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What are the treatment options for GERD?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At March 18, 2024
Reviewed AtMarch 18, 2024

Patient's Query

Hello doctor,

GERD was identified using the Bravo test. Right from the start of the year, the scope was evident. Barrett's esophagus and esophagitis were not evident. During the late summer, a screening colonoscopy revealed slight discomfort. The likelihood of Crohn's disease was raised by a biopsy, but it was not confirmed. The doctor is not convinced that colitis is the cause.

I started feeling full after eating only a small amount of food two months ago, along with nausea and a decrease in appetite. Following that, I started experiencing epigastric discomfort, which led to an MRI and CT scan last month. They were both clear. The uncontrollable reflux/heartburn persists after taking omeprazole and famotidine twice a day. I sometimes feel like there is food trapped in my throat. An investigation on stomach emptying was suggested by my current Gastroenterologist. Due to lack of appetite, I have dropped a little weight, but for the past two weeks, I have been largely stable.

Following my EGD that was done early this year, is there any reason to think that my stomach or esophagus have changed? Do I need to ask any more questions? I know that this contributes to problems with the gastrointestinal tract, and it has made me quite worried, but I am not convinced that explains everything. Kindly help.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

So a normal CT (computed tomography) scan and MRI (magnetic resonance imaging) together with a normal endoscopy and almost normal colonoscopy (indicating mild inflammation/colitis) reassure that there is nothing serious within. Repeat endoscopy is not advised within a year if earlier procedures were normal, particularly in the absence of warning indicators such as blood or coffee grounds vomiting. Additionally, there is no problem eating (regularly). Globus hystericus is a condition when a person has sporadic lumps or food trapped in their neck (a sense of feeling something in the throat, especially in nervous or anxious persons).

Such problems might occasionally result from functional gastrointestinal abnormalities, which is why a gastric emptying study was required. You are correct that worry alone cannot account for everything, but this is truly a terrible cycle. Anxiety is caused by health problems: greater anxiety, more health problems.

I have also checked your prescriptions; due to your sensitive nature, you are taking both mental and gastrointestinal drugs. You should wait for the stomach emptying test, which will show whether there are any delays in the gastric emptying process, among other things. Appropriate examinations have been conducted so far.

Constant worry or anxiety would undoubtedly make you feel sick to your stomach more; at the same time, if you can manage not to overthink things and stay away from any stresses around you, your primary care physician can optimize your mental prescription to help you as well. Omeprazole is a fantastic medication, but if it is not working for you, you can replace it 30 minutes before breakfast with another proton pump inhibitor, such as 40 mg of Pantoprazole (proton pump inhibitor). Frequent usage of Gaviscon (Sodium alginate) and other antacid syrups. Stay away from alcohol, reheated meals, and eating out.

I hope this helps.

Thank you.

Patient's Query

Hello doctor,

I am worried about the whole thing, and I am still having difficulties swallowing meals. Is an endoscopy necessary to rule out esophageal cancer? Is it better to get a second endoscopy within a year? My health has always been a subject of concern for me, and so I am now exploring stomach-emptying research.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is highly unusual to get esophageal cancer within a year after undergoing a routine gastroscopy. That is why, if there are no red flag signs and a normal previous endoscopy, redoing the endoscopy within one year is not recommended.

The warning signs are persistent or progesterone dysphagia (inability to swallow food or liquids), blood in vomiting or feces, unintentional weight loss, a family history of malignancy, and so on. Abdominal imaging, such as CT(computed tomography) scans and MRI (magnetic resonance imaging), frequently includes lower chest cuts, including the lung base and the junction where the esophagus joins the stomach.

Regarding your health worries and restlessness, keep in mind that we are all human beings who might acquire cancer at any time in our lives. Your symptoms are very normal. Examine why you are more concerned than the other person, who may be having the same symptoms, and understand that we do not have perfect control over everything as humans.

You have conducted a few good investigations, such as radiological imaging, endoscopic assessments, and stomach-emptying research. I am simply trying to ease your health concerns, and your treating physician is doing all possible under the circumstances. So relax, take your medications on a regular basis, and adhere to the most recent medical recommendations. Please let me know when you plan to finish your stomach-emptying research.

I hope this information will help you.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

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