chronic gastritis and severe reflux for over a year....help!

[sue]

I am a 27 year old Canadian woman who has been living and working in Japan for the last 2 1/2 years.  For the last year and a half I've been having a lot of problems with gastritis and reflux and I can't seem to get rid of them.  I first noticed the symptoms last year when I felt a terrible burning in my stomach and had a lot of belching and heartburn after I ate.  I had an upper GI X-ray done and there wasn't anything wrong except for excess acid production.  I was given Zantac to take twice a day (75 mg at a time).  It seemed to help at first, but then a few months later the symptoms got worse.  I had an endoscopy done about 10 months ago and I was diagnosed with having gastris and some acid reflux. I was also tested for H-pylori at that time, and the results were negative. I was given famotidine (20 mg twice a day), but then when that didn't help I was given lansoprazole (30 mg after evening meal).  I took lansoprazole for about 6 months and it seemed to be helping, but in the last couple of months I noticed it wasn't nearly as effective as it had been at first.  The doctor changed my medication to omeprazole (20 mg twice a day), but I found it didn't help anymore than the lansoprazole.  In the last month or so, the symptoms have become very uncomfortable and distressing.  I'm continuing to take lansoprazole along with antacids the doctor recommended(Gaviscon and Maalox), but I still have trouble.  After every meal I have terrible burning pain in my stomach just below my ribs and I feel nauseous but never vomit.  Sometimes I have heartburn all day and my esophagus and throat feel really raw and painful from all the acid.  I am reduced to eating bananas and bread becasue any food with even a little acid or oil causes terrible discomfort. I sometimes wake up in the middle of the night from the pain of reflux, and often the pain radiates up into my left shoulder. The doctor here told me that lansoprazole or omeprazole should have cleared things up, but I've been on the medication for more than 6 month and things are worse than ever. The doctor says my problems are caused by stress from my job and life in a foreign country, but I don't feel particularly stressed. I can't understand why none of this medication is helping me.  Can stress be a main cause of gastritis and reflux? Since the discomfort has been getting worse, I've started to worry that maybe I have a more serious condition like gastric cancer. My endoscopy was done about 10 months ago, but do you think I should have another one done? Any advice anyone can give me would be greatly appreciated.  I'm so frustrated with this problem and I can hardly eat anything.  

Thank you!

[sue]

Yes, the drugs are the same.  Prevacid is lansoprazole and Prilosec is omeprazole.  The drugs have different brand names in Japan, so I was using the names of what the drugs contain.

[Karen]

I was reading about your chronic problem and find it hard to believe that with no medication help, that the Drs. aren't checking further for esophagial problems such as a weak LES muscle or for signs of Barrets Syndrome which I have after suffering for too many years with GERD. I am currently having a procedure done to help me called a Nissen Fundoplication, as I cannot take the medications, Prilosec and Prevacid without side effects, such as polyps in the esophagus from meds.
I had to have an EGD done for 5 years to monitor my Barrets and it should be done more frequently if you are suffering like you say you are.

I hope this helps you a little and you can e-mail me at ***@**** if you need to talk further.
Karen

[Larry]

dear sue,
I have been dealing with the same symptoms as yours for 6 months
it is driving me crazy some of the things i have tried is pepsid
gaviscon,tums, I also had a upper gi and was told it was normal.
for the longest time i thought it was my heart and I even was rushed to the hospital because i thought it was a heart attack thay did every test you could think of and found nothing I to can only eat bread if I want to be symptom free. I feel like I am at the end of my rope it really has had a effect on my life and I feel bad for others who suffer if you come across anything helpful please write good luck

[HFHSm.D.-Gastro-rf]

Dear Sue,
We often evaluate patients who provide a similar history to yours.  The initial treatment and investigations includes H2-receptor antagonists, proton pump inhibitors and endoscopyto look for other causes for the symptoms.  If your endoscopy was carefully performed by an experienced endoscopist, it is very unlikely that you have developed a new condition.

In sutuations like yours, it is necessary to have a better understanding of the cause of the problem.  We would do an esophageal motility study and 24 hr pH probe tests to assess the frequency/duration of the esophageal reflux.  If there was still uncertainty regarding the cause of the symptoms, we would consider other possible etiologies e.g. gastroparesis, gall bladder problems, small intestinal pathology, infections.  the nature of the evaluation would depende on the history that we obtained.

Before your symptoms are labeled as 'stress-related' it is necessary to exclude all the likely treatable conditions.

[AHRAGON]

Dear Sue

Consider your diet..And your life style. Look to your emmune system, you might consider more exercise. If you are not drinking water, In addition to your regular regimen, you might consider hyro - therapy and more exercise.  My research denotes our emmune system is the best for curing any disease. But it must be given time to work...I also suggest drugless therapy
as drugs according to research have side effects...Look for the cause of your condition...

I hope you feel better, all the best
Ahragon

[debbie]

Sue,
Your symptoms sound just like mine.  I have had recurrent "heartburn" for several years, but in the last 6 months has gotten increasingly worse.  Usually pain at nite which feels like a knife stabbing me directly in the middle of my abdomen and pain radiating up over the left shoulder, also around the sides and into my back; lots of gas too.  I thought it was "stress" and reflux.  I was taking Prevacid for about 5 weeks with minimal relief and went to a GI specialist.  After listening to my symptoms, he told me he thought it was biliary colic--related to gallstones.  He ordered some blood tests and an ultrasound of the gallbladder, liver and pancreas.  My liver enzymes went up after an attack and my ultrasound showed gallstones.  I am scheduled to have a laprascopic cholecystectomy (gallbladder removal) tomorrow.  I was looking through anything on the internet gallbladder-related because I'm a little nervous.  But with my tests, it seems pretty clear what the problem is.  If you want to contact me, my email is ***@****
Good luck and I hope you feel better!