Acid Reflux And Ppi Help Please!!

If I understand you correctly, it sounds like you're not having good success managing your reflux with PPIs. I can not take them at all, because of the massive headaches they cause. There are several formulations of PPIs by different pharmaceutical companies, and it's possible that your doctor can prescribe another one that will work better for you.

You don't say, but you should also be managing your reflux with diet and behavior modifications. What you eat -- and when you eat it -- can make a big difference, as well as things like sleeping on an incline (don't use extra pillows!).

We're all in this together. You can find a lot of information and support here on this forum.

-Bruce

Unfortunately, you can't use "what worked before" as your guide to continued management of reflux. If you have been diagnosed with GERD, you have to understand that, most of the time, it is a progressive disease. It requires us to stay on top of the symptoms, and be ready to consider other options when symptoms change.

I don't mean to be overly critical here, but you CAN NOT eat at 9pm and go to bed at 11pm!!!!! Even those patients who can use PPIs, and get good results from their use, don't eat AT LEAST 3-4 hours before bed. In my own case, since I can not tolate PPIs, I don't eat past 3pm, and go to bed at 12-1am. Before bed I chew two Gaviscon tablets, which granted only last 2-3 hours, but at least help to limit my exposure.

I'm not sure I'm understanding everything you described. When you say "drank", does that mean alcohol? If so, not only is that dangerous to do while taking prescription medication, but it also will exacerbate your reflux.

-Bruce

Hi PPI-LESS

The surgery was successful in reducing my DeMeester score into the "normal" range. Unfortunately, since I have LPR, even a normal amount of reflux is still destructive to my throat. I'm going to a new doctor next month at the Mayo Clinic in Jacksonville, but I'm afraid the only option available to me now is the Nissen.

I won't "write the script"...hopefully he'll have something else to offer...

-Bruce

I rarely experienced something I would call heartburn before the surgery, and never now. All my symptoms were/are LPR -- hoarseness/laryngitis, burning in throat, dysphagia/difficulty swallowing, asthmatic symptoms, and headaches. Save for the 2-3 weeks following surgery when I was symptom-free, all these symptoms continue.

-Bruce

There is really only one typically GERD-only symptom, and that's heartburn. All the LPR symptoms are considered "atypical", and can include the ones I listed for myself, and some others. Yes, I also experience a bitter taste in my mouth, in the morning. This despite sleeping on a steep incline, and taking Gaviscon before bed.

LPR is GERD, but a special complication since it involves a weak pharyngeal sphincter as well as the LES. Any symptoms affecting your throat, vocal cords, and trachea/lungs are LPR. Do you experience hoarseness? Excessive mucous? Coughing, choking, inability to speak for long periods? Shortness of breath, rattling sounds in lungs? Do you note any improvement in these symptoms from PPIs? These are questions you must ask yourself.

Based upon my experience with the TIF, I believe it is not appropriate for those with LPR symptoms. I was a good candidate for the surgery, because my LES was described as "robust" with plenty of tissue to gather and suture. I can't fault the procedure or the surgeon, however, because, as I said, it was successful in reducing my DeMeester score. But as a sufferer of LPR symptoms, even a normal amount of reflux is still not good enough.

I was -- and still am -- afraid of the laparoscopic procedures. I made a choice several months ago to not continue with the doctors at the University of Alabama/Birmingham because the only surgical choice they offered was the Nissen. I was drawn towards the possiblities offered by the less-invasive TIF, and that was an easier choice (although still difficult) than the Nissen. However, at this point, I regret that decision.

That said, I wouldn't know what I do now had I not had the TIF. Hope this helps.

-Bruce

Your next step should be the Bravo pH study, and also have the physician take biopsies for eosinophilic esophagitis. It's entirely possible, if your reflux is mild enough, that the TIF could help you. As I said, though, if you have LPR, you need to eliminate ALL the reflux, which is something I don't believe the TIF can do. Even the manufacturer of the EsophyX device admits that the TIF is a bridge surgery between PPIs and the Nissen.

I tried to go back on Nexium a month ago, but only managed a week before the headaches got too much for me to bear. Even though it's been almost four weeks off the medication, I'm still struggling with the headaches. Today I'm a little better, though.

-Bruce

I went back to specialest today cause I did not know what tabs to take or what he put me back on pantoprazole my protium that worked for me at the start hope it works now