Introducing Myself + Some GERD Questions

I've been using this forum extensively to learn more about my new affliction and I feel like I know many of your stories already. Thus, I thought I'd introduce myself and ask you all a couple questions.

At this point, I've had GERD continuously for nearly a month after a very sudden onset. I'm an early 30's male and prior to December 2011, I'd NEVER had heartburn in my life. It all started at 3am one night after a delicious dinner of homemade chili and hasn't relented ever since then. I woke up with an intense burning pain in my chest that completely perplexed me and it's been getting worse ever since.

At the suggestion of a doctor friend I began taking Prilosec OTC about a week after my heartburn began and then subsequently upped the dose to 2x / day a few days into it after my heartburn didn't abate. I've now been 40mg of Prilosec a day for about 3 weeks and thus far my symptoms haven't relieved that much.

As a result I went to see a GI Doctor last week and she immediately suggested I get an EGD to determine why my heartburn wasn't going away with a pretty healthy PPI usage. The results of the endoscopy was a bunch of inflammation in my stomach and esophagus and a few biopsies sent away for testing (waiting on results).

My question to all of you, is why aren't the PPI's helping me? I'm now taking 40mg of Prilosec about an hour before dinner, along with a Pepcid in the morning and in the evening (10mg of famotidine 2x / day). I definitely have some relief from the pain, but I'm amazed at how much I still have continuously.

I'm also wondering if perhaps I'm not feeling true heartburn now at all, and that instead, my esophagus has become so inflamed that even a much less acidic reflux causes me to feel pain? Do you think this is possible? Should I give the prilosec more time to work it's "magic" or should I try switching PPI's now to something like prevacid or protonix?

Any suggestions would be helpful. I feel like I am constantly popping pills at this point and none of them are helping me all that much. Very weird and distressing!

Thanks for reading!

Hi Speedy --

Welcome to the forum, but sorry to hear of your difficulties.

As Denise suggested, it's probably too early to determine the effectiveness of the Prilosec. But, it's true that the different PPIs work differently for everyone, and it's possible, as you wondered, that another type may work better. If you've only been noticing the symptoms for about six weeks, I wonder how severe the inflammation could be vs. how quickly you should be noticing improvement. It's good that you're working closely with a doctor, and being proactive with tests.

Denise has given you some great suggestions to get started. Managing reflux requires a multi-prong approach so that we can keep the meds to a minimum, and maintain as much "normality" as possible.

-Bruce

Hey Denise and all,

Thanks for the replies and all the suggestions! Unfortunately my GI doc didn't give me as much advice as I would have liked - it was more of a "wham, bam, thank you ma'am" type appointment. The only thing she changed was to take my 40mg of Prilosec before dinner (instead of in the morning) and to take an H2 (like pepcid or zantac) at night before bed. So far I haven't noticed any appreciable difference with these changes (~1 week).

I have also applied nearly all of the lifestyle changes, pretty much from the beginning. I now sleep on a wedge pillow (ugh), eat mostly bland and soft foods, wait at least 3 hours before laying down, and avoid any of the common food triggers (with rare exceptions). I also don't smoke, drink alcohol, or use caffeine.

In part, that's why I feel even more disconcerted about the whole thing. I've always been very proactive about my health and GERD has just completely snuck up on me. I don't have any of the common risk factors (i'm skinny, exercise, don't overeat, don't drink coffee, etc.), so I'm having a difficult time accepting the diagnosis and finding ways to "improve" my behavior.

I had also hoped that I would find relief by way of Prilosec (or another PPI), as it seems so many people consider it to be a miracle drug for this sort of thing. It just hasn't worked out that way for me - I continue to have a constant dull ache and burning in my chest, and it just doesn't seem like it's working.

I imagine that I need to be more patient with the situation, but it's been hard on me, and I feel like each day that I continue to feel pain and burning, my esophagus will become progressively more damaged.

Anyways, I guess I just wanted to rant to people who will understand. I think calling the GI Doc's office and asking them about switching PPI's is a good idea - it certainly can't hurt!

Thanks again for the replies.

I'm a new member & have a quick question: what liquid can I drink at bedtime to take sleeping pill will not cause GERD symptoms? Tried water, milk, OJ & pop. I only have symptoms at night & I NEED to take a sleeping pill. Thanx!

1957reader, I would say water is your best choice. Pop and OJ will only make it worse. Have you considered that maybe your sleeping pill is causing the reflux? I would also consider taking some max strength pepcid or something along those lines if you already aren't.

Speedygerd, I too am a new member and have found the forum beneficial. And I have had the some of the same issues with my GI doctor, so after 9 months, I'm trying a new doctor. If you aren't happy, I would suggest you do the same, 2nd opinion can't hurt. Also if the Prilosec isn't working at all, which it stopped working for me, I had to go on Nexium. But there is also Prevacid, and Zegarid. You could give those a shot as well.

Again, thanks everyone for the helpful replies.

My wedge pillow does extend down to my hips and I've supplemented it with other pillows to make a nice long and healthy slope. At the top of my ski jump, I'd say my head is elevated at least 12 inches above my fiance, so it's a health slope indeed and it doesn't pinch me at all.

So far sleeping has probably been the easiest part of this ailment to deal with - I rarely have night time reflux that I notice and I'm learning to sleep comfortably. I may eventually do the blocks under the headboard thing, although our current platform bed doesn't lend itself very well to that. I'm also waiting at the very least 3 hours before going to bed and the vast majority of the time it's been longer than that. I also eat a pretty small dinner these days and do most of my eating during mid-day. I've even been splitting lunch into two separate meals to keep them smaller.

In fact, waking up in the morning is the most pain free and asymptomatic I am all day long. However, the problems start as soon as I eat breakfast and don't stop pretty much the whole day. I am trying to follow pretty closely to a GERD diet. I really do think that much of my pain these days is coming from the existing inflammation in my stomach and esophagus, as with all the drugs I'm on, I'd be surprised if my stomach has any acidity left!

My main challenge right now though, is that I'm nearly at the point where I have to stay on my feet all day long. Sitting down after meals for me has been pretty difficult (symptoms turn on right away) and then when I stand up, they are relieved quite a bit. Perhaps I need a new office chair? Or maybe I need to sit in something that makes me more upright and digestion easier. Anyone have suggestions about what worked for them in terms of sitting at a computer?

I also think in part I just need to be more patient, as it's going to take time to heal my internal wounds and see what the true "baseline" is going to be for me.

I also already feel like I need to find a different doctor, as mine seemed very dismissive about the situation and I was having difficult imaging them as a long term partner in working to manage and potentially resolve this condition.