How to manage severe GERD symptoms and its complications?

Question

Hello doctor,

I’ve had GERD for years, but lately, it’s been getting worse. What used to be occasional heartburn is now happening almost daily. A few times, I’ve even woken up at night feeling like I’m choking on acid, which has been pretty alarming.

My voice has become hoarse, and I’m having trouble swallowing now and then. It often feels like something is stuck in my throat. I’m on a PPI, but it doesn’t seem to be helping much anymore.

Could this mean my GERD is progressing into something more serious, like Barrett’s esophagus? Would it make sense to do an endoscopy or other tests at this point?

I’d really appreciate your advice. Something just doesn’t feel right anymore.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

The changes in your GERD (gastroesophageal reflux disease) symptoms, like daily heartburn, acid reflux waking you up at night, hoarseness, and trouble swallowing, are signs that your condition may have progressed or that complications could be developing, such as Barrett’s esophagus.

Persistent or worsening symptoms may indicate a more serious issue. Barrett’s esophagus, for example, occurs when chronic acid exposure causes changes in the lining of the esophagus. This condition can raise the risk of esophageal cancer. New symptoms like hoarseness and difficulty swallowing definitely warrant further evaluation.

I suggest you do the following tests:

Endoscopy: A small camera is used to look inside your esophagus and stomach. This helps check for damage, swelling, or anything unusual.
24-hour pH monitoring: This test tracks how much acid is coming up from your stomach over a day or two to see how serious the reflux is.
Esophageal manometry: This checks how well the muscles in your esophagus work, especially if swallowing feels weird or food gets stuck.

I advise you to do the following:

PPI (proton pump inhibitors) Adjustment: If your current PPI (acid medicine) is not helping, your doctor may change the dose or switch to a different one.
Lifestyle Changes: Avoid foods that trigger your symptoms, like spicy, greasy, or acidic foods. Do not eat late at night, raise the head of your bed when you sleep, try to stay at a healthy weight, and do not smoke if you do.

If an endoscopy confirms Barrett’s esophagus, your doctor may recommend regular follow-ups with surveillance endoscopies. This helps monitor any changes and catch potential problems early.

Given severe GERD symptoms, it is important to consult with your healthcare provider as soon as possible. They can provide a thorough evaluation, discuss treatment options, and determine whether any further tests are needed. This will help manage your GERD more effectively and reduce the risk of complications.

I hope this helps.

Please revert in case of further queries.

Thank you.