Treatment options for Acid Reflux

[MountainReader]

I'm a 42 year old female.  Fairly healthy.  I've been diagnosed with GERD since 2002.  I had it under control with low-dose PPI's, diet changes and lifestyle changes until 2006.  For the next couple years, I was diligent about my diet, lifestyle changes and taking my prescriptions which included taking high-dose PPI's twice a day (Prevacid Solutabs, Nexium, Protonix, Prevacid, Zegrid, Kapidex, Aciphex, etc....) and supplemented with Gaviscon or Zantac.  I was also on Advair 500/50 and Singulair.  My symptoms were a harsh chronic cough and difficulty breathing/severe asthma.  Testing (Barium Swallows, Esophagram, Manometries, pH tests) showed my refluxing was extremely severe (getting worse) and that my LES wasn't functioning properly.  After some life-threatening breathing incidents despite treatments, I ended up having a Nissen Fundoplication.  I considered the surgery successful since I was able to get my breathing back under control and my coughing stopped.  I've stayed on my Dexilant daily since the surgery though.  I've had several EGD's and a Barium Swallow that show the wrap is holding.  My most recent EGD was last December and came back 'normal'.

I'm frustrated now though.  I had about 4 months of problems (coughing and breathing issues) last winter that were attributed by my doctors as acid reflux and confirmed through pH testing.  I've been doing better until a month ago.  I started having heartburn about 5 days a week.  I'm on samples of Dexilant twice a day, but it isn't covered by insurance at that level and I'll be back to once a day in a week.  I'm also supplementing with Gaviscon.  I'm careful with my diet, sleeping on an incline with my headboard propped 6 inches, not eating 4 hours before sleep, etc...  I've been to see a Gastroenterologist and am monitored every 3 months by my Pulmonologist.   I also regularly see my ENT.  My Pulmonologist made a comment a couple months ago that my wrap is 'tight', but my GI doc who does my EGD's has never said anything about it and I haven't noticed any issues swallowing.

Are there any other options for my acid reflux treatment?  Right now, my breathing is OK, but so frequently it eventually leads to severe breathing  problems when it persists.  I'm willing to try other treatments.  Are there questions I should be asking my Gastroenterologist, ENT, Pulmonologist or Primary Care doctor?

[selmaS]

  There are soooooo many meds that can trigger a flare and I know for me even big weather changes can affect me....but as u learn the triggers u can work around them and effect the symptoms to calm so much better.....

hang in there : )

[MountainReader]

Thanks Selma.

I took Meloxicam for a couple weeks when I developed some tendonitis issues.  Based on conversations with my doctors, I think it was the NSAIDS that triggered this flare.  I haven't taken any NSAIDS for over 3 weeks now, but unfortunately I'm still having the symptoms.

You are right about stress being a factor though.  

[selmaS]

  Hi and welcome to the GERD forum.

I have not had this procedure, and I know there are both good and bad outcomes, and I am sure a member that has had this surgery will post soon.

May I ask, have u had an increase of stress recently? Just wondering if that is affecting how u feel?

Praying u feel better soon <3