Thank you very much in advance,
Chris

P.S. I've already altered my diet (less fatty foods, no caffene, I
don't smoke, less beer).  Any other advice to help with symptoms?

Gaviscon is unlikely to have any affect on your system.

The lump in your throat sensation is a very common symptom of acid reflux
disease.

HMc
-

I've been on something similar for about 18 months and dr initially said
"for life". Now he's telling my B12 deficiency might be caused by these
meds.  So Just curious why you stopped the Prilosec?

Anyhow, hope something there helps
J

HMc

Chris

Chris

GERD is caused by a failure of the lower esphageal sphincter to keep stomach
acid out of the esophagus. It's a mechanical problem. It has nothing to do
with stress. Transient LES relaxation that causes occasional heartburn is
common, but when we're talking about enough acid reflux to ulcerate the
lower esophagus, we're taking GERD and it is highly unlikely that occasional
Gaviscon is going to do the trick.

A doctor that would give a patient the kind of information yours gave you
clearly does not understand the pathophysiolgy of acid reflux. I would
suggest another opinion from a specialist, such as some general surgeons or
most gastroenterologists.

HMc

--------------------

I have to add that out of 10 symptoms, he only gave me time to say 3.
He asked if I had heartburn, I started to say "no, if I don't eat fruit, red
meat, acidic juices, tomatoey, spicey, rice, cooked veggies and/or bury them all
with bread, to sop up the acid".  He cut me off after the "no".  After the test,
he flew by and said I didn't have any symptoms yet I'm in excruciating pain if I
delay eating too long and another excruciating pain out my back after every meal
(not my spine) and especially after I eat certain foods.  And my GP certainly
felt/feels that I have GERD ???
I'll continue to eat as if I have GERD/gastritis yet that still leaves me with
the pains.  Also I suspect getting into nutritional deficiences. (well, I know
for sure B12 but not checked for anything else).

Too weird and after this gastro doc's report flies over my GP's desk, he's
likely to stop my Pantoloc so I'll be back with the bloating and nausea too.

Where /what now?
J

An EGD cannot diagnose GERD; it can only diagnose the *complications* of
GERD. If, on EGD, a doctor sees a stricture, acute esophagitis, or Barrett's
esophagus (pre-cancerous change), then the patient can be presumed to have
GERD. OTOH, if the EGD is negative, that DOES NOT definitively mean the
patient doesn't have GERD. If their symptoms are suggestive and their EGD is
negative, a smart doctor will arrange a 24 hour pH test, which will
continuously record the amount of acid in the esophagus over a 24 hour
period. Anything greater than about 3.5% of the time is abnormal and
represents GERD. Period.

An alternative to 24 hour pH testing is empiric treatment with proton pump
inhibitors such as Nexium, Prilosec etc. A common regimen is to use Prilosec
40 mg orally twice a day. That will shut down acid production and in most
cases of true GERD, they symptoms will go away, at least in the short term.

Many people tend to blame the doctor for not listening to them, rushing
them, not getting the whole story. It is wrong for you as a patient to let a
doctor get away with that. He can only rush you if you let him. Go to the
appiontment with a list of questions and make sure they all get answered.
Make sure that he hears ALL of the symptoms you have. If you can't get
across to him, tell your referring doctor that you weren't satisfied that
the first guy took the time to hear your history and request a referral to
another specialist. You are paying a lot of money for the advice and
treatment of these doctors. You have a right to insist that they listen to
you and understand your whole problem. If they don't, you have to make noise
about it.

'HMc

--
CBI, MD

 Heartburn (uncomfortable, rising, burning sensation behind the {*filter*}bone).
Regurgitation of gastric acid or sour contents into the mouth.
 Difficult and/or painful swallowing.
Chest pain.
************************
well I don't have heartburn because I'm avoiding the foods that cause it, and I
told this last gastro doc that (and his nurse) unless the pain out my back is
"back heartburn" ???
I'm no longer getting the chest pains, since I'm "managing" by avoiding the
foods that cause this, so I didn't mention that.
if I regurgitate it's either during sleep and/or I learned years ago, not to
bend over in the hour or so after eating, so it wasn't on my list, but if he'd
stopped barrelling through the hospital to other rooms/areas long enough to
listen, I would have explained this to him.
wake up with sore throat and sour taste in throat
swallowing difficulties and pain with certain foods - have to stand up to eat to
stop the swallowing pain/{*filter*}.
(some) foods get stuck and I {*filter*}on them (toast, crispy foods, stringy foods
like lean turkey)

nausea ,bloating - these are the only symptoms that Pantoloc seems to control.
hiccups and/or swallowing reflex starts up when I bend/twist (this was actually
the first confusing sign 3 years ago) - they've since stopped. - perhaps
Pantoloc helps with this too.

rotten odor coming from inside (dental is fine) - more recent, past year or so.
severe upper body muscle "charley horse" pains (started 3 years ago) that don't
stop unless I eat and lie down to immobilize my back muscles.  These are the
ones that got my attention and took me to ER (see below)
Severe pains out the back, after eating (most foods).  More obvious when I'm
lying down. Worsening in past year.
coughing, hoarseness ,  throat clearing, wheezing, yes intermittent, wasn't on
my list

My new GP guessed at GERD 18 months ago.
Since then I've been on 40 mg of pantoloc per day.  For a while we tried twice
daily, but the symptoms weren't getting better.
And have only been getting worse.
Sore throat, swollen tonsil and lymph glands on left side.  Antibiotic didn't
fix, so I'm assuming it's the acid that's irritating the back of my throat?
test result for cat scratch fever is pending..long story.
Severe stomach pain with Erythromycin when my GP ignored me when I told him it
couldn't be tonsillitis because no fever, no white spots and only left side
tonsil swelling (I didn't bring the tonsil/lymph into the appointment yesterday,
because I didn't want to blur things for the gastro doc) .  Besides there wasn't
time.

