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Posted 9/28/2011 4:14 AM (GMT 0)
Hi all!

I've had issues with indigestion for years - 10 years ago I had an endoscopy and they said 'mild hiatus hernia'.

After reading "Why Stomach Acid is Good For You" I tend to take HCL pills with food and this helps enormously, but I still need PPI's / H2 to calm the indigestion - tend to take one PPI every three / four days.

Six weeks ago I had indigestion for 2 days on holiday and didn't take my PPI.

Result? Globus sensation, throat pain radiating towards glands, ear irritation.

After 3 weeks on PPI's all symptoms disappeared for about 1.5 days and I stupidly had a couple of large meals which caused me to reflux.

This threw me back a long way, but today the only symptom is a voice that gets sore easily which is a pain as I talk a lot in my job. At the weekend I was almost symptom free, but as soon as I go back to work my voice gets sore again. When my voice gets sore I also get hints of globus again.

Anyone any ideas how long it might be before I get my voice back to normal? Any tips?

I saw a nurse after two weeks into this and she said 'take Omeprazole 40mg for a month and come back if not healed'. I feel like I'm getting there - should I still go back to the doctor?

Many thanks in anticipation of your help!

Phil

Posted 9/28/2011 2:04 PM (GMT 0)
Hi and welcome to Healing Well!

We take ppis because they turn off (or very much turn down) the production of stomach acid - then if you have reflux it contains no acid and in theory cannot damage the oesophagus (though some people are damaged by pepsin, but that's another story relating to LPR). If you take a ppi and then supplement the stomach acid with HCL pills, then you are putting the acid back into any reflux that may occur. HCL supplementation doesn't really fit with taking a ppi.
You can, however, take digestive enzymes without HCL in.

I'm just concerned that you may not be able to heal whilst taking HCL and potentially refluxing that up into your oesophagus, possibly even higher up. If you have voice hoarseness you may have acid or stomach contents washing higher up and irritating your larynx.

I would see if things get better on the ppi without the HCL supplement. If not you may need a more up to date gastroscopy. You may also want to read up on LPR and see if it sounds like you. But it's going to be difficult for anyone to evaluate if the ppi is being effective if you are supplementing the acid that it is supposed to take away (I think).

As for healing, that would happen after a good time of being symptom free, which is something sadly a lot of us never quite manage (or not without surgery) and I would expect 1 or 2 months of not refluxing acid is needed.

You may want to think carefully about having a fresh gastroscopy done to see if your hernia is bigger, or if you have oesophagitis from acid reflux.

Have you raised the head of the bed to protect your throat at night?

MMM
Posted 9/28/2011 6:52 PM (GMT 0)
Many thanks for your detailed reply, MMM

I think you could be right - I'll lay off the HCl for the time being. Just need to make sure I don't eat very much because if I do with HCl then I can feel it sitting in my stomach hours after the meal!

The voice is getting better every day and the other symptoms are receding - globus is very slight now and ear twinges just about gone.

I guess I'll see how it goes over the next few days without HCl and hopefully by next week I'll be nearly there!

Phil
Posted 9/29/2011 8:15 AM (GMT 0)
Yes, try without HCL (presumably betaine hydrochloride). If you still have 'heaviness' you could try digestive enzymes without betaine HCL in them.
Presumably you're not talking about feeling full when you've only eaten a small amount, which is an indication of stomach ulcer....

Hope you're feeling on top of things soon.

MMM
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