Is there a connection between GERD and chronic hives?

Question

Hello doctor,

I had chronic hives for the past few years. I started having chronic hives again after a few years and went to see an allergist. She said that I was idiopathic and put me on 180 mg tablet of Fexofenadine in the morning and 10 mg of tablet Cetirizine in the evening. The hives were gone for a couple of weeks and then returned in full force. Since then, I have added antihistamines, such as tablet Hydroxyzine, to no avail. A few days later, I noticed that my throat felt like it had a lump in it.

As the weeks have passed, this feeling has shown up more and is accompanied by constant small burps. When looking up my symptoms, what showed up most was gastroesophageal reflux disease (GERD). However, I have never had the painful burning feeling. I have only had the throat lump feeling with constant small burps. I took some over-the-counter antacids (Tums, Magnesium) to no avail. On Monday evening of this week, I added an H2 blocker (150 mg Ranitidine). This seemed to help my hives but did almost nothing for the GERD symptoms.

The symptoms are so frustrating that I have started taking Lansoprazole (proton pump inhibitor) (15 mg), hoping that that will cure the symptoms. I do not want to just cure the symptoms but want to know the cause. Do you have any idea what this might be or whether the hives and GERD are related?

I have changed my diet in the past week (for example, this morning, I ate bananas and oatmeal), but the GERD symptoms remain throughout the day.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I want to assure you that everything is going to be fine soon.

The probable causes include hives and gastrointestinal esophageal reflux disease (GERD), which may be linked together. When there is acid reflux, acid comes from the stomach up to the throat via the esophagus. It constantly irritates the larynx and pharynx, and there is a feeling of a lump due to inflammation (induced by acid) and small burps.

No matter whether one feels heartburn or not.

The reason, in your case, is lower esophageal sphincter elasticity. Incompetent sphincters cannot keep the acid in the stomach, and it comes up in the esophagus.

I was referred to a gastroenterologist for a gastroscopy (endoscopy will show your physician the status of the lower esophageal sphincter (LES) at the lower end of the esophagus).

The treatment plan included:

Capsule Dexilant (proton pump inhibitor).
Tablet Ebastine (H1antihistamine).
Tablet Prednisone (corticosteroidoids).

(Leave all other medications).

As a preventive measure, you should avoid tea, coffee, soda energy drinks, and spices. No fast food and no junk. Take plenty of water and keep engaged in good physical activity too.

When you get the reports, do follow up for guidance.

I hope this helps.

Thank you and take care.

Regards.