES valve simply quit working and acid was washing up and down my esophagus.  It eroded my vocal chords, and also started to remove the enamel off my teeth.  I had the Nissen Fundoplication surgery with great results.  
You have gone back to a careful diet, are taking all the good drugs, and GERD symptoms remain.  I'd suggest talking to your doctor about another Endoscopy.  Your last one was two years ago, a lot has changed.
My mantra regarding PPI meds is to take them EXACTLY as prescribed.  The science is clear, if they aren't taken 1/2 to 1 hour before eating a major meal, they won't help a bit.  For example, taking them at bedtime just creates expensive urine.  
Hope that helps, and best wishes.