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Stomach issues

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GERD & Acid Reflux
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/6/2021 12:35 PM (GMT -8)
Hello,
I have been having issues since the beginning of January. It started out with a pain near my ribs, under my left arm. I thought it was a heart attack.
Around this same time I started getting this wretching nauseous feeling along with a pain in my upper left stomach at random times. When I wake up, after I eat etc.

I have been taking Celebrex for years for muscle skeletal issues and recently, like about two months ago switched to diclofenac. I’m wondering if the meds may have caused this? I stopped taking this two weeks ago when I saw the gastro.

Since then I have seen my cardio, gastro, and primary doctor. I had a chest X-ray and ekg, all normal. I had an endoscopy twice in my life. The most recent was two years ago and that said mild chronic gastritis and a small hiatal hernia. I was put on 40 mg of pantoprazole. I had stopped taking it though bc my heartburn symptoms had gone away. When I saw the gastro two weeks ago he said to take the pantoprazole 2x daily.
I am having a endoscopy on Monday and am pretty nervous as I’m just not feeling right. Any insight? Thank you.
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2965
Posted 2/7/2021 6:28 AM (GMT -8)
MCass:

Try not to be nervous, the endoscopy will be the quickest way to see what's going on. The PPIs helped before, and that means that they will probably help again. Try and start a strict GERD-friendly diet, and keep a food diary to try and pinpoint your potential trigger foods. I know you are suffering, but you've only been experiencing these symptoms for about a month, so that's good. Speak to your doctor about discontinuing the diclofenac, it might not have anything to do with your symptoms and may cause you additional discomfort.

Sharon
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/7/2021 6:40 AM (GMT -8)
Thank you so much for the reply. It’s much appreciated! I find this form to be helpful. I have been trying to eat very light for now. I haven’t taken any of my “pain meds” in two weeks. A food log is a great idea. I’m going to start it today. Yesterday I had an apple with a little peanut butter for lunch.. it went down easy enough but then I had the pain in my upper left stomach as I finished it. It lasted about ten mins. For dinner a whole wheat English muffin with a little butter and bone broth soup. No pain after that, just feeling a little more full then usual. Thank you for your input! Stay well and safe!
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2965
Posted 2/8/2021 3:46 AM (GMT -8)
MCass:

Another suggestion would be to try and chew your food thoroughly. I've found that very helpful. Also, ask your doctor for an anti-nausea medication such as Zofran.

Good Luck, and let us know how your appointment goes.

Sharon
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/8/2021 9:03 AM (GMT -8)
Hello Sharon,
I had my test done and the doctor said everything looks good. He said I still have a small hiatal hernia but that wouldn’t cause my symptoms. He also said he didn’t see any gastritis this time. He took biopsies and I’ll be seeing him again next Monday. I was a bit out of it and didn’t get to ask him everything I would’ve liked. I’m at a loss as to what is causing my symptoms. I’m continuing the food diary like you mentioned. I’m writing down my symptoms in there as well. Thank you so much for responding. I hope you’re doing well.
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/10/2021 6:09 PM (GMT -8)
Just following up, I read the report, it said mild antral erythema. He said he took biopsies for celiac. I haven’t heard anything back yet. I’m following up with him on Monday. I’m still feeling nauseous though. I was fine all day until after dinner. I’m worried as to why. I had blood work done January 20th. And had a ct scan of the abdomen on 12/05 with out contrast. My gastro had ordered an abdominal sono almost two weeks ago now. Other then a lot of gas, it was normal. Wondering what I can do. I’d appreciate any advice.
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2965
Posted 2/11/2021 2:32 AM (GMT -8)
MCass:

Usually mild antral erythema is just inflammation of the stomach lining caused by gastritis - I've been diagnosed with this in the past. Gastritis is famous for causing nausea.

I've been told by my doctors that biopsies, including for celiac disease, can take up to two weeks. At this point, the only thing you can do is wait until you have your followup with your doctor next week. Make a list of questions to ask, I've found that always helps. Don't forget to inquire about the anti-nausea (Zofran) medication.

Good luck, and let us know how your appointment goes.

Sharon
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crf
New Member
Joined : Feb 2021
Posts : 8
Posted 2/11/2021 5:52 AM (GMT -8)
MCass:

I can relate to some of what you're mentioning in your post. I also have other medical issues as well. I don't take Celebrex, but I do take other meds for my heart and thyroid. I have been for almost 20 years. I've been dealing with some kind of stomach/gastritis problem for the last 2-3 years, and have had two endoscopies and a colonoscopy. One endoscopy a little over a month ago. What they found on all of that, was basically "gastritis". That's the docs catch all term for irritation and inflammation...erythema. I also have a small hiatal hernia. I've had to change my diet several times over the past 20 years, and again a couple times in the last 2-3 years due to this stomach issue. I was on a couple different ppi's 3 years ago when this first started, and I'll NEVER take them again. Made me sicker than the condition. The side effects are brutal for me. I'm very sensitive to all meds and seem to be extremely sensitive to anti-acid meds. I weaned off the ppi's to Ranitidine, then weaned off that too. Felt somewhat better for 18 months or so. This latest time, I started having more stomach issues and started taking Famotidine, since I kind of knew what was going on. Ranitidine is off the market. Had another endoscopy and they found gastritis again. No ulcers, no celiac, no H Pylori, all biopsies negative. All "good" news...I suppose. With my GI doc's input, I was on the Famotidine, and then added Sucralfate a about a month after that. Was on both for a period of about 3.5 months total. The side effects from both drugs were very bad for me. I weaned off both and right now I'm trying to not take anything. I'm still dealing with the rebound effect and it's making it very tough. I have no idea how long that will last. It could be months. I have a post in here about acid hypersecretion if you want to read it. I went into more detail in that post. I wake up every morning and wonder..."ok, how am I going to feel today?" I get all kinds of odd pains and sensations at different times of the day. They come and go, and don't seem to be linked to anything I'm currently ingesting or doing. Hopefully, I've eliminated whatever is causing the irritation...I honestly don't know yet. I get what apparently are acid surges...which are kind of like a hot flash of some kind. They're very unpleasant. I also have nausea every day along with some indigestion. I'm hoping that all this will resolve at some point when I get over the withdrawal, and maybe I'll start to feel better. I go in to my GP for a complete blood work up in a couple weeks. I hope all of that is ok. Acid reducing drugs can mess with your blood levels too.

