Help...Frustrated with GI doc and change in medications

MountainReader · 06-12-2008, 09:16 PM

I have reflux. I've had if for years. Two years ago, I had asthma that was out of control and they changed my reflux medication to help get the asthma under control because the acid was causing it to flare up. I have been on Prevacid 2x/day since then. I have felt my acid was 'under control' during this time, because I wasn't feeling the acid symptoms. For me, I have never had the heartburnsymptom. I get a chronic cough and some belching. Anyway, I went for some more testing last month in an attempt to get my asthma under better control because I had a rough winter. (Acid, extremely cold air, chemical smells and pollution trigger my asthma. Summers are usually good for me asthma wise.) I had a modified barium swallow and an esophagram that showed that even though I wasn't feeling it, I still had a lot of acid coming up to my throat. The Pulmonologist said I would never get my asthma under control until until the acid is better controlled.

I had an appt with a GI specialist last Friday. He switched me from the Prevacid, which I didn't feel any acid symptoms using, to Nexium. I am now on day 6 with the Nexium. On day 2 I started getting major heartburn, nausea, and a lot of belching. This has continued through today. I have even added Gaviscon per the doctor's advice. Today, I started in with a horrible cough. I had trouble getting my breath even with the use of my Albuterol. (I am also on 2 other asthma medications daily also.) It was so bad by early afternoon that I almost made a trip to the emergency room. I can feel the acid coming up my throat and I know the cough and trouble breathing are as a result of the acid. I tried calling the GI doc and his nurse called me back and told me that even though I am feeling bad, I needed to continue following the doctor's instructions to stay on the Nexium, supplemented with Gaviscon, for at least another week because Nexium controls the acid better. I don't think I can handle another day, or through the weekend, with the acid affecting my asthma so much. I really don't want to have to go to the emergency room just because the Nexium hasn't "kicked in" yet. Anyone have advice out there? Has anyone else switched PPI's and had it take a long time to take effect?

rush_rulz · 06-13-2008, 03:27 PM

I feel your pain. I was told the Nexium could take a month to start working. Its been over 1 month for me and while I felt a difference, I will say I have good days but when my days are bad they are worse. I don't believe its neccessarily from the Nexium though; not trying to say that.

For me, I too have asthma but the main Dr at the Allergy clinic I go to told me that he is thinking if I could get my reflux under control I may not even need the inhaler. Depending on how soon I eat and then take the meds, I actually feel worse when I take the symbicort for the asthma but then some days, I feel BETTER. It is so weird, as if its both asthma and the reflux making me gag. That is my main symptom, the gagging. I've been highly minimizing my caffeiene and carbonated drinks intake and yesterday had none at all and wouldn't you know it last night I developed heartburn which I usually rarely get....and then it turned into chest pain! Nasty. I am supposed to take Pepcid before meals and Prilosec although the Dr did not say for how long I should do the Prilosec...I guess until I see the GI (will be my first time) and also have been on the nexium for over a month like I said before. It is strange that my heartburn symptoms would get aggravated from going OFF caffiene or was it something else?

Anyway, I hate going through all this and would be curious as to when everyone's symptoms developed. Other than rare feelings of burning in my stomach (usually wake up with diarea when this happens the next morning), at night, I did not have upper GI symptoms at all. This nasty constant gagging (aggravated after meals OR just liquid-yes even water) has only been going on since Dec of last year...after a very bad bout of bronchial pneumonia.

janewhite1 · 06-13-2008, 03:38 PM

I can't begin to imagine why a doctor would tell you that you have to switch from one PPI to another. Their effects are almost identical, no clinical trial has found one to be superior. If I were you, I would stick with the one that works and doesn't cause bad side effects.

Vanessa74 · 06-14-2008, 11:40 AM

I agree with JaneWhite,

It seems as if the Prevacid must have been helping if you were not feeling the acid/burning. The Nexium does not seem to be doing it - so I would switich back, especially since it is affecting your breathing.

Also, do they test to make sure what you are refluxing is ACID? I read a study that said people on PPI's still reflux as much as people NOT on PPI's however - the fluid that is being refluxed is not acidic as the PPI's knock that stuff out. The PPI's do not STOP refluxing they simply take the acid out of the liquid.

I hope you feel better soon - maybe a second opinion is in order?

Vanessa

MountainReader · 06-14-2008, 04:39 PM

Thanks for your replies and support.

I have had an endoscopy, Manometry, 24 hr PH, modified barium swallow and an esophagram. They have confirmed that I do have reflux. The last two tests were done while I was taking the Prevacid with no apparent symptoms. They showed the reflux and aspiration.

The reason I changed medications even though I felt OK on the Prevacid was that my asthma was out of control all winter despite a heavy treatment for the asthma. The testing showed that although I am not feeling the acid, it is coming up and aggrevating my asthma...a lot. The change is to see if I can find another treatment that works even better so that I can get the asthma under control. If it wasn't for that, I would have continued my current treatment.

I am going to THE premier digestive institute in my area. Several of my other specialists all recommended this as the best doctor for me to see.

I do have a loose LES. At this point, I am just wondering if maybe the best option for getting my asthma under control would be to have surgery. My Pulmonologist said that he really couldn't do much more for me until I get the reflux under control. I'll know more when I have my follow-up appointment.