Posted 6/2/2012 8:47 PM (GMT -7)
Long time lurker here and I wanted to ask people for some help/suggestions. But, before I do that, I should give my description and story. I apologize if this is too long, but a lot has happened in the last couple of years.
I'm a 28 year old Asian male who's 5'6" and about 115 lbs.
about 20 months ago (September 2010), I began having some pretty bad "stomach issues". I say issues because they share some similarities with GERD, but there are also some odd symptoms that don't quite fit in place. My issues during that time were severe indigestion including gas and burping (sometimes difficult) that would persist well after eating (3-4 hours). My stomach would also feel full and uncomfortable (slow stomach emptying), and I would have that stuck feeling in my throat, as well as nausea. The other problem I had was I would feel a cool minty (yet chemically tingly) sensation in my throat/mouth/tongue/nose at times. But, I did not have the standard acid reflux symptoms of burning or sore sensations in my throat or chest. Without any medication, these symptoms would get slightly worse after every meal and eventually I went to see the doctor who put me on nexium and carafate. For the next 2-3 months, I would go off nexus and carafate and prevacid since I dislike being on medication (and my parents have gone on and off PPI's as such before), and each time I went off of medication, I'd get back them several days later as my symptoms returned.
At this point (January 2011), I had no choice but to do some research of my own and discovered acid rebound and the effects of PPI's. I decided to try and get off medication and to control my eating and see if I can fight off my symptoms. I tried using DGL along with enzymes to help me through, but my effort was in vain. My symptoms listed above would return, and I discovered that my stomach would "shrink" in the sense that I would get full earlier than normal, to the point where I wasn't eating enough food to compensate for the energy I would expend through the the day. I tried eating smaller meals but the delayed emptying would just mean I couldn't eat much the next time I ate. After a month of hell, I had to get back on PPI's.
I soon discover something disheartening. I discover that my body seems to get tolerant of the different PPI's after roughly 4-6 weeks of usage. I would notice that my symptoms would slowly creep back and I would be force to switched between Dexilant, and Prilosec and Nexium in the next 3-4 months. I tried to do research online about PPI's and tolerance, but most people say that this happens after year's of usage. I'm not sure why my body is so different, but it was obvious that PPI's could not be my long-term solution. After some research and testing, I eventually switched to 2 x 150mg of Zantac (Ranitidine) and a teaspoon of Slippery Elm powder a day. The slippery elm powder seems to work decently, and I eventually moved to about 1 teaspoon of slippery elm powder before every meal. This worked for the better part of 7 months and I could eat pretty much anything and at the most I'd have some mild indigestion and burping. I was quite impressed with this. The unfortunate thing was that my theory about acid rebound did not pan out, and I could hardly miss a dosage of slippery elm powder or else my symptoms would slowly crawl back. In essence, my body never fully healed.
This is where things go from okay to bad. about a week ago, I started having worse than usual indigestion due to stress from work and life stuff. Not a big deal overall. But, then I went to a wedding and danced and jumped around and stuff, and noticed some pains in my lungs and chest area. I didn't think of anything at the time, because every since 20 months ago, I've never been able to do any jumping and running or else I would get that "cool tingly" sensation in my throat/nose/mouth. However, a day later, I find that I'm getting acid reflux at night, of which I've never had in the past. When I lay down to sleep, I feel as if air is rushing from my stomach and out into my neck and lungs and makes my chest and throat area uncomfortable. I wake up with a slightly sore throat, difficulty breathing (as if I'm in a sauna), and some chest and back discomfort. The cool/tingly sensation in my throught/mouth is back as well and pretty persistent throughout the day. In the past week or so, I've had to re-introduce myself to Zantac and I am taking 300mg's total spread-out in the day along with my Slippery Elm powder before each meal and I would say I feel somewhere between my best and worst moments.
When I realized that I was tolerant to PPI's, I went to get an endoscopy done and the doctor only noted mild gastritis. I sleep on an elevated bed (about 2 inches), and I make sure to take my Zantac about an hour before I take my slippery elm tea so I don't have poor absorption. My diet has mainly been stir-fried vegetables and meat with rice, both of which are lightly seasoned and not heavily greasy. For some reason, tums or other OTC ant-acids seem to make my stomach feel really bad.
Here's where I need some advice. Overall, I'm pretty stressed out about all this and with the added stress of work and stuff, I would say I'm on the edge of breaking down (only the love and care of my parents are keeping me up). I'm also not sure where to go from here. My tolerance to PPI's only makes it a short term bandaid and I'm not sure how much more Zantac I can take in a day. I'm also not sure what changed physically. Having a crappy HMO also means I have to see my primary care doctor before I can see my GI. Who knows how long that'll be. I guess my question is, do you guys have any ideas as to what's going on with me???
If you ask me, I think there are two things at play. Part of it is that I think I have a weaker stomach than most people. My mom's always had trouble eating things that are hard to digest so there's a genetic part to it. However, her digestive system heals after a while, unlike mine. So, why doesn't my body heal? I believe that I must have a somewhat dysfunctional LES that must have gotten damaged even further after the wedding I attended a week ago. This would explain why my slippery elm dosage has not been sufficient and I've had to introduce a relatively high dosage of Zantac along with it. This would also make sense as to why my "cool tingly" sensation has gone from sometimes, to almost every single moment. My GI didn't mention anything about a weak or damaged LES after my endoscopy. So, If I see my GI again, what tests should I ask to be done to test the function of my LES?
Am I missing anything else??? or let me know if you want any other details or if you want me to re-write something that doesn't make sense, since I've written alot and am not sure it all makes sense to you. Thank you!
What tests should I ask my GI to perform to determine if I have a weak or dysfunctional LES?