In any event...the endoscopy is the only way to find out what may or may not be going on in your gut. Don't be afraid to do it and don't be afraid about the results. Knowledge is power. My only advice would be to be very cautious about doing a ppi or H2 blocker, and take a great deal of time when you wean off either one. No matter what any GI doc says, there ARE major rebound effects from them and it can be far worse than the original condition. Alot of GI docs are clueless about acid rebound. They deny it exists. Your stomach needs to make acid and a ppi shuts that all down. An H2 blocker does too, but to a slightly lesser extent. When you go off the drugs, your body goes into overdrive making stomach acid and you'll feel worse. From what I've read, the rebound will eventually subside and the stomach acid will return to "normal" levels. I sure hope that's correct. I wish you the best of luck with your situation. Keep us posted.
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Tu Wang
Regular Member
Joined : Jul 2015
Posts : 235
Posted 2/15/2021 10:11 AM (GMT -8)
Hi CRF,
I hope you are feeling better now. Weaning from PPI is a tough job. All the best to you. Rebound might be tough but you can do it. Stomach sensitivities is the toughest thing to deal with but just do the diet. Losing too much weight is my current situation as stomach sensitivities is back. I tried having Olive Oil on my diet. Eating small portion and frequently had helped too.

All the best.
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/16/2021 3:27 AM (GMT -8)
Hello everyone. Crf, I am sorry to hear of the symptoms that you have been experiencing. I followed up with my doctor yesterday. He said that all biopsies were normal. So the erythema could have been from the diclofenac. I have decreased the pantoprazole to 40 mg 1x daily. I take it first thing in the morning. But I am still experiencing nausea and pain in the mid to upper left abdomen. If I eat light I’m fine. I went out to eat with family a few days ago and had more food then normal and felt awful after dinner. Very full and pain in upper left abdomen almost feels like a chest pain. I had a ct scan with out contrast in December as a yearly fu to something else. It was normal. But the original ct scan in December 2019 had contrast. So the dr I saw yesterday was thinking of ordering another one but then decided not to. Too much exposure at young age etc. Should I request another ct scan with contrast?? Would a ct scan with out contrast have seen anything abnormal? Thank you for any advice.
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/16/2021 3:34 AM (GMT -8)
Can mild antral erythema cause symptoms?
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2965
Posted 2/16/2021 5:41 AM (GMT -8)
You are probably experiencing some rebound acid from cutting the dosage of your Protonix. You need the PPI to take care of the gastritis. Did you doctor tell you to reduce your dosage? All of your symptoms are consistent with your gastritis diagnosis. Try eating smaller, more frequent meals. Your endoscopy and biopsies were normal, so I would go with what your doctor is telling you.

Sharon
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/16/2021 6:11 AM (GMT -8)
Thank you Sharon. The doctor honestly did not have too much to say. It was as if the erythema he found shouldn’t be causing the symptoms.. that is why I’m like, well what’s causing it? But I did tell him that I dropped the night time dose on Friday. So, I’m sorry to be a pain but you have experienced this? The nausea comes and goes throughout the day. I am wondering if it’s anxiety. But then the feeling of fullness and sharp upper left pain after certain meals. Usually more fatty meals.. You think that is somewhat normal for this? He did say that this could’ve been caused by the pain killers. Lol I’m a mess.
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crf
New Member
Joined : Feb 2021
Posts : 8
Posted 2/16/2021 6:35 AM (GMT -8)
Hi MCass. My GI doc also didn't think that my irritation/inflammation/erythma should be causing symptoms to the extent I'm having. My belief is...that's too much of a generalization, which I suppose docs have to do somewhat. Everyone is completely different and what affects one person may not affect another the same way. I do agree with Sharon...you're probably going thru some rebound from the PPI.

From what I 've read, Diclofenac is a pretty potent NSAID. Much more than aspirin. I'd be willing to bet that could be contributing to your irritation. Do you take that with food? I don't know what the protocol is for it. I also don't know what the protocol is for CT scans/ x-rays. I don't think it's advisable to have too many, too close together.

As always, you need to talk with your doc and work out what's best for you. Best of luck. .
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2965
Posted 2/16/2021 8:17 AM (GMT -8)
MCass:

I definitely think your symptoms are related to your eliminating the night time dose of Protonix. Usually, a doctor will suggest a plan for weaning off of the PPI. If that is your intent, I would ask the doctor how you should go about it. Go back on the evening dosage and let your doctor tell you the process he wants you to take. You usually get rebound acid if you just stop taking it. You mentioned you are taking Diclofenac. Is it orally, or Voltaren that is topical?

Sharon
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MCass
New Member
Joined : Feb 2021
Posts : 11
Posted 2/16/2021 9:12 AM (GMT -8)
My doctor seemed very uninterested to be honest. I stopped taking the diclofenac. I had been taking it orally for about two months. I have used the cream as well but not on a regular basis.
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