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Q. Will I get any relief at all from this constant heartburn and all the other symptoms?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on May 06, 2020 and last reviewed on: Apr 02, 2021

Hi doctor,

I am 28 years old. Before a couple of weeks. I started to have severe heartburn. I felt really bloated and nauseous especially after taking meals. Before a month. I had faint heartburn throughout the day and I waked up in the middle of the night with severe heartburn in my chest. After a week, it was so bad and it went inside my throat too.

I went to the hospital and the doctor prescribed me Ranitidine 150 mg for 14 days. In the second week, it got worse and I was unable to sleep. I had a lump in my throat with extreme fatigue where my leg was fluttering involuntarily and my lip had voluntary twitching. In the third week, I started to take Omeprazole 40 mg with Ranitidine.

My heartburn got reduced but I experienced other symptoms like bloatedness, stomach making noises, nausea, breathlessness, heart palpitations, and constant pressure in my nose and head. On the fifth week, I still had heartburn on and off. My lump on the throat got improved but still, I have heaviness with something clicking. The doctor advised me to take a double dose of Omeprazole and so I took 80 mg with Ranitidine. Will I get relief from this constant heartburn? Am I in a sort of serious trouble?

I have lost some weight and I am taking bland food. My symptoms get worse at night and it affects my quality of life as I cannot do anything throughout the day due to my constant heart palpitations, heartburn or pressure in my nose and head, or bloatedness and nausea. I do not have any other health illness except hypothyroidism. After having acid reflux, my stool came out pale yellow, and now it has started to be brown. What is the cause?

#

Hi,

Welcome to icliniq.com.

Heartburn is a common symptom that occurs normally and in some cases, it occurs secondary to acid reflux in the food pipe. It settles down with a single dose of taking suppressant medications. In some cases, there is an absence of response in the body even after taking maximum doses of acid suppressants. This condition is referred to as refractory gastroesophageal reflux disease (GERD). It is diagnosed by taking an endoscopy. It is a procedure where the gastroenterologist inserts a tube with a camera into the esophagus to see the cause. There are some tests taken to confirm the diagnosis.

There are some diseases that mimic GERD. The most common one is an oesophageal motility disorder. I know that you are taking Omeprazole 40 mg twice daily. But it is important to take this medication before 30 minutes or 45 minutes of taking meals. It is very important to be followed. I suggest you do an endoscopy soon to rule out the cause other than acid reflux. Continue taking Gaviscon. Take 15 to 20 ml at a time for four to five times a day half an hour after meals.

A feeling of having a lump in the throat is a common symptom observed in reflux patients. It is called globus sensation. It will go away once the acid gets controlled. Stress and anxiety create a vicious cycle where the disorder gets perpetuated and influenced by it. For now, follow these treatment options and do blood works as mentioned. If you are unable to get a particular diagnosis by doing an endoscopy, then I suggest you do testing for esophageal motility disorders and other allergic and hyperallergic problems of the esophagus.


The Probable causes:

You seem to have refractory GERD (gastroesophageal reflux disease).

Investigations to be done:

You need to do a complete blood count. Check your thyroid status such as TSH (thyroid-stimulating hormone), FT4 (free thyroxine), and FT3 (free triiodothyronine).

Differential diagnosis:

You seem to have GERD (gastroesophageal reflux disease), motility disorders, and eosinophilic esophagitis.

Regarding follow up:

Have a follow-up after a week.


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