I am having symptoms of severe heartburn and stomach ache. Could it be due to stress?

Question

Hi doctor,

I have had stomach issues for over 15 years. I have taken some form of Omeprazole (Esomeprazole, Pantropazole, Omeprazole) 5 times a week for all those years. My heartburn and stomach "ache" have gotten much worse recently. I have been going through immense financial stress (primarily, and dealing with personal issues) due to the COVID, and in constant worry, so I know that is a big factor for the recent upsurge in my symptoms. I was diagnosed with Barrett's Esophageous five years back. I have had at least 4 Endoscopies. I do not smoke and drink alcohol once per week. Hope you can assist.

Answer 1

Hello,

Welcome to icliniq.com.

Well I can understand your situation and reason for you being upset. It seems that you have GERD (gastroesophageal reflux disease). And the first line treatment for GERD is acid suppressant medications, which you are already taking. You can simply increase the dose of your current medication to twice daily, and make sure you take all these medications before meals. Additional you can use tablet Baclofen 5 mg (skeletal muscle relaxants) thrice daily half hour before meals. This medication will prevent from acid reflux in to food pipe and hence would improve your symptoms. Further, its dose can be increased up to 30 mg in a day, but I want you to start from low dose now.

The treatment for Barrett's is surveillance endoscopy and biopsies on 1 to 3 yearly basis, and ablation of the segment of Barrett's with different endoscopic modalities if any suspicion lesion is found on biopsy. Endoscopic procedure like radiofrequency ablation (RFA) and cryoablation are the preferred modality now. Your gastroenterologist probably have discussed with you about this. So I suggest you to increase the dose of your current medication plus start using Baclofen.