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GERD (Acid Reflux) Community
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Avatar universal

What else could it be?

For 5 months I’ve experienced severe acid reflux. The cause does not seem to be lifestyle (my doctor has said this is “clearly not lifestyle related”) and symptoms are not managed through lifestyle changes. Medication seems to work intermittently. Losec worked for a few weeks, then stopped working. I’m now on Nexium. It took about two weeks to kick in, worked well for about a week and now symptoms seem to be coming back. Supplementing with Tums, Gaviscon, Pepto Bismol, etc. has limited to no effect.

An endoscopy showed nothing out of the ordinary (no hiatial hernia, no esophageal erosion, etc.). The doctor said that the “valve was tight”. An H-Pylori blood test was negative. A gastrin blood test was within normal range. I asked the GI specialist if this was “GERD”, she said “I don’t think we can call it that”. I don’t seem to have any motility issues.

Despite extreme vigilance in adhering to medication protocols (i.e. 30 minutes before eating, same time every day) and lifestyle, I continue to experience symptoms. The symptoms make it hard for me to work, sleep, eat and enjoy life.

I am an otherwise-healthy 37 year old woman with no children. I am 5’5” and 108 pounds. I have no other health issues and am on no other medication aside from the Nexium. I walk daily and eat extremely well (no coffee, tea, alcohol, pop, chocolate, processed foods and any known heart-burn triggers). I sleep with my bed elevated. I don’t lie down within 3 hours after eating.

What else could this be? How am I supposed to manage something for which there appears to be no known diagnosis, cause or cure?
3 Responses
Avatar universal
Well, I never did get a reply. Turns out I have Celiac disease.
Avatar universal
Hi,
I went through your post.

You have just mentioned that you have severe acid reflux. You have not mentioned what symptom you actually have - whether it is heartburn, regurgitation, chronic cough, feeling of lump in the throat.
Going by the description you have given, I assume that you have heartburn that is not responding to PPI medications and lifestyle modifications.

In these circumstances, a 24 hours pH monitoring test should be done to see whether you actually have acid reflux.

I would like to add that heartburn could be due to other causes as well like a bile reflux or an eosinophilic esophagitis. The treatment for bile reflux is slightly different from acid reflux. Eosinophilic esophagitis though common in children is reported in adults also.

You have mentioned about a tight valve. Did you try to mean a normal valve? Because a tight valve can indicate a condition called achalasia cardia which very rarely can cause heartburn ( difficulty in swallowing is the more common presentation in achalasia cardia).

Celiac disease does not cause heartburn.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar
Avatar universal
I thought it would be interesting to post an update. After aggressively seeking more diagnostic tests, my doctor had me undergo an endoscopy. It showed signs of celiac disease. Shortly thereafter, I had a blood test to confirm the diagnosis. I have been gluten free for a year and am 100% back to normal (but of course, will have to maintain a strictly gluten free diet for life). Because my symptoms were not "classic" celiac disease symptoms, it was by sheer luck (and by being a strong advocate for myself) that I got the diagnosis. I hope this information helps someone else!
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