I am at my wit's end lately so decided to join this board and see if I can get some insight into what I can do to help myself get better. I have been researching on the net and I'm afraid I have not seen much in the way of hope when it comes to finding a cure for GERD. Many years ago I was diagnosed with a hiatus hernia, then later on GERD (and was taking Omeprazole for it until about a month ago.) I was lucky that I rarely had symptoms. The worse was that every now and again I would eat something that would set off my stomach for a couple of days, tops. I didn't realize how lucky I was until I began reading the accounts of people suffering from GERD and other stomach problems...it seems that so many continue struggling with pain.
In my case, a few months ago I had a huge glass of orange juice one night that precipitated a bout that has yet to leave me. Chocolate, caffeine and anything citrus killed me so I have cut those out (well, I still have one coffee a day but it doesn't bother me.) I began to think "ulcer" so asked my Dr. to send me for an upper GI series and to do a blood test for the H Plylori bacteria...I know it's standard to have an endoscopy but as I explained to my Dr. I have such a phobia about it I have terror about it and will do anything to avoid it. So we are at an impasse. She gave me a new prescription (Rabeprazole) to take twice daily but my symptoms aren't getting much better. I have also been taking 1-2 tbsp of apple cider vinegar daily, since I read that works wonders, and I do believe it soothes some of the symptoms. Yet with all this, I have bad days when I experience pain as if the medication isn't working, and the dietary changes are for naught.
I don't even know why I am typing this now, other than that this has been a bad day. I hope someone can give me some tips on what path I should take from here...
I also have panic disorder (have had it for 21 years).
The medications used to treat panic disorder can aggravate acid reflux, such as the benzodiazepines because they have myorelaxant (muscle relaxant) effects and this relaxes the LES (lower esophageal sphincter) allowing acid to reflux into the esophagus.
I take alprazolam (Xanax) 1mg qid (4x/day) and have been on that for a long time, yet it is very effective for my anxiety. I don't have any panic attacks while on this medication.
It is common for people with panic disorder to also be on SSRIs. I don't take those anymore, but I have read that they are harsh on the stomach and increase the risk of upper GI bleeding by 7 fold. (7x increase in risk of bleeding) In fact, it happened to me after taking a low dose of Prozac for 2 months and had to be hospitalized. Before my stomach began to bleed I felt a constant burning "lit match" feeling 24/7 in my stomach.
Are you taking any pain relievers such as NSAIDs? (aspirin, ibuprofen, naproxen, etc)? Those can cause gastritis and ulcers by themselves. H. Pylori infection causes 80% of ulcers and NSAIDs cause almost all of the rest.
I had an endoscopy and it isn't as bad as it sounds. I tried it without sedation event though the gastroenterologist didn't want to perform the procedure without me receiving IV sedation (he wanted to give me lorazepam/Ativan IV to cause sedation, but I refused).
Anyway, he sprayed Cetacaine, a local anesthetic, in the back of my throat and told me to swallow when he put the flexible tube in and I did that just fine. I felt like gagging a few times and he said men are more prone to the gag reflex than women.
The procedure only lasted a minute or two. It is really mind over matter with endoscopy. The prodecure is so short and you can get a shot of Ativan to help calm you down. It is very safe and effective and will reduce your recall of the endoscopy.
There is another way to look for H. Pylori without undergoing endoscopy. There is a breath test that can be done. You drink something (I forgot exactly what it was... urea perhaps?) and the doctor can check your breath for H. Pylori.
The good thing is that if it is H. Pylori, you'll only have to take some medications for 7 to 14 days to kill the bacteria. Then your stomach will begin to heal itself and you shouldn't have gastritis again unless you become reinfected (H. Pylori is contagious and can be caught via kissing or poor hygiene).
The irony here is that eradication of H. Pylori sometimes results in GERD.
Untreated, H. Pylori can result in ulcers or even stomach cancer. If you are on omeprazole for the rest of your life it probably won't give you an ulcer, but your risk of stomach cancer will always be there.
Have the breath test if your doctor can do that. I think it will be more comfortable than undergoing endoscopy, but if I had to undergo endoscopy again, I would surely do it. You only have to swallow at a specific time and it isn't painful. It just feels strange and makes you want to gag, but you can focus or meditate on other things to try to reduce gagging. It is such a short procedure though.
Good luck. I do know from a psychiatrist in Pasadena, CA that there is a strong correlation between GERD and panic disorder. He believes this to be due to bile reflux caused by improper CCK (cholecystokinin) release. Too much bile is released because of CCK and then, because bile is alkaline (opposite of acidic), the stomach overproduces acid in an attempt to bring the pH of the bile down.
This results in acid reflux. However, bile can reflux and although bile is not acidic, it is far too alkaline and can cause damage to your esophagus and also symptoms in your stomach, including diarrhea or IBS-like symptoms.
Xanax seems to inhibit CCK and reduce bile reflux.
If you take a proton pump inhibitor and it isn't reducing your symptoms, it is time to ask your gastroenterologist about bile reflux.
