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GERD/LERD Archive Questions

Below are Dr. Fantry’s answers to GERD/LERD questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 69.

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Q : 1

I occasionally get a GERD attack while sleeping. My throat airway blocks and I'm panicked at not being able to breathe. It then does 'reset' but wonder if this could be life- threatening and/or what should/can I do when this happens, if anything?

If you are following reflux precautions (not eating within a few hours of recumbency and elevating the head of the bed)and taking acid suppressive therapy (PPI before dinner or at bedtime) and you are still having these symptoms related to nocturnal reflux, further evaluation and more optimal long term treatment may be required. There is not a specific "GERD" treatment when the event actually occurs.

Q : 2

I have been diagnosed with severe gastritis, duodenitis, reflux esophagitis and SCHATZKI'S ring. At night, my stomach become bloated and very acidic. What course of action can I take to prevent this. No matter what time I eat dinner, my stomach is bloating every single night.

Bloating after eating is not a typical symptom of gastritis, duodenitis, or reflux, all of which can be adequately treated with acid suppressive therapy. Most Schatzki's rings are asymptomatic. There is not a specific treatment for bloating which can be related to swallowing air, ingesting certain gaseous foods/liquid, irritable bowel syndrome, malbsorption or intestinal obstruction and I would recommend that you discuss this further with your physician. Dr. Fantry

Q : 3

I had a Nissen Fundoplication in 2010. While it has stopped the extreme GERD I was experiencing, I am still dealing with bloating and stomach distention. Is there any thing that would help this?

Bloating and stomach distention are symptoms unrelated to GERD. There are many potential causes of bloating and distention including air swallowing and irritable bowel syndrome. These symptoms can also be precipitated by a fundoplication (gas-bloat). There is not a specific remedy and you should discuss potential cuases evaluation and treatment options with your physician. Dr. Fantry

Q : 4

After 9 months, I have finally been diagnosed with non acid reflux. I don't feel I am getting anywhere with my current doctor, although through research, I realize there is not much help for this. Do you or anyone specialize in the non acid problem?

Non-acid reflux is related to GERD where there is persistent nonacid reflux on medical therapy for acid reflux. There is not any proven, longterm medical therapy that is effective for nonacid reflux. If you have proven, symptomatic, bothersome nonacid reflux, the primary treatment option is antireflux surgery. If you would like to be seen at the University of Maryland by one of my colleagues in our Division, you can call 410-328-5780. Dr. Fantry

Q : 5

I've recently read some articles about how GERD may actually be caused by bacterial overgrowth from low stomach acid - making digestion of carbohydrates difficult - causing symptoms. What are your thoughts on taking probiotics and lowering carbohydrate consumption for treatment of GERD?

There is no great data or proof to suggest that bacterial overgrowth and low stomach acid cause GERD or that probiotics and lower carbohydrate consumption are effective treatments for GERD.

Q : 6

What is erosive oesophagitis?

This term is used to describe breaks in the lining of the esophagus with associated inflammation that may be seen at endoscopy due to untreated or incompletely treated GERD.

Q : 7

I was just diagnosed with LERD and have had larynx spasms. These spasms are frightening because I can't breath. What is the best way to avoid getting larynx spasms again? Are they life threatening?

If laryngeal spasms are thought to be due to LERD, the best way to avoid them would be to aggressively treat underlying GERD. This usually consists of lifestyle modifications or reflux precautions and medical therapy with a proton pump inhibitor once or twice daily. GERD and LERD in general are not considered life threatening diseases when diagnosed and treated properly.

Q : 8

I have been suffering from GERD symptoms for the last few weeks. I have also been having headaches. Could the headaches be triggered by episodes of GERD.

Headaches are not triggered by GERD. However, headaches can be a side effect of commonly used medications to treat GERD, namely proton pump inhibitors {PPIs} such as Prilosec and others.

Q : 9

I was born with esophageal atresia and I have chronic reflux with aspiration 5-7 times a week. Are there any treatment options that would help this situation?

Treatment for reflux would include reflux precautions and acid suppressive therapy with proton pump inhibitors such as Prilosec. An evaluation with a barium swallow, endoscopy and potentially pH monitoring may be beneficial.

Q : 10

What is your opinion on the relationship between GERD and obstructive sleep apnea (OSA). Is there a correlation between the two?

GERD and OSA are common entities with similar risk factors. Based on available data, it remains controversial as to whether or not there is a correlation or causal relationship.

Q : 11

I'm on Nexium and in the last month or so I have pain in my chest that wakes m but goes away when I sit up slowly. Should I have another chest X-ray to be sure that I haven't developed something more serious?

Yes, you should follow-up with your primary care physician to ensure that there is no significant heart or lung issues that may contribute with your chest pain. From a GERD perspective, avoiding eating within a few hours of lying down and elevating the head of the bed may help. Nexium should be taken twice daily 30 minutes before breakfast and dinner. If unexplained symptoms persist, further evaluation may be warranted.

Q : 12

The only thing that helps my heartburn is Prilosec. How long can I safely take it? I utilize it only when absolutely necessary.

Prilosec and other similar medications called proton pump inhibitors (PPIs) are commonly used on a daily basis for long-term management of frequent heartburn due to GERD. If you have severe heartburn requiring Prilosec, you should discuss this with your physician to confirm the diagnosis and discuss optimal long term treatment strategy.

Q : 13

I have been diagnosed with GERD. I was wondering if GERD causes one's stomach to be distended? I had an upper GI study done and my doctor told me that for some reason my stomach is distended, but that I don't need to worry about it because it's not very distended.

GERD does not cause the stomach to be distended.

Q : 14

I have used slippery elm to treat my GERD with great success. How long can I stay on it? Is it safe to use regularly?

I do not prescribe or recommend slippery elm to treat GERD.

Q : 15

I suffer from achalasia. Do you suggest a dilation or myotomy?

Pneumatic dilation and laparoscopic heller myotomy are generally considered equally effective primary treatment options for achalasia. A number of factors may be involved in deciding which is the best option for an individual including age, features on an esophageal motility study, available expertise to perform these therapies and personal preference.

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