How to diagnose and manage nighttime GERD?

Question

Hello doctor,

I have had gastroesophageal reflux disease (GERD) for years, but now I am waking up at night with a choking sensation and trouble breathing, which is very unsettling. My sleep is being disrupted, and I have noticed hoarseness in my voice every morning. I am concerned this could be silent reflux (laryngopharyngeal reflux (LPR)) or something serious like Barrett’s esophagus. What diagnostic tools, such as a pH study or endoscopy, would you recommend to identify the cause and guide treatment?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Please elaborate more about your problem.

How did you come to know about gastroesophageal reflux disease (GERD)?
For how long have you been facing this problem?
What medications you have taken till now?
Any lifestyle modification you have done?

Due to limited information provided by you, I suggest you do the following tests.

X-ray barium swallow study.
Upper endoscopy.
Esophageal manometry.

The differential diagnosis would be GERD.

The probable diagnosis is GERD.

I advise you to take the following. These include:

Capsule Lansoprazole 15 mg (proton pump inhibitor) to be taken twice daily.
Tablet Domperidone 10 mg (anti-sickness medicine) to be taken twice daily.

Do follow-up if symptoms increase, after investigations. An ENT doctor is to be consulted for hoarseness of voice.

The following preventive measures are to be taken:

Eat a small meal.
Do not sleep immediately after consuming a meal.
Start physical exercise and reduce abdominal fat.
Drink plenty of fluid.
Avoid spicy and oily food.
Increase fiber diet.
Do not eat food after six to seven pm.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

If the doctor feels, he will get your colonoscopy done.

I hope this helps.

Thank you.