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Unexplained Stomach Acid
Dear Doctors/Professors

My reflux problem started approx 4 years ago.

I did a juice based diet and then shortly after I would experience burning only in the stomach area nowhere else. It didn't travel up the Oesophagus at all.

The treatment method was and is still Nexium 40. I take 1 Nexium 40 every 3 days and then obviously repeat this as the stomach acid returns.

Now during these 4 years I have gone for the following tests to rule out anything sinister My tests are as follows;

2009 Endoscopy - Clear no abnormality found.
Biopsy Normal
2010 Colonoscopy - Clinical Notes were ( Mucosal Erythema terminal ileum) that was explained to me as slight inflammation within normal limits. To back this explanation a biopsy was performed to rule out crohns colitis etc. Everything came back normal.

Follow up 2 Years later

Endoscopy : Notes as follows A small sliding Hiatus Hernia <5cm. Biopsy Normal
Barium Test missed that but the endoscopy got it.

Self treatment methods

I have lost 25kg.
I tried a naturopath with certain pills to beat the acid, it worked for 5 days then the acid returned. So back to nexium.

I have tried everything you can imagine, I have read every article on the internet about what foods to avoid yoga etc everything. This reflux returns no matter what I do. I have discussed with my doctor and he assured that there is nothing there and that it is safe to take Nexium. Also I quote 'it is good that Nexium relieves the symptoms'. Those were his words of wisdom.

My goal would be to eradicate Nexium and eradicate this chronic stomach acid.

In your opinion what is left for me to do, I do not want to burn my stomach lining, I don't want to be at risk for stomach and bowel cancer.
What can I do to beat this unexplained returning stomach acid. Again the burning is contained to the stomach area only and does not travel upwards.
Please advise as this acid is not Food related, What can I do???
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2 Answers
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4610897 tn?1393869202
Hello. Thank you for your question regarding gastroesophageal reflux disease (GERD).

In regards to treatment with Nexium, a regimen of once every 3 days is usually not effective. I recommend proton pump inhibitors (like Nexium) to be given daily, preferably 1 hour before breakfast or lunchtime meal DAILY.

In regards to lifestyle changes, which are often very effective, I recommend the following:
1.Elevate the head of your bed (with a brick or an adjustable bed) to > 30 degrees.
2.Avoid fatty foods/peppermint/chocolate/onion/garlic/alcohol. These are known GERD triggers.

I congratulate you on your weight loss and the knowledge you have acquired on this condition.

Antireflux surgery should be considered after medications have failed. That is, failing once DAILY high dose PPI or twice DAILY PPI (like nexium). This does not sound to be the case. However, some patients elect to have surgery to eliminate need for medications. This surgery, however, does not guarantee cure. There is a fair amount of patients who still need medications after the surgery and a significant amount that require a second operation, if this first surgery fails. I recommend you discuss this option with your surgeon, but my guidance to patients is to give once or twice daily regimens a try before thinking about this. In addition to a PPI, a H2 blocker like Zantac can be added.

Although you have had an endoscopy before, it was quite some time ago. I recommend you ask your physician to be tested for peptic ulcer disease (ulcer) if your symptoms continue despite 4-8weeks of twice daily PPI therapy.  

In summary, I recommend:
1.Talk to your physician/gastroentertologist about once or twice daily Nexium therapy for 4 to 8 weeks
2.Talk to your physician about surgical options for GERD, to include antireflux surgery
3.Talk to your physician about testing for peptic ulcer disease with an endoscopy if medication fails for 4 to 8 weeks.

Dr. S
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Avatar universal
I have spoken with my doctor numeous times about the subject.

He instructed to take nexium and not worry about surgery as it very dangerous and you are prone to infections. His theory is that if you can relieve symptoms by taking nexium then simply leave it.

My concern is that long term Nexium use is going to affect me in some way.

I would like to correct this problem as I dont even know why it started.

As for the Peptic Ulcer it was checked in Biopsy and nothing was found.

Most importantly have you ever heard of cases like mine where no matter what they did stomach reflux would return??

Much appreciated with your response.

Im just trying to beat this naturally first than if I must and there is no other option go to surgery.

Thanking you in anticipation.
Discussion is closed