Question QUESTION: Hello, I have struggled for a year in October with constant, every day burning in my stomach and resulting heartburn. I have been tested for H pylori, celiac disease, and had an upper GI series with barium and upper endoscopy today. Everything has come back normal, except they found gastritis during the endoscopy. I don't know what that means or if it could be causing my syptoms.
I have used Prilosec with sucess, but the doctor wants to me stop using it and switch to something like Pepcid because my endoscopy was normal. But I am in almost constant pain without it. What could be causing this for me? I don't understand why if I don't have an ulcer, GERD, an infection, etc. I can be having this much of a problem. Any thoughts?
ANSWER: hi erin,
thank you for your detailed question. without going any further, may you please respond to a few of my questions so I can better address your needs.
1. when you state "constant pain," what do you mean? is it discomfort or pain? can you describe it for me please? is it sharp? dull? stabbing? where is it located? from 1-10, 1 being no pain and 10 being excruciating pain, how would you rate your pain? how would you rate your discomfort? does that "pain" radiate anywhere else in the body? what helps relieve this pain? what makes it worse?
2. in reference to the pain, when do you notice it? before meals? after meals? how long after meals?
3. what is your weight and height?
4. any other symptoms besides heartburn? nausea? vomiting? diarrhea? fever? headaches? etc
5. what is your usual diet? breakfast? lunch? dinner?
6. any food allergies?
7. when using pepcid, did you notice any relief?
i will await your response. thank you.
---------- FOLLOW-UP ----------
QUESTION: 1. when you state "constant pain," what do you mean? is it discomfort or pain? can you describe it for me please? is it sharp? dull? stabbing? where is it located? from 1-10, 1 being no pain and 10 being excruciating pain, how would you rate your pain? how would you rate your discomfort? does that "pain" radiate anywhere else in the body? what helps relieve this pain? what makes it worse?
The burning pain I feel, I would rate as a 7 at its worst. It's not so much the severity that bothers me though as the consistency. Without medication, I experience it every day. Sometimes eating makes it better, sometimes worse. I do also experience pinching/stabbing pains in my abdominal area on a regular basis, but have been told my family doctor that it is "muscular."
2. in reference to the pain, when do you notice it? before meals? after meals? how long after meals?
It's usually the best in the morning before I've eaten anything. About an hour after I eat, it's in full swing. On the worst days, it's already there when I wake up.
3. what is your weight and height?
5'1'', 168lbs.
4. any other symptoms besides heartburn? nausea? vomiting? diarrhea? fever? headaches? etc
Somtimes I experience nausea and feeling full very quickly after eating.
5. what is your usual diet? breakfast? lunch? dinner?
Breakfast is usually a cereal, lunch usually a sandwich with fruit, dinner can vary, sometimes we make home-cooked dinners with a meat and vegetable and sometimes we eat convenience food. Usually followed by dessert of some sort.
6. any food allergies?
None- they ruled out lactose intolerance and celiac as I mentioned
7. when using pepcid, did you notice any relief?
I haven't tried pepcid yet, I normally use prilosec and when I take it everyday I feel almost 100% fine. However as I mentioned my doctor thinks I should come off it since the problem "isn't GERD."
Thanks!!
Answer hi erin,
sorry for the delay as i've finally found internet access.
thank you for your response to my questions. per your response, it seems more than likely that your problem is not with an ulcer, but more in line with essential dyspepsia with hypersecretion of gastric juices. this condition fits well with your symptoms as an increase acid (aka hydrochloric acid) is produced and present in high amounts even during fasting over night. in such a case, physicians currently do not have any idea as to the cause. changes in lifestyle, however, have been shown to decrease the symptoms in the long run. such changes include taking an antacid such as pepcid immediately after waking up and prior to any food or liquids. pepcid is not a long-acting drug and will reduce its effect over the course of the day. that is where a change in diet will help. the significance of dietary changes have been well accepted in the medical community. such changes include an abundance of nutritious meals and albuminoids with an avoidance of certain types of food and drinks.
avoid: spicy foods, caffeine, fried foods, heavy diet, carbonated drinks, high acidic foods, alcohol, and junk food
instead of three big meals per day, try spreading it out to 5-6 small meals per day. if the portion if larger than your fist, that's a lot of food per meal... excluding a fried chicken or a McDonald's burger which is heavy and aggravates your stomach.
a consult with a nutritionist would be beneficial to you. or, ask your physician for a list of dietary foods to eat and avoid.
changes in lifestyle include a good exercise program. the program should be personalized to your specific body, needs, and health. most of the "general exercise programs" out there are ineffective. one hour of a good workout in the morning prior to breakfast will rejuvenate your body and increase the amount of calories lost per day versus working out in the evening. any exercise program should not be strenuous at first. if you decide to hire a personal trainer, it is always "buyer's beware." they can either help you or harm you.
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Thank you. I am glad you will take the initiative to be an informed patient.