Sucralfate (Carafate) works well for bile reflux by coating it and thus preventing the stomach from overproducing acid against the bile. That's what the psychiatrist said (he's also a neurologist).
Good luck... sorry for the long post.
;-)
Paul
The Following User Says Thank You to knightrider2009 For This Useful Post: melody627 (08-17-2011)
I really think you should get a endo, it the best way to get checked for any problems with the esophagus and such. I had my endo in April it took 15 min and I felt great afterwards, no side effects at all, the medication I got was a wonderful drug, it was a twilight drug that only last a real short time so you wake up feeling great, I can't remeber name it starts with a V. Get the endo you won't regret it. Hope this helps. Take care
I also wanted to let you know I too suffer extreme anxiety, Im afraid of any medical proceedure and I hate medicine, I think I'll die if I take anything but advil . I take prilosec now, but was on aciphex which I swore made me sick and left me feeling awful. Endo is really nothing, you can do it.
I also have panic disorder (have had it for 21 years).
The medications used to treat panic disorder can aggravate acid reflux, such as the benzodiazepines because they have myorelaxant (muscle relaxant) effects and this relaxes the LES (lower esophageal sphincter) allowing acid to reflux into the esophagus.
I take alprazolam (Xanax) 1mg qid (4x/day) and have been on that for a long time, yet it is very effective for my anxiety. I don't have any panic attacks while on this medication.
It is common for people with panic disorder to also be on SSRIs. I don't take those anymore, but I have read that they are harsh on the stomach and increase the risk of upper GI bleeding by 7 fold. (7x increase in risk of bleeding) In fact, it happened to me after taking a low dose of Prozac for 2 months and had to be hospitalized. Before my stomach began to bleed I felt a constant burning "lit match" feeling 24/7 in my stomach.
Are you taking any pain relievers such as NSAIDs? (aspirin, ibuprofen, naproxen, etc)? Those can cause gastritis and ulcers by themselves. H. Pylori infection causes 80% of ulcers and NSAIDs cause almost all of the rest.
I had an endoscopy and it isn't as bad as it sounds. I tried it without sedation event though the gastroenterologist didn't want to perform the procedure without me receiving IV sedation (he wanted to give me lorazepam/Ativan IV to cause sedation, but I refused).
Anyway, he sprayed Cetacaine, a local anesthetic, in the back of my throat and told me to swallow when he put the flexible tube in and I did that just fine. I felt like gagging a few times and he said men are more prone to the gag reflex than women.
The procedure only lasted a minute or two. It is really mind over matter with endoscopy. The prodecure is so short and you can get a shot of Ativan to help calm you down. It is very safe and effective and will reduce your recall of the endoscopy.
There is another way to look for H. Pylori without undergoing endoscopy. There is a breath test that can be done. You drink something (I forgot exactly what it was... urea perhaps?) and the doctor can check your breath for H. Pylori.
The good thing is that if it is H. Pylori, you'll only have to take some medications for 7 to 14 days to kill the bacteria. Then your stomach will begin to heal itself and you shouldn't have gastritis again unless you become reinfected (H. Pylori is contagious and can be caught via kissing or poor hygiene).
The irony here is that eradication of H. Pylori sometimes results in GERD.
Untreated, H. Pylori can result in ulcers or even stomach cancer. If you are on omeprazole for the rest of your life it probably won't give you an ulcer, but your risk of stomach cancer will always be there.
Have the breath test if your doctor can do that. I think it will be more comfortable than undergoing endoscopy, but if I had to undergo endoscopy again, I would surely do it. You only have to swallow at a specific time and it isn't painful. It just feels strange and makes you want to gag, but you can focus or meditate on other things to try to reduce gagging. It is such a short procedure though.
Good luck. I do know from a psychiatrist in Pasadena, CA that there is a strong correlation between GERD and panic disorder. He believes this to be due to bile reflux caused by improper CCK (cholecystokinin) release. Too much bile is released because of CCK and then, because bile is alkaline (opposite of acidic), the stomach overproduces acid in an attempt to bring the pH of the bile down.
This results in acid reflux. However, bile can reflux and although bile is not acidic, it is far too alkaline and can cause damage to your esophagus and also symptoms in your stomach, including diarrhea or IBS-like symptoms.
Xanax seems to inhibit CCK and reduce bile reflux.
If you take a proton pump inhibitor and it isn't reducing your symptoms, it is time to ask your gastroenterologist about bile reflux.
Sucralfate (Carafate) works well for bile reflux by coating it and thus preventing the stomach from overproducing acid against the bile. That's what the psychiatrist said (he's also a neurologist).
Good luck... sorry for the long post.
;-)
Paul
Hey Paul, do you think Clonazepam makes reflux worse or better? I was prescribed it along with my PPI. I want to ween off of it, but I'm scared it'll make my reflux worse, not to mention the withdrawal symptoms I'll have. I don't even know why I was prescribed it exactly, but my doc said to relax my stomach or something.
About carafate, can you take that while on a PPI at the same time? Or you have to do one at a time? I also heard Carafate makes you nauseous, and since that's my main symptom, I'm afraid to try that too. Thoughts?
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