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Frustrated with the state of GERD medicine

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Posted 2/24/2013 1:17 AM (GMT 0)
So seriously, medicine doesn't know what substance causes esophageal adenocarcinoma, who is more likely to get it, why only some people get Barrett's...

And you have a Dropping Acid diet book. that blames acid and its interaction with pepsin, and makes recommendations food and medication-wise completely the opposite of...

the Fast Track diet, which does not blame acid and which argues for a trend towards no PPI as opposed to max. PPI (that Dropping Acid's author has).

I've reached a point where this is just ridiculous. This disease is so common, and affects so many people...but doctors don't know anything. Great.

Sometimes I defend Dr's but it just hit me how the entire area of GERD medicine is stuck in the middle ages.
Posted 2/24/2013 3:46 PM (GMT 0)
ARM,

You took the words right out of my mouth! When you compare all the so called experts, it amounts to a big pile of sh....poo.

I have tried the Koufman diet and showed some improvement with reflux but almost always have water brash daily. Now, I'm going to go the ahead and give the fast tract a try and see what happens. I really don't have anythng to lose....other than my esophaguse, lol.

One of these three are the cause of cancer, now which one is it?

Stomach acid (control by ppis, most of the time/protected by carafate)

Pepsin (control by high ph intake)

Bile (protected by carafate)

Seems to me carafate may be the best defense (other than diet) against cancer. Funny thing is, I believe this was what dr's used before ppi's came around. Hmm, and cancer has gone up and up ever since.

Posted 2/24/2013 4:58 PM (GMT 0)
My GP loves Pepto Bismol.

My peception is that this is greatly impacted by funding resources. Drug companies fund drug research, and surgeons support surgical interventions. No one is funding dietary reasearch brcause there is no money in it. I do respect Norm Robillard's work and the not-for-profit Digestive Health Institute that he founded. But since he is a microbiologist, not an MD, he will have difficulty getting his work published in anything they read. Without that, the docs won't recommend his diet. It is a visious circle.

Post Edited (sunbeam48) : 2/24/2013 10:08:40 AM (GMT-7)

Posted 2/24/2013 5:51 PM (GMT 0)
Hi theacidrefluxman,

It's not only GERD medicine that's stuck in the middle ages, but all areas of medicine. If the USA (and others) put forth a total effort equal to that of World War II, I believe that more practical research and rapid treatment innovation would occur. In the era in which we live, medical care is big business.

Why cure Cancer?
There's so much money (business) in treating it, trillions of dollars in fact! Isn't everything for greed and profit?

When I was young, my dad said to me that Doctors know no more than 1% about the human body. I now feel that he was wrong. Perhaps the figure should be revised upward to 2%.

Money is the motivator. Sad, but true, I feel.

FWIW,

GM :-(

Post Edited (Gastricman) : 2/24/2013 11:01:41 AM (GMT-7)

Posted 2/24/2013 6:21 PM (GMT 0)
What I don't get is, in my case, why it fluctuates so much. I had a really good 4 month period during which I began to think about reducing my PPI. One week away from home has given me a massive flare up, so that I'm bad enough to even consider surgery. If it is structural how can it vary so much - surely the hernia is there or it isn't?! And my hernia is small - there are people who have small hernias and no symptoms, why aren't I one of those?!!

MMM
Posted 2/25/2013 3:58 AM (GMT 0)
Totally agree. I have no diagnosis other than I was told my LES was tighter than ususal?! And that this is "unchartered territory" as far as any treatment. Great! All my symptoms are very much LPR like, yet was told I don't need to even take zantac. I still do though. I'm at a loss of how to even treat myself.
Posted 2/25/2013 3:50 PM (GMT 0)
I'm sick of hearing one thing from my GI doctor and another from my ENT. The GI doc claims that Dexilant should stop regurgitation, but I still have it when on the meds. The ENT says that Dexilant only removes the acid but won't stop the reflux. So which is it??? I'm more inclined to go with the ENT.

Another point of confusion: My ENT offered botox as a means to relieve the lump or tightness in my throat (which the GI doc said is caused by the UES spasming). The ENT had me undergo an esophageal functioning test and ph test. He said that if the ph test showed non-acidic reflux, he couldn't do the botox injection, but he would do it if it was just acid reflux. After suffering through the testing, thinking I might finally have an option for relief, he tells me that he thinks that the Dexilant is suppressing the acid and the regurgitation is still irritating my throat, causing it to spasm. So why tell me he would proceed with the injection if the test showed acid reflux? Did he just suddenly change his mind about how the Dexilant was supposed to work??? This is so confusing to me that I'm not sure I'm even making sense anymore.

Long story short, the ENT has now referred me to what he called a "reflux specialist" who really is a surgeon. But could he have told me that himself? No, I had to find out by googling the doctor's name he gave me. I wanted to call him back and say, "Man up. If you think I need this surgery, at least tell me that's what you think."

UGH- sorry for the rant, but I've had it. I think the surgeon's going to have some explaining to do, because my doctors have different theories on these meds.
Posted 2/25/2013 6:38 PM (GMT 0)
Yes, we are frustrated! 😩 Had a professor tell me: "never forget that it is the PRACTICE of medicine."
Posted 2/25/2013 7:13 PM (GMT 0)
I was just going to post something like this! I am so fed up myself. One day I feel "ok" the next I am in pain. If it is a structural problem, like MMM said, why am I ok one day and not the next? I don't understand, and the treatment options are not appealing. I am really just tired of it all. My entire life is planned around this issue. I am considering the Linx, but I am not thrilled that you can't have an MRI. I am 30 years old and I am terrified to get pregnant because of the GERD.
Posted 2/25/2013 8:02 PM (GMT 0)
Hi ericapeace2000,

May I ask how are you currently being treated for your GERD?
How was your condition diagnosed in the first place (i.e. what symptoms and tests performed?)

