A few queries about Gastritis and GORD (GERD)?

Question

I am a 30-year old male who doesn't smoke, drink to excess and in general good health. My diet however is not the best! But, I've recently been to A&E complaining of chest pains and I was diagnosed with Gastritis coupled with GORD. I had an ECG done at A&E which ruled out a heart problem. I went to the doctor for a second opinion but they seem to think it's the same and they have prescribed me Omeprazole 20mg which I have been on for a month now (except for my second week where I was upped to 40mg as my symptoms had worsened). I've also had a stool test done which came back normal as well as a blood test which also came back normal.

However, I have a few queries:

1.) What are the signs that the Gastritis/GORD is going away? Is it gradual or is it sudden?
2.) Is it OK to occasionally have a junk food meal? (I have a party to go to shortly and it's looking like a take-away). Also, if this turns out to be a curry, would a Tikka Massala be OK spice-wise as I know you're meant to reduce the spice intake?
3.) How long can I expect to be taking the Omeprazole for?
4.) My symptoms seem to get worse at night, is this usual for Gastritis/GORD?

I haven't had any of the serious symptoms like throwing up or being in unbearable pain. I am able to do most things I used to but it can be quite painful when it flares up. However, at present, I've noticed a few extra symptoms which I never had before . These are a really sore throat (which I think is tightening anyway as I'm having difficulty swallowing), my stomach occasionally feels like it's pulling and then feels like its being sliced with a very thin razorblade but only for a small period of time, I've developed a really bad jawache and the small of my back is beginning to ache. I've also got what feels like a bruise under my ribcage in the area where you're meant to press when you do CPR (I think it's called the sternum). Do you think this could be the Omeprazole taking effect?

However, I think the GORD is reducing slightly but maybe it's just moving to other areas - do you feel my symptoms are worsening, staying the same or getting better?

I should also mention that I have Generalised Anxiety Disorder (GAD) which means I worry about virtually everything so as you can imagine this is sending my stress levels through the roof!!

Any info you could give me would be great!!

Cheers all!!

Answer 1

Hello,



If the Omeprazole is definitely helping the pain, then we can probably conclude that excess stomach production of acid is at the root of the problem. Especially if the relief is dose-related, the 20mg and 40 mg you mention.



Presumably you had cardiac enzymes and Troponin T blood tests as well as the ECG. For double certainty that your heart is fine.



The reflux element of GERD is that usually, there is a one-way valve where the food pipe joins the top of the stomach. If for any reason this valve allows leak-back, then as well as causing pain and inflammation in the stomach, some of the excess acid can also escape upwards through the leaky valve.



Acid upward-leaking into the food pipe, causes burning sensations behind the breast bone, and the experience of water-brash where "hot" water comes up into the mouth.



Your worries may be causing your stomach to overproduce acid, but I think good medical practice requires other causes to be ruled out. This means ruling out,



- (1). A stomach ulcer,

- (2). A duodenal ulcer,

- (3) A stomach infection with the hyper-acidity germ called H. (short for Helicobacter) pylori.



In my opinion you should next have an endoscopy, - your food pipe, stomach and duodenum looked at with a flexible fibre optic camera. I have had one of these and it' s no big deal, really.



If you have an H. pylori infection the endoscopy will pick this up, and a triple-antibiotic tablet course should fix it, hopefully permanently. In that case, your need for Omeprazole may cease.



In some ways a stomach or duodenal ulcer is not so likely, on the grounds that we shouldn't invoke double illnesses , (the philosophical principle of Occam's Razor).



But pain getting worse at night, is sometimes a symptom of an ulcer, either duodenal or stomach. Taking omeprazole at a dose of 20 mg in the morning, and 20 mg at night, may be worth trying pending more medical advice.



The acid return may be causing you a sore throat, I am a bit more uncertain about the other new symptoms. If you have jaw pain, you should have another Troponin T blood test, in my opinion, as heart pain can radiate to the jaw. I would not have thought omeprazole at only a 20mg dose, was responsible.



I hope these ideas are of some help. Ideally you should stop drinking alcohol altogether until this is settled, in my opinion. I feel that your doctors may not have got to the bottom of your symptoms yet.



Best wishes,



Belliger

retired uk gp

Answer 2

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Answer 3

Have been on the nexium very long? maybe it isn't the right acid reflux medicine for you, I had to try prilosec, zantac, and finally the nexium, and put blocks under my bed to elevate my head at night along with 2 pillows you may try those also it does help. Juices are a killer sometimes, but I still drink and eat the things I want to I just don't overdue it. I rule out by taking chances what really sets it off then I stay away from those items. It is Gerd

Answer 4

I suffer from silent reflux, in that I never felt anything. Now that I was prescribed Omeprazole 20 mg like you, I can feel myself regurgitating. There are no signs other than another endoscopy for the gastritis but if you suffer GERD symptoms, I believe it would be gradual from what I have read.



You need to eat very healthy with GERDs as many types of food cause the symptoms to worsen. I was told to keep a food journal. If you eat junk food like a burger and there are no symptoms then you can keep that on your list. But most foods are greasy, fatty, spicy ones that worsen the GERD. You need to start clean eating mostly veggies and fruits and ease back into the foods you like later on as your symptoms dissipate.



Unfortunately, GI docs put people on these things for life. I hate this drug because of the many side effects. I never felt anything before but I am thinking mine is worst at night as well. It just depends on the person. Some people have reflux day and night and the medication does nothing to stop reflux, only the symptoms of GERD.



You can thank the drug you have to take for the worsening of your symptoms. Sore throat is part of it because as you sleep the acid has gone up so a sore throat is common. I use honey to help mine. Omeprazole causes rebound reflux and this has been documented in clinical studies. I hope the drug works for you because it is doing nothing for me. I only have to take it because I was diagnosed with longsegmented Barrett's Esophagus with no cancer.



Please try some relaxation exercises because stress just makes it worse. Eat lots of oatmeal, whole grain, lots of greens like collard greens, asparagus, spinach and kale. No carbonated beverages of any kind, no colas, caffeine or coffee. Keep a food journal so that everytime you eat something you can determine if it causes symptoms or not. If it does, stay away from that food or drink. Eat smaller meals (portions) so you tummy does not distend (eat 4 to 5 small meals and not 3 big ones), wear loose clothing (no pressure on the tummy - will cause acid to rise), Sleep on your left side and not your right side (the junction between the tummy and the esophagus is located on the right causing acid to be pushed up) and don't eat late - eat your heaviest meal early in the day and keep it late in the evening. Don't eat anthing 3 to 4 hours before you are ready for bed. Raise you bed post so you are at an inclined so the acid won't spill upward while you are sleeping. Yeah I know it sucks.

Answer 5

take omeprazole first thing with cold water...eat after half an hour ...the pains in chest are usually your innards which are swollen with gas resting on vegus nerve which can radiate pain anywhere in your body which is very confusing..my main pain was in back of my shoulder right side and pain in upper right chest dull ache..ive had it all and found that if adhere to my initial advice im ok and can eat anything ...also when you are bloated the gas moves your bowel so that food does not have time to digest and it appears you have diarrhea[?]..acid reflux or over acid production is very real and the effects can devastate life....never take omeprazole and Lipitor together very bad experience

Answer 6

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