What are the effects of proton pump inhibitors on acid reflux?

Question

Hello doctor,

Approximately two months ago, I experienced persistent acid reflux for over two weeks, for which I was prescribed PPIs. My symptoms subsided quickly with the medication. However, shortly after starting the PPIs, and a few weeks after my symptoms resolved, I began experiencing sudden stomach pain, cramps, and localized chest pain characterized by uncomfortable burning sensations in both my stomach and chest. This onset occurred approximately two weeks ago. About one week ago, I started to feel some improvement, with reduced stomach discomfort and diminished burning sensations, particularly after adhering to a cleaner diet. Nonetheless, I have been experiencing a sensation of a "ball" in my chest or throat, along with localized chest pain near the lower part of my sternum. Despite avoiding gluten for the past four or five days, today, after consuming it, I noticed an increase in burning sensations in my sternum, accompanied by persistent localized chest pain or pressure. Several weeks prior, I experienced sudden onset heartburn, indigestion, constant chest burning, localized chest discomfort, and increased bloating and gas. The chest burning symptoms fluctuate in intensity. Although I am currently taking PPIs, they do not seem to alleviate my symptoms consistently, as some days I feel better than others.

Kindly help.

Thank you.

Answer 1

Hi

Welcome back to icliniq.com.

After thoroughly examining your medical records and incorporating laboratory findings (attachments are removed to protect the patient’s identity), I have several additional inquiries:

Have you experienced any challenges with swallowing food?
Are you experiencing vomiting, particularly any instances of vomiting blood or black-colored vomit, or noticing blood in your stools?
Has your weight remained stable over the past six months?
Is there any history of liver or gastrointestinal diseases, tuberculosis, or cancer within your family?
Could you provide details regarding any prior surgeries or medical admissions?
How would you describe your stress levels, particularly with recent stressors over the past few months?

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Your red flags or alarm signs in history are negative which is reassuring. Follow the below instructions:

It is advisable to consider a regimen of acid suppression medication for a duration of two to four weeks. Dexilant (dexlansoprazole) is a recommended option.

Additionally, incorporating a regular antacid syrup such as Gaviscon (Aluminum hydroxide 80 mg, Magnesium trisilicate) with most meals is beneficial. Consult your doctor and take the medication accordingly.

Including yogurt in your diet serves as a natural source of probiotics.

You may also introduce commercially available probiotics into your daily routine. These are accessible over the counter and do not require a doctor's prescription.

It is crucial to minimize stress and anxiety, as your symptoms are likely exacerbated by health-related anxiety.

Avoid excessively searching for your symptoms on the internet, as unfiltered information can exacerbate health anxiety.

Refrain from eliminating gluten from your diet, unless you have a documented allergy or intolerance dating back to childhood or many years ago. Celiac disease typically does not present with your current symptoms.

Recommended precautions include avoiding dining out, consuming reheated meals, and limiting alcohol consumption if applicable.

The sensation of a lump or ball in the chest or throat, known as Globus hystericus, is common in individuals experiencing anxiety and stress.

If symptoms persist or for further confirmation, an endoscopy may be warranted.

Wishing you continued excellent health.

I hope these suggestions help.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Yes, stress and anxiety can lead to notable gastrointestinal symptoms in susceptible individuals. Red flags were the questions previously discussed. The sensation of a lump appears consistent with Globus hystericus; otherwise, a lump in the esophagus would typically result in swallowing difficulties. If you have not experienced past issues with gluten, there is no need to unnecessarily restrict your diet.

I hope this information will help.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

It is advisable to effectively manage stress, as doing so may lead to an improvement in your symptoms. However, in cases where symptoms persist or do not resolve, undergoing an endoscopy procedure would be the recommended course of action to address the issue comprehensively.

I hope this information helps.

Thank you.

Answer 5

Hello,

Welcome back to icliniq.com.

Adhere to the following dietary regimen for optimal health:

For the initial two weeks, maintain a consistent dietary pattern.

Following the initial period, adopt an alternate-day fasting approach for one week.

After completing the alternate-day fasting week, discontinue the fasting routine.

Throughout this period, prioritize stress reduction by avoiding known stressors.

Emphasize the consumption of nutritious, home-cooked meals exclusively.

Refrain from dining out or consuming reheated meals.

Maintain a balanced diet, without imposing unnecessary restrictions.

I hope this information helps.

Thank you.

Answer 6

Hello.

Welcome back to icliniq.com.

Dexilant (Dexlansoprazole) is not classified as an anti-acid medication; rather, it is a proton pump inhibitor. Its primary function is to reduce the production of stomach acid. Therefore, it is unlikely to directly cause nausea. However, if you are experiencing nausea, it may be attributed to an upset stomach. Regular use of dexlansoprazole could potentially alleviate this symptom.

I hope this information helps.

Please revert in case of further queries.

Thank you.