So about a month ago I was diagnosed with GERD after an upper endo showed some erosion in my esophagus. Doc put me on Aciphex and that seemed to make things worse so I stopped taking it last week. He now wants to send me for a sonogram to rule out problems with spleen/pancreas etc. since I also have achy feeling on left side (around where spleen is). Then he said that maybe I don't have GERD (!) but he wants me to start taking Protonix now and see if that helps.
I definitely have reflux symptoms but is it possible that they are just short term and treatable as opposed to chronic GERD? Could you have erosions without chronic GERD?

Also, could some other problem (i.e. enlarged spleen) cause reflux? He didn't seem to have any answers.

Or do you just think this guy is a quack and I should find someone else? I'm going for the sono tomorrow so I guess I'll wait and see what that says but I'm not starting the Protonix until I find out if anything else is going on.

Any advice is greatly appreciated.

Hi,
Are you seeing a doctor at a major medical center or Univeristy Hospital? That always makes me feel more confident because many times the doctors work in teams and if they can't figure something out they have collegues to discuss your case with. Sorry to hear that you have erosion. What exactly does that mean, will it heal? It seems that it may be awhile before I can even get into GI clinic so I hope the Aciphex isn't making my symptoms worse.

I would go to a Gastroenterologist, who specializes in stomach disorders, such as reflux, gastritis, hiatal hernia, etc.

Lori

I would go to a Gastroenterologist, who specializes in stomach disorders, such as reflux, gastritis, hiatal hernia, etc.

Lori

The doctor I'm seeing is a Gastroenterologist and I have had an upper endoscopy as well as an ultrasound (still waiting for the results of that).

The doctor I'm seeing is a Gastroenterologist and I have had an upper endoscopy as well as an ultrasound (still waiting for the results of that).

You can have reflux that is not acidic and can cause problems.

You can have reflux without having GERD. Other factors such as a hiatal hernia.. ulcer.. medication and other things can cause "reflux" that can sometimes be stopped if they find the underlying cause. It all depends.

You can have reflux that is not acidic and can cause problems.

Really?? I've never heard of that. Is it caused by the weak LES valve? How would they determine that it isn't acidic?
Would that mean that you would have it no matter what you eat?

You can have reflux without having GERD. Other factors such as a hiatal hernia.. ulcer.. medication and other things can cause "reflux" that can sometimes be stopped if they find the underlying cause. It all depends.

Thanks. Maybe that's what my doctor meant about me not having GERD because I clearly have some reflux. If he can't find any other problems and the drugs continue to not work, maybe it will resolve on its own. I was taking NSAIDs prior to this problem and having a lot of stress and I'm not convinced that didn't have something to do with this.

Debbie,

If you have erosions in your esophogous, acid is causing it. Acid isn't supposed to enter your esophogous, but when it does, it causes erosions. The only way to heal the erosions is to stop the acid from getting into the esophogous. The most common way to do that is to use a PPI (like Aciphex, Nexium, Protonix, or Prevacid, or Prilosec).

These PPIs treat the symptoms, but not the cause. They work by substantially reducing the amount of acid that your stomach produces - which in turn significantly reduces how much acid can escape your stomach into your esophogous. They work very well in doing this, and most people find that their erosions physically heal after using PPIs, and the symptoms of the reflux (the weird pains in your side, heartburn, coughing, whatever) go away or are significantly reduced.

As for the cause - well, your stomach isn't producing too much acid, but something is letting the acid get into your esophogous. The 2 most common ways are:

1) Loosening of the LES - it gets flacid and flabby and the acid gets through to the esophogous.

2) Hiatal Hernia - this is a little different. For some reason, a piece of the stomach forces itself up through the LES and bulges into the esophogous, with the same results.
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Both of those causes result in the same thing - acid reflux disease, because the results of both causes are the same thing - erosions.

Acid Reflux disease is caused by the loosening of the LES or UES. There are 2 types of acid reflux, that are characterized by which spinchter is primarily affected.

GERD reflux is the type of acid reflux that describes acid refluxing only into the esosphagous. Heartburn (the sensation that results from the acid in the esophogous) is the major symptom of GERD, not the actual condition. GERD is typically treated with 1 dose of a PPI per day, and sometimes 2 doses.

LPR reflux is the other type of acid reflux and it is characterized by acid moving beyond the esophogous and into the throat, due mostly to a weakened upper esophogeal spinchter (UES). LPR symptoms can be dramatically different from GERD, and only 10% of LPR patients experience heartburn. So it's often called "silent reflux". The reason for this is that the esophogous can tolerate a PH of 4 before burning. The throat, however, can only tolerate a PH of 5 before burning. (remember - the more acid something is, the lower the ph it has). So LPR patients usually have less acid coming up the esophogous, but it does more damage in the throat because of the increased sensitivity). LPR is always treated with 2 doses of a PPI per day.

To me, it sounds like you have a GERD or a hiatal hernia. Whatever is causing it is still treated the same way - with PPIs. If the PPIs are effective, it's a confirmation that acid in your esophgous was causing the problem.

If I were in your shoes, I would start taking 2 doses of a PPI every day as it is clear you are truly suffering. You just need to find one that works best for you. Just try all 5 until you find one that works well. If you already have an aciphex prescription, just take 2 together in the morning and see how that helps. I take Nexium, which works great, but you have 5 choices: Aciphex, Nexium, Protonix, Prevacid and Prilosec OTC. I'd give each brand at least 1 week before trying the next brand, unless you develop any weird side effects.