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What Questions do I ask?

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GERD & Acid Reflux
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Posted 1/9/2012 10:03 PM (GMT 0)
Hi All,

Thanks in advance for any suggestions.  First of all I have been diagnosed with GERD, and Barretts.  I had an upper GI scope last April.  Haven't been real happy with my GI Dr., so I'm going to a new one next week.  What basically lead me to this point was constant chest pain.  I did all the heart stuff first, all negative, then went to GI.  I kept telling my doctor I was still having chest pains, but he didn't seem too worried.  I went off Nexium for awhile, I am now back on it, only for about 5 days.  I guess my question is, what questions should I be asking the new doctor?  I have one family doctor telling me it's diet, the GI doctor telling me diet makes no difference.  I tried cutting down on caffine, acid, things like that, and honestly, made no difference.  I don't feel the heartburn, or acid coming up, so is it the GERD causing the pain?  Could it be something else?  Anyone else experience the same kinds of things?  Again, thank you for your help.

Posted 1/9/2012 10:21 PM (GMT 0)
Is it exactly chest pain or upper abdomen pain?
Posted 1/10/2012 2:24 PM (GMT 0)
It's definitely chest pain, upper left.  I've never had an abdominal pain at all.  Never had problem swallowing or anything like that either.  It's been pretty constant, sometimes worse than others, but pretty much every day.  I thought maybe the nexium would help, was on that for three months previously, and no real change.  On it again, hoping it will help some.  Is there any specific tests I should ask for?  Like I said, I did the stress test and heart related tests, that came back negative.  I've had a Hida scan, gallbladder was negative, working fine, a little on the high side actually.  Then the upper GI, which they found the Barret's and gastritis. 
Posted 1/10/2012 2:52 PM (GMT 0)
Hey Chance,

Welcome to HealingWell. I hope we can give you some good advice here.

Since you're in the clear for heart problems, I would suggest asking for Esophageal pH monitoring. This will place a device (either a capsule or a tube that goes down your nose) on a point in your esophagus above the LES. It will record when and if acid is splashing back up into your esophagus and possibly causing your chest pain. Here is the Wikipedia page, which I found to be very informative: http://en.wikipedia.org/wiki/Esophageal_ph_monitoring

It is possible that Nexium isn't the right drug for you, or that your dose is too low, etc. That's another good one to ask - tell him your symptoms, how long you were on the Nexium before, and your symptoms before, during, and after. I personally would need to write it all down, so maybe you would like to also.

I think what's really important right now (in addition to further testing) presenting to your doctor that you're living in pain. You said that he didn't seem to worried - to me, that is unacceptable. I understand if he's not too worried because it's not a lethal condition, but leaving you to live your life in pain isn't a solution. That right there would prompt me to ask the new GI doc what options you have, be it a medication change or whether or not you're a good candidate for surgery (in which case, the pH monitoring is necessary).

It seems very strange for your old GI to tell you that diet has nothing to do with it because for a lot of us, it does. However, if you've tried excluding trigger foods and found no difference, there could be something to that. I would suggest making a food diary to present to your new GI. Not only does it show him what your diet is like and let him make suggestions for changes, but it also shows him that you're actively interested and trying to change your condition. Plus, the whole time you could have been eating something that was bugging you. This is what happened to me - I was perplexed and frustrated because I stopped eating all triggers but still had a myriad of symptoms. Finally I started a food diary and realized that I had problems with dairy. I would NEVER have thought about it without the diary.

Also, have you made any other lifestyle changes? Such as not laying down for 3-5 hours before bed, and sleeping with the bed raised? These "small" things can make a world of difference sometimes, and again shows your doctor that you're working with him to find a solution.

Keep us posted! I'm eager to hear if this new GI takes your plight more seriously.
Ashley
Posted 1/10/2012 3:28 PM (GMT 0)
Hi Ashley,

I did try the diet change for a few weeks, took caffine, acids, and alcohol out ouf my diet completely, and I had no change. Maybe that wasn't long enough to notice a difference, but honestly I thought with as bad as my diet probably was that it should have been an immediate impact...haha...maybe not. I definetly wait after I eat to lay down now, 3 to 4 hours. Like I said, my GI doctor said none of this to me, and I even asked specificially about diet. At one point he wanted me off the PPH's, and I went back to just maximum strength pepcid, and that was a big mistake, 2 days and I was up in the middle of night seeking relief. I've tried all the medicines, and honestly, as far as the reflux goes, it helps, I don't feel it, but yet I still have the chest pain. I will definitely ask about the ph monitoring, and probably have another scope done, since it's been almost a year since the last one. Thank you for the suggestions, and I will definitely keep everyone posted. If I can help at least one person, then it's all worth it.
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