Summarise:
Long term managed GERD for years on a pill a day (Pantoprazole). Didn't matter when I took the pill. If I forgot to take it, I'd get a small amount of heartburn after a few days and/or sour taste in mouth/burning tip of tongue.
After weight loss earlier this year, I stopped taking my PPI to see if the weight I'd lost had improved things. A few weeks went by, no heartburn, felt great. Then tight throat/burping one day. Got worse and worse, ended up week long heartburn, regurgitating food etc. Endoscopy revealed mild gastritis and weak LES.
Switched to Esomeprazole. Symptoms were really bad at this point. Burning throat including swollen lymph nodes, all day and night long. Really bad heartburn a few times, which seemed to be from too much liquid too soon after eating. After increasing to twice daily Esomeprazole and very limited diet (still losing weight), things settled down somewhat. Now I have a persistent either sour or sometimes burning taste in my mouth. If I forget to take my dose, the heat/acidity increases very quickly. My throat no longer burns, but it gets sore overnight while I sleep. This goes away during the day after eating/drinking. I am also sure that my gums and teeth are deteriorating (gum recession/thinning, teeth more sensitive, especially the front top and bottom teeth). My gums feel soft and spongy, not smooth and hard like they used to. It's what I'm most worried about
at this point in terms of getting this sorted soon. My other main symptom is belching all the time, which are not usually involuntary, but responding to a build up of pressure in my esophegus/throat that needs relieving (sometimes there is pain there too, like a bit of trapped acidic reflux is pressing against something).
So I went and had a manometry and PH impedance test (this was given as I did not want to come off the PPIs even for testing) in preparation for surgery. The manometry was normal so I don't have an underlying motility issue. However the impedance test was also normal and this was a shock to me. I did have to fast for it, so I ate even less of my already limited diet than usual on the day of the test. I was also careful with bending or doing too much because it was so uncomfortable wearing it. I am wondering if this has caused a false negative and I should have tried to eat normally (ie. twice as much as usual). I don't know if the test device they used (Digitracker PHz) detects acid gas reflux or not.
I was absolutely sure I was going ahead with the Nissen fundoplication but now I am freaking out a little that it won't help or that surgeons may even refuse to operate based on the normal tests. The fact that my primary symptom is the sour/hot regurgitation (I don't feel the regurgitation though, it just appears in my mouth, sometimes after "wet belching" but sometimes on its own), I had really bad heartburn a few times from small meals + water that really shouldn't have given me heartburn (including chicken soup), and that I get some relief from twice daily PPIs (gets much worse if I don't take it) would all mean that it must be reflux related.
Anyway, what do people think? Anyone had normal PH / impedance test and went through anyway, knowing deep in their heart that they had refractory GERD?
Post Edited (AusDad40) : 6/26/2019 6:39:17 AM (GMT-6)