AboutJohn Thai, MD Expertise Gastroenterology, Hepatobiliary diseases, Infectious Diseases - including Viral Hepatitis A/B/C/D/E/G, liver transplant, surgical procedures including biopsies, pancreatic diseases, bariatric surgery, endoscopy (EGD, colonoscopy, etc), and Nutrition
State and federal laws require physicians to abide by HIPAA regulations and patient privacy laws, please do not include any personal identifiable information in your question as this is a public forum. Any questions identifying an individual's full name, address, telephone number, specific area of residence, or date of birth would be rejected. This also pertains to information regarding minors. My advice would be to only include relevant data such as age, sex (Male, Female, etc), weight (if this is pertinent to the question), medications (if this is pertinent to the question), and sexuality (if this is pertinent to the question). I am only providing this service as an education of medical disorders to the general public.**
I have been treated for gastric reflux since 1983; the first medication I was prescribed was Tagamet. I felt better almost immediately and remember thinking how miraculous it was!
Since then I have had continuing problems. Over the years I’ve had a couple of upper GI series, colonoscopies, endoscopies, etc., etc., due to the reflux plus other problems, namely: “leaky gut,” food allergies, and inflammatory colitis. My blood tests for H. pylori always came back negative.
When the one-a-day pills first came out I did try Protonix and Aciphex, one after the other. Protonix caused severe headaches and body rashes and after a week I was told to discontinue the medicine; Aciphex stopped working for me before a month was out.
For the last few years I’ve been taking Ranitidine (generic Zantac) 150 mg., 3 times a day, which has been affective against the gastric reflux until recently.
A couple of days ago I started taking the first 2 doses of 150 mg. Ranitidine during the day, and replaced the last dose with Prilosec OTC (omeprazole) 20 mg. in the evening to keep away the reflux during the night. It appears to be working so far, but I have a couple of questions.
WHY isn’t the Ranitidine enough anymore? Tagamet stopped working for me years ago, which is when I switched to Ranitidine, and now it is not working well enough to keep me reflux-free.
Could my gall bladder have anything to do with it? It’s been acting up for a couple of years and I have to be careful what I eat. I don’t have health insurance anymore, and my family doctor says I can hold off doing anything about it, but I’m to let him know right away if anything changes.
Also, I had reactions to Protonix and Aciphex, both proton pump inhibitors. I’ve only been taking the Prilosec OTC now for the third night; should I expect a reaction to it, too?
If it helps I am 50, somewhat overweight, had a complete hysterectomy in 2001 due to fibroids and anemia but kept one ovary, which seems to still be working. I am also prone to eczema, both “regular” and nummular.
Thanks for your time, and any help you can give. It is greatly appreciated!!
Sincerely,
Linda
ANSWER: Hi Linda,
The only and best way to determine your gallbladder's function is to have an ultrasound or a more sophisticated test call HIDA scan. Symptoms can come and go; however, I do recommend that you have an ultrasound to determine if you have gallstones or if there is a dysfunctional valve of the gallbladder causing your symptoms. You must try to rule out the possibility of having a fatty liver (non-alcoholic steatohepatitis) which causes pain in that area too.
Proton-pump inhibitors, like prilosec, protonix, and aciphex, takes approximately 2 weeks to work. They work by blocking the production of stomach acid. You have to take it at least an hour before you eat. I usually recommend taking it immediately after you wake up and an hour prior to dinner. To be honest, 20mg is a prophylactic dose. You must speak ot your physician regarding which dose is best for you.
As far as zantac (ranitidine) and tagament, they are histimine blockers which blocks acid secretion from the stomach... however, it does not decrease the amount of acid produced by the stomach. It takes about 12 weeks to see the full effects of it. Zantac works best when taken at night time as it works up to 12 hours. It is to be taken 2 times a day. One of the problems you have to be careful about is that zantac does cause liver problems.
The main question is what is causing your reflux. I cannot tell you as I will need to perform a thorough history and examination. Again, prilosec works. It's just how you told to take it, which is a common error by the pharmacist or physician not informing you.
Regards,
John T, MD
---------- FOLLOW-UP ----------
QUESTION: Dear Sir,
I neglected to mention that I do not drink (well, maybe I have two alcoholic drinks in a year), and I have never smoked a cigarette in my life. Would any part of your answer change knowing that information?
I understand that there are sooooooo many different remedies for gastric reflux because some work for some people and not for others, and because there are different causes for the reflux.
What I don't understand is WHY did Tagamet work for a couple of years starting in 1983, then stop working. And why, is Zantac (ranitidine) now no longer working for me as well as it had been, for years?
My doctor KNOWS that I am taking 150 mg. of ranitidine 3 times a day; I've tried to take less, I have even tried other medicines for reflux, but I either had an "allergic" reaction to them, they just ceased working, or just were way too expensive for me to purchase w/o insurance.
I last saw my doctor about 3 weeks ago, to get a new prescription for eczema and to check with him about my gall bladder. My son had his out last year after years of problems and it had gangrene, so now I worry over every little twinge. My doctor and I decided we could wait, as long as there is no change; however, I'm not sure I understood what you were saying about my gall bladder.
ARE there situations where gall bladder disease can aggravate gastric reflux? My reflux was under control, and now within the last week or so it's not, so I need to know if I should notify my family doctor.
THANK you, Sir, for all the time and help you give in answering questions on this web site. It really is greatly appreciated!!
Take care!
Linda
Answer Hi Linda,
It would not have changed my answer more or less if you were drinking or smoking. I would have just advised that you stopped smoking.
I will answer your other questions once I get a clearer picture. Are you being treated by a gastroenterologist or a family practitioner?