My life is ruled by GERD and the highly undesirable long term effects of the PPI drug that I take.

Gastricman
Posted 2/25/2013 9:21 PM (GMT 0)
Please read what i just posted....finally i see improvement.
I tried the fast track and did not work.
I tried the drop the acid diet and did not work....now i understand why....its not totally alkaline. Has acid foods, if our gerd was not that bad maybe it would work but this requires a temporary drastic change...go alkaline completely for a week and see if you feel better. No cheating!!!
Im in my second week and everyday i feel more improvement.
You have nothing to loose!!!
Posted 2/25/2013 9:27 PM (GMT 0)
I was diagnosed at age 22 by endoscopy I started having issues when I got home from graduating college.I went to my doctor because I had stomach pain above my navel. I had experienced heartburn on and off but nothing debilitating. It turned into chest pain/esophageal spasms and a lump in my throat as well as mild heartburn. I was put on prevacid, and I tried all the other PPIs at that time. My esophagitus was mild so they really did not make a big deal out of it even though I still had symptoms. I was young so I just dealt with it, changed my lifestyle a little and went on. I had a really bad flare up Last February so I radically changed my diet and went through more testing. I had another edoscopy done and I had the same mild esophgitus. I also had an ultrasound done on my abdonmen, a chest x ray, blood test for celiac (negative, but I think I am still sensetive so I follow gluten free)and I had a gastric emptying study. Everything came back normal. I currently take Nexium 40 mg and a host of other vitamins/natural suppliments. I went on zoloft due to the stress of the condition. I take gaviscon at night, I try and take the gaviscon advance but it is very expensive and takes a while to ship from the UK. I have a new doctor and when I see him in April I probably will be setting things up to get the PH Study and Mamotry test done. I can't believe I have lived with this for 8 years already. Currently my symptoms include mild heartburn on and off, back pressure/pain, and a very mild sore throat in the morning that is gone quickly. The back pressure is mostly after meals and shifts from upper to mid back. It is very uncomfrotable.
Posted 2/26/2013 3:30 AM (GMT 0)
I agree with everyone on here...

I can longer tolerate the PPI's after 5 years of pure hell on them. I had a Nissan (didn't do a thing), gall bladder removal (that DID help), and I think I learned more from the internet than my doc knows - and I REALLY like my GI doc. We BOTH now agree that the PPI's made me worse, as well as a few other things.

Compared to what we know about the heart as an example, we really are in the middle ages when it comes to GI issues. :(

Side note to kitkat880: Once I stopped the PPI's that 'lump in the throat' went away. Go figure....
Posted 2/27/2013 2:20 AM (GMT 0)
So here's a question that bothers me: if GERD is simply mechanical, a malfunction of the LES, it seems that we should be able to eat about anything in small quantities. If the amount of food is small, and the stomach is perhaps only 1/3 full, it shouldn't matter if the LES relaxes, or if a little gas is produced by that food.
Posted 2/27/2013 4:24 AM (GMT 0)
Not sure, I know any kind of shifting of my body or gas being produced is horrible for me. My stomach feels worse with less food in it. It gets really rumply, like it's eating itself. It kinda jets contents up into my mouth/noise and then a few seconds later my chest will start hurting.
Posted 2/27/2013 5:14 PM (GMT 0)
I also have to have a flow of food. I try and eat something every 2-3 hours as much as I can with my busy life. I really do not understand how each day is different with a structural problem. I think there has to be some nerve issue or something else.
Posted 2/28/2013 12:28 PM (GMT 0)
One reason I have been told that sometimes I have symptoms & sometimes not is because the hiatel hernia is a "sliding hernia". This means the stomach moves up through the whole in the diaphragm & causes the LES to relax too much & then symptoms are worse. When the stomach slides back down below the diaphragm, symptoms are not as bad.
Posted 2/28/2013 2:36 PM (GMT 0)
I can understand things fluctuating with a hietal hernia, but I don't have that and it still changes!
Posted 2/28/2013 4:24 PM (GMT 0)
I'm so with everyone here! It's frustrating and confusing. I feel like if I went to 12 digestive specialists, and 12 surgeons, I'd get 24 different answers.

I almost quit this forum because I read so many conflicting things...but when it comes down to it this is the best place for the information I need right now, that I can find on the internet.

I've decided to listen to what feels right for my body, take the advice that feels right, and go with it.
That being said, someone mentioned a weakened LES as the cause for regurgitation. My LES is apparently fine (through tests anyway) and I still get regurgitation if I forget to take my meds...so now I'm confused on that.

Also YES you still have reflux weather you are on PPI's or not, Just had my second Manometry and that's what I was told. Reflux is reflux reguardless of any acid, rolleyes

I'm scheduled for the results of that test, and it must not have been good because they are sending me for blood work right after for a Nissen that was tentatively set up before the manometry, depending on the results of the test.

If it realy is just the 'practice of medicine', they've gotten plenty of practice on me.They should be paying us for all this practice, not us paying them wink
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