Upper Endoscopy necessary for GERD?

hi there,

i've had symptoms of GERD (mostly the 'silent' kind) for the past couple of months. The doc I saw suggested endoscopy to (I guess?) make sure esophagus, stomach look ok. And to check for H. Pylori.

Of course, after reading a lot about GERD and finding that it's due, usually to LOW stomach acid, not high, and also reading about how PPIs usually worsen that condition (and of course my doc recommended them), and also after reading articles by docs suggesting that upper endoscopies are overprescribed, I wonder--is an UE necessary if I don't have vomiting, bleeding, etc? As in, do docs just prescribe it because that's what they're used to doing? Apparently they don't find much more about GERD when they do, and also H. Pylori can be detected in other ways (I think).

I've been working on natural ways of increasing stomach acid, changing diet (no carbs, sugar, etc.), trying to encourage flora growth in gut and reduce bacteria...

I do have a history of stomach/colon cancer in my family.

Any advice is appreciated! Thanks so much.

Thanks, Tony. Yeah, I suppose it's a good thing to have done. I'm just a little nervous about it!

If you google 'low stomach acid', you'll see lots of articles about it. Apparently it's responsible for 95% of reflux issues. PPIs (from what i read) can further lower the stomach acid, which is not beneficial to us (the lowering, not the actual acid--the actual acid is very necessary!).

Interesting, as most docs don't seem to subscribe to this fact.

I thought my reflux was better, but the 'silent' kind came back with a vengeance last night...:(

Thanks again!

Thanks, Poppie. Do you think the endoscopy has value in determining damage to esophagus, stomach, H.Pylori, etc?

I know there are other tests to determine H. Pylori...

I thought I was having heart issues, so when heart studies found nothing, we went with an endoscopy. It revealed GERD, a hiatal hernia, stage 4 esophigitis, and eventually Barrett's.

'smooth', what treatment did your endoscopy lead to? I guess finding out that you have a severely damaged esophagus would be worth finding out...!

It sounds awful, but sometimes deep down in my heart, I wish they had found something from that scope. Anything. A reason to explain why I have LPR. A tear in my sphincter. A weak sphincter. Gastritis. Something. But they found nothing.

That way, I would know there was a reason for my LPR. A reason why I've had such bad symptoms for 7 months, and will probably have them for the rest of my life. But they didn't find anything. And every day, I just wonder---why? I'm a young healthy person otherwise. WHY?!

I agree with the idea that you'd like them to find *something*; I've dealt with unrefreshing sleep/fatigue for most of my life, and I always wished it was less idiopathic, more concrete. But alas, it's not to be (not yet, anyway!). Really didn't want this disorder on top of it, though...

Interestingly, I've noticed that when my stomach is distended and bile/acid coming up into my mouth/nose (i.e. reflux), I feel a new fatigue/suckiness. When my stomach, a little later, feels better/normal, the fatigue goes away. What could this mean?

I've heard that surgery can be tough. I hope you find relief soon...Have you seen any improvement yet?

electracat, um, I'm at a healthy weight now. That was a plus. I do overeat at times like I did the other night. I had some heartburn from it, which poor TonyG had to hear about. Haha. It's a little frightening.

The important thing is you're here and receiving good advice from people like Tony beforehand.

Hi Tony,
I had the endoscopy! Preliminary results are negative, but haven't gotten biopsies back yet.

Just wanted you to see what the moderator posted a couple of years ago;

"With laryngopharyngeal reflux, you may not have the classic symptoms of GERD, such as a burning sensation in your lower chest (heartburn). That's why it can be hard to diagnose and is sometimes called silent reflux.
Dr. of choice - an ENT who may use the Laryngoscope to check out the vocal cords for reflux damage, nodules or lesions."

I have these symptoms of LPR, which is why I mentioned having an ENT check me out, not a gastro. I guess a gastro doc wouldn't check on the vocal cords, etc? But...it still all stems from the stomach, in the end, so I would imagine seeing a gastro--maybe in addition to an ENT?--is as necessary for LPR as it is for GERD..??

I've read a theory about GERD/LPR in that the stomach is bloating (due to low acidity, bacteria, etc.) and 'pressing' the acid up the esophagus. That's what it feels like for me. Even though I have the 'silent' kind, no real 'heartburn', my stomach is constantly funky, especially when the reflux is happening. Does that imply that it's more of an issue with my stomach than with my LES, or is it both? Also, if you read about low acidity (which is responsible for most reflux issues), it does cause poor digestion which, in turn, could cause the reflux. PPIs lower acidity even more, which is why they're not a good choice for long term solutions...

A little freaked out because, as I struggle to get this under control, I'm losing weight. And I'm already skinny!

Whew. sorry for the long-windedness. And all the acronyms. ;) I guess I'm thinking/questioning aloud, a bit..
Thanks for reading! sad

Thanks, Tony!