Question about how to relieve GERD symptoms?

Question

A couple months ago I was diagnosed with GERD. It's killing me. They prescribed me pepcid. Which I am taking twice a day. Plus I have taken every form of zantac and tums. I have even changed my diet to eliminating anything that creates heartburn. I got a sample menu online so I know everything has been eliminate. Nothing is helping. If I lay down, I can use a heating pad, which works as long as I'm laying down using it. Once I get up I'm still in pain. Also burping has been helping. But I have to gulp down water so I can burp, because I don't have the need to do so. I called the doctor, but can't get in for another 2 weeks. And the nurse won't answer any of my questions. I really need some help, as this is making it really hard for me to eat, drink, sleep or even breathe..

i am 21 years old and just had a baby six months. i had really bad heartburn during the pregnancy. let me know if you need more details to help answer the question. thanks for any advice.

Answer 1

In the week or so that I have been answering questions here, I have responded to a number of GERD related inquiries. After reading this, please click on my name to the left and then on that page, scroll back through my previous answers to the obvious GERD questions for additional information.

There are several points you should know about in the escalating response you should mount against GERD symptoms. First of all, I agree with the recommendation above that you should wait after eating, before lying down. However, I would recommend a time frame significantly longer, 2 or 3 hours, before you do, since the stomach is a storage organ and meters your food out over an extended period. What you're going for is an EMPTY STOMACH to reduce reflux in the supine position, and while you're at it, prop up your torso when you sleep so that the run is downhill into your stomach. This won't stop reflux, but it will help put it back in your stomach faster once it occurs.

Acid reducing medications that used to be by prescription only are now being supplied as "over the counter". Zantac was the first, and the OTC version was half strength. The prescribed dose is 150 mg twice daily and the OTC pill is 75 mg. Pepcid is the same way, except that a full strength OTC dose of 20 mg is now available too. These medications are called H2 blockers, and although they effectively diminish the production of acid in the stomach, the effectiveness is often gone before the next dose is due. I have had numerous critical patients who I have actually been able to measure gastric pH and then customize acid control dosing accordingly. Package directed doses have never been sufficient or frequent enough in that setting.

I do not recommend that you start eating these pills randomly, but know that under a doctor's supervision, you can have escalating doses of medication that may improve effect. Also the "proton pump inhibitor" or PPI class of medication is known to be more effective.

Acid reducing medication doesn't stop reflux. It only stops the reflux from being acid. For the most part, thats a pretty good thing, but if you have an inflammed and irritated esophagus, then even bland refluxate will cause pain. The recommendation to eat smaller meals is absolutely correct. You do not want to allow the stomach to have extra leverage to push stuff up. Another less commonly recognized phenomenon though, is "aerophagia" or air swallowing. Every time you swallow, you entrain about 10 to 15 cc of air. For people who reflux a lot, an instintive increase in the rate of swallowing, aimed at replacing refluxed content back into the stomach, results in a substantial gastric air bubble. This tends to increase burping and reflux!

Reflux is ultimately an anatomic problem. It is caused by relative incompetence of the esophago-gastric junction. I say relative, because you can have what should be a strong enough valve, but have enough overpressure in the abdomen to defeat it. Some people have reflux because they are substantially overweight. The overweight makes the pressure inside the abdominal space substantially higher, especially when they are lying down and the pressure is enough to defeat the valve. The most effective and most durable treatment for overweight related reflux is weight loss.

For people who just have weak esophago-gastric junctions causing reflux and no other issues to complicate matters, the proven most effective treatment is anti-reflux surgery. This has been demonstrated multiple times, and by several methods.

Surgical treatment for reflux is typically done laparoscopically. A series of tiny incisions are made into the abdominal wall. A thin camera and long thin instruments are introduced. The stomach is then freed up from its upper attachments and a loose wrap of stomach is passed around the base of the esophagus and stitched to itself, forming a ring. This is called a "fundoplication" and it buttresses the esophago-gastric junction in a manner that returns it toward a much more normal level of functionality. It recreates the one-way valve effect that is supposed to be there.

Unlike medication which only serves to remove the acid from the reflux, this method actually halts the reflux. Depending on your status prior to surgery, you could go from requiring a significant amount of medication to requiring none at all, or to requiring significantly less. You may have changes to your esophagus that are concerning to the gastroenterologist such as changes to the esophagus lining that need to be evaluated on a regluar basis (every year or so) in case the changes start to look like cancer. If so, antireflux surgery doesn't relieve you of the obligation to continue to monitor this problem. However, some evidence exists that in patients with early changes, there is reversal of the abnormal tissue back to normal. How this relates to cancer risk is as yet unknown.

Answer 2

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Answer 3

This book is probably the most informative and practical guide on the subject of acid reflux and heartburn that I have ever read https://tr.im/getridofreflux
I was prescribed Lansoprazole which was brilliant but after two years of aching joints, extreme muscle pain which the doc gave me cortisone jags for, with some research I discovered the drug Lansoprazole was causing these rare side effects but it was I who diagnosed it NOT my doctor, I came off the drug 2 months ago, changed my diet and discovered just eating an apple stops any acid reflux, I eat an apple before bed, brilliant no acid, any time I feel the slightest sign of reflux I simply eat an apple. Apple juice is not that good nor is anything else I have tried including honey at stopping reflux.

Answer 4

There is a chiropractic technique that speciallizes with organ function. I work on people with similar symptoms every day in my clinic. Not all chiropractors do this, so go to www.sorsi.com to locate a doctor in your area, most of these doctors should be able to help you are at least point you in the right direction. If you are in the Minneapolis/St. Paul, Minnesota area, look up my website at healinghandschiro.com.

Answer 5

Get OTC generic prilosec. It is essentially the same thing as nexium, but it is OTC. Prilosec beget nexium because prilosec was going off patent. Prilosec is a proton pump inhibitor; meaning, it stops acid secretion in the stomach. If that does not work, then you should go and see a MD because it might be a valve problem or you might need a prescription strength dose.

Answer 6

You don't mention your age, that would be helpful in making suggestions.....anyway....You might consider using Nexium instead of Pepcid. Eat frequent small amounts rather than large meals, remain upright for thirty minutes after eating. Do not lay flat to sleep, keep your torso semi upright. I have found Alka Seltzer helpful in relieving me of gas distention and discomfort.
Do not take fluids with meals.

Answer 7

Instead of GERD you may develop a hiatal hernia that was caused by the pregnancy!! Should check this out with a doc!!!