What are your options when you are young, healthy, at a good weight, avoid trigger foods and alcohol, never smoke, take 2X daily PPIs, and you are miserable from your GERD symptoms? This question came from a woman who has done so many things right, but she is still suffering severe GERD symptoms along with anxiety. There are, however, options she can consider, but an important consideration is a second opinion from a GERD expert.
I am a 46-year-old female and I was diagnosed with Barrett’s esophagus with no dysplasia 3 years ago. My GI put me on 20 mg of Omeprazole. I had atypical symptoms, pain in upper abdomen and shooting pain into my back. I did not have terrible heartburn except when I was pregnant with my two children. Last year I had another endoscopy and they did not see any Barrett’s, however, I know it doesn’t go away.
I am a teacher and when I started back to work in August, I began having heartburn. It continued to get worse so I went to see my GI. I constantly have a burning in my throat. That is my main symptom. Sometimes in my chest if I eat chocolate. I know my triggers and try to avoid those foods. I gave up soda when I learned I had Barrett’s. I drink one small cup of coffee, but now it gives me heartburn. My doctor increased my PPI to twice a day and gave me Carafate to drink 4x a day. Neither is working. I am so frustrated and miserable.
Next week I am having the bravo pH test and motility test. I researched the tests. Do you think my GI would recommend surgery if needed after these tests? I am stressed after what I read on your site about PPIs masking symptoms and the disease still progressing. I should mention, I am a worrier and feel like that could be the reason I got this disease in the first place. I am not overweight. I don’t drink or smoke. What can I do to get relief and do you recommend surgery if my sphincter muscles aren’t working correctly? What else could be causing my heartburn? I feel so frustrated and of course worried. Any advice would be greatly appreciated!!!
Thank you for your question, and I’m very sorry that you are experiencing these symptoms with so much anxiety. It is good that you are now aggressively managing your disease and it is clear you have done your research. You are at the young age of 46 and doing everything you can to manage your symptoms, including powerful PPI medications. You have a long life ahead of you, so it is critical that you get this disease under control. You are correct about your medications; PPIs only mask the symptoms of GERD but cannot stop disease progression. The reflux action will bring bile and pepsin into the esophagus, which can cause great damage, including Barrett’s esophagus and adenocarcinoma.
Motility and pH testing is essential at this point to determine if you are a candidate for surgery. The pH test will determine the frequency and severity of your reflux episodes. This will also confirm your doctor’s previous diagnosis and the fact that your heartburn is due to acid reflux. Esophageal motility testing, or manometry, will evaluate the quality of lower esophageal sphincter (LES) and the strength of the esophageal muscles. After these test are complete, your doctor will determine if antireflux surgery is available along with your other treatment options. Keep reading to learn about when to consider surgery.