Stubborn Heartburn

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pharcyder
Regular Member


Date Joined May 2012
Total Posts : 69
   Posted 5/2/2013 9:33 PM (GMT -6)   
Hello everyone! I have a few questions about heartburn. Perhaps you can help me :)

I have a "gaping LES" and small hiatal hernia. I had an endoscopy done in april of 2012 and I had esophagitis while on lansoprozole 30mg/day.

Since last year, I have taken Dexilant 60mg/day for about 6 months. I didn't get full relief so I now take Nexium 40mg twice daily.

I still get heartburn just about every day. I try to limit myself to 10 tums a day, but sometimes more is necessary. My hearburn isn't that bad, but I do feel constant discomfort.

So, what's up with my heartburn? My doc says I shouldn't get heartburn while on such a high dose of PPIs, especially since my hernia is small.

How long can I keep dealing with this heartburn before it turns into barretts/dysplasia/cancer? My endoscopy revealed no barretts last year.

My doc also said Nissen isn't a good choice right now because I'm so young (mid 20's).

So what are your thoughts? Thank you all for your help :)

Stephen

Pat Tall
Veteran Member


Date Joined Aug 2012
Total Posts : 950
   Posted 5/3/2013 5:58 PM (GMT -6)   
Stephen ,-- you sound to me like a candidate for the Linx. They would also correct the hernia at the same time. Have you done all the other things,-- such as elevating the head of your bed, stop eating several hours before bedtime , give up coffee , beer, carbonated drinks, acid type foods like tomato, chocolate etc. Take aloe,- like George Brand. You probably had a barium swallow test ? Maybe time to see surgeon experienced in fundoplication and Linx for an opinion. You will find out if you are a candidate from surgeons point of view. (I don't think they would try to talk you into it.). They look at things from a different perspective. ( these are only my thoughts ). B T W. the Linx can be taken out and that is a good point in my view.

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 5/3/2013 10:10 PM (GMT -6)   
Stephen-

Not sure why your doctor said surgery wasn't a good option as they do this surgery for infants to 80+y/o.

What stood out to me was "gaping LES". If it isn't closing no amount of PPIs will help. This is what happened to me. My LES stayed open about 3/8 to 1/2 inch.

You may want to get a 2nd opinion about this.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

pharcyder
Regular Member


Date Joined May 2012
Total Posts : 69
   Posted 5/4/2013 9:16 AM (GMT -6)   
Opnwhl4,
Even while on PPI's, will my esophagus be damaged if my LES stays open? This is a scary thought. I don't want to get cancer.


Stephen

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 5/4/2013 2:22 PM (GMT -6)   
If on PPI's your esophagus won't get damaged as long as the PH level is kept high enough. So your Dr. must think it is being kept high enough despite the symptoms. That is why he thinks surgery isn't a good option at this point...because what you are feeling isn't acid if your acid is well-controlled.

A few studies show Barrett's usually appears on first endoscopy or not at all (5-20 years out).

Read these guidelines by the American Gastroenterological Assoc. and they might help you understand where your doc is coming from. Ultimately the decision is yours on what you do though.

http://www.gastrojournal.org/article/S0016-5085%2808%2901605-3/fulltext

PS. I am in a very similar boat as you.
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