In Dire Need of Advice

A little history and then my problem...

Hi, my names is Jessica and I had my first severe acid reflux attack in November of 2013 at the age of 28. At the time I was prescribed Dexilant 60 mg for nearly 2 months with a strict diet of bland foods. Later I would be prescribed Meloxicam 15 mg for Costochondritis. I got off the meds and I'll admit that I promptly slid back into eating foods that actually tasted good.

Fast-forward 6 months and the reflux is back. I first tried over-the-counter meds and nothing seemed to work. I called a new doctor (due to insurance changes) and was prescribed the Dexilant again. I also made the changes in my diet back to the blandest of bland. Went to a gastroenterologist who performed an endoscopy, x-rays of chest, and ultrasound of gallbladder. Out of all the tests, the only thing that popped out was some minimal damage to the esophagus. He couldn't explain why I was still having chest pains.

I have been dealing with this second attack of GERD since August of this year. I need some advice on meals and what I am doing wrong (Gastro now has me on Dexilant in the morning and Nexium 22.3 mg in the afternoon).

My diet right now consists mostly of: egg whites, chicken (cooked in a 0 fat cooking spray because I am terrified to use olive oil), green beans, broccoli, squash, apples and bananas. Occasionally, I will eat a pack of original Quaker grits and awful beans with no seasonings.

Can anyone give me pointers on why i am still feeling like this? Most of the day it feels like I have a band constricting my chest and it gets a lot worse when I don't eat immediately when I get hungry.

I very sincerely would like any kind of advice.

Jessica

Hi Jessica,

Welcome to Healing Well! Sorry to hear you're suffering. People respond differently to reflux. Some can have very little reflux and get lots of pain and symptoms. The fact that there was some damage to your esophagus is evidence of reflux, which is why your doctor has you on PPIs.

If your esophagus is sensitive, it would explain why you're reacting to your reflux with the discomfort you're experiencing.

Before I had my Nissen fundoplication surgery, I would get gastritis and reflux episodes that would lead to very painful esophagitis. Healing esophagitis takes a lot of time and patience. Being on a PPI an hour before breakfast and an hour before dinner can be an important part of getting it healed and comfortable. Be sure that the first thing you eat after the hour wait time is something high in protein (like milk). This ensures you get the full positive effect of your PPI.

When I suffered from esophagitis and gastritis enough to be very painful, I couldn't eat anything like beans, broccoli or apples. The only thing I could tolerate at its worst was egg custard. Be sure that whatever you eat is chewed to a liquid and is smooth before swallowing. This will protect irritated tissue from further damage.

There is one thing that aways helped me when my esophagus/stomach were inflamed. A prescription drug called Carafate suspension coats, protects, and provides comfort. It's worth a try if you've got good prescription insurance (it's expensive). If you don't, you could try the generic version. It's called Sulcrafate, and comes in a tablet. You can melt the tablet in a little medicine cup or shot glass by adding a little water and stirring it. Then throw it back like a shot. By melting it, it can coat your esophagus on the way down. The Carafate suspension works better if you can get it, but I've used the Sulcrafate and received comfort from it as well.

Patience and careful eating will make all the difference. This type of healing can take months, not weeks, so don't panic if it takes time. Hang in there!

Best wishes,
Denise

I'm with gerdo. You might ask your GI to send you for a barium swallow to see what's going on. Hiatal hernias and refluxing don't always show up on a simple look down the throat. It can be very informative to see what's going on when you swallow, sit up, lie down ... It's an easy test, doesn't hurt, no anesthesia.

Do you have pain on eating everything? Is there any chance foods of rougher texture or certain foods trigger your reactions?

Your Nexium is only half strength. Take it the way Denise said, and make sure to eat or it won't work. The cells that release acid have to be activated by food in order for the PPI to close them down. It takes about 45 minutes for most drugs that have to be metabolized to start working.

Frankly, I don't believe all the bland food baloney. I do swear by trigger foods, however. The only way to figure those out is to keep a good food diary. There are many posts on this you can read - see search box at the top of the page.