All after I had attended ER twice (2 years ago) with very severe acute pain,
then a third time with "chest pain and wheezing".
I was referred back to my GP. (the one I had then didn't have a clue what was
wrong, so I changed doctors for the 3rd time) because my first doctor (7 years)
didn't have a clue either.

Then I go through the test yesterday and he says I don't have ulcers nor GERD.
Fine, I don't have ulcers (maybe), nor Barrett's but how can he say that I don't
have GERD and/or gastritis?  Just makes no sense to me, except that his nurse
stopped me after about 5 of the symptoms and nodded as if to say "yes, GERD",
when he came along she said to him "swallowing difficulties" and he left. I was
lying on the cot and she told me to lie down, partially dressed, so unable to
run after him.
When he came back after the test, despite not being groggy, she kept pushing me
down, telling me I might get dizzy, so he flew by, said I don't have GERD and
left.  I can't go running through the hospital searching for him like a crazy
person partly dressed, because I'll be so treated..like a crazy person.  Now was
I able to reach out and try to stop him from leaving because his nurse was
pushing me back down on the cot.

He also blew me off when I asked about the hiatal hernia which he dx'd 1994 yet
recent upper GI said "nothing found".  I presume they meant no ulcers, nothing
cancerous.  The swallowing test was upright.  The swallowing difficulties are
seated.
Who eats standing up?  How can this test possibly see swallowing difficulties?
esp since the upper swallowing difficulties come and go and the goo they make
you swallow seems to help my esophagus.  They'd have to see the swallowing when
I eat my regular meals, I suspect.

http://www.***.com/
3 of these doctors missed the symptoms
http://www.***.com/
2 of these doctors missed the symptoms and 2 GPs
What in heavens name is wrong with this picture?

I'm sorry to go on and on, but I'm sitting here with burning pain out my back.
And I haven't even eaten yet, so apparently it's there all the time, but I've
learned to ignore it.  Is it possible that I have an ulcer in the back part of
my stomach /esophagus and since it's in an unusual place and we're on the left
side when EGD'd, that it got missed?

Have to say that my experience with doctors has been awful and not just in this
city/province.  It started 35 years ago.  18 months of severe pains after eating
certain foods.  My then GP told me I could NOT have an x-ray for gallstones
since: And I did go back, every 2 months, repeating the symptoms.  Here's what
he said over the period.
1) people don't get gallstones at age 22
2) people who have gallstones always throw up
3) women don't get gallstones, men do
4) it must be a draft on my left rib causing the pain
5) no idea why I was getting pain out my right back area (it was the gallstones)

18 months later, a urologist was kind enough to run an x-ray and I got rushed
into surgery.  2 very large gallstones.

I hear what you are saying.
But what I want is proper diagnosis, symptomatic relief and stopping the
worsening of the symptoms.
I wanted to discuss with him possibly changing meds, possibly combining meds
and/or with OTC's, possibly since the symptoms are so severe and worsening,
consideration of one of the surgeries.  I'd like to restart NSAID's for shoulder
inflammation due to worsening osteoarthritis, but I can't do that until I get
the GERD or whatever it is, under control

Instead, if he writes in his report what he said "you don't have GERD nor
gastritis".  How is that possible?
Since I'm now B2 deficient, my GP is likely to stop the GERD med.
I'm not directly paying, Canadian health care is paid through our taxes.

In light of this my current GP is likely to go into "psychosomatic mode" and
refuse to refer me to another, or back to the original one.  The first gastro
doc gave me about half an hour, but we were incessantly intertupted by knocks on
the door and phone calls.  Seems like he'd been running late with appointments
and someone was waiting for him to go for a lunch meeting.
So because of that (meeting interrupted and shortened), I asked to see him again
to discuss the symptoms, I got 5 minutes, blown off again and he wrote to my GP
that he had no idea what was wrong.

Can bowel problems cause GERD-like symptoms?
This last gastro doc said that I'm late on getting 5-year checkup of bowels due
to strong history of  bowel cancer in my family.
If it's going to be a useless exercise, I'd rather forget it.  But I do have
some burning way down on the left side and some indications that there might be
some "malabsorption" (veggies, red meats).  Actually when I eat red meats, black
coloured stool.  So should I persist on the bowel thing or just give up?

I'm starting back on Panoloc twice a day, based on what you say below. And if
necessary, I guess 3 or 4 times a day. because I sure don't know how to stop
these symptoms or get proper diagnosis/advice from any of the doctors I've seen.

Thanks for your patience. (and replies, if any).
J

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