Son has been suffering with GERD for past year. I saw on the Infectious disease thread that some of you have some experience with this so thought it might be better to start a new thread. He was taking over the counter Nexium (suggested by the walk in clinic he visited) but recent reports on side effects gave both of us pause. He saw a primary care doctor and either he didn’t ask the right questions or doctor didn’t seem to think his issues were severe. He says there are many nights that he can’t sleep because of the heartburn.
He doesn’t have much experience with physicians and is a terrible advocate for himself. Any advice that I can pass along?
Most docs are going to prescribe medications and tell him not to eat late at night, spicy foods, etc. You can find a lot of the recommendations on the internet. You can research the other meds that are prescribed for this condition, though all meds have side effects.
I have no evidence that this works, but I have read a lot of anecdotal stuff that reducing simple carbs can help with this. I’m talking sugar, white flour products, white breads and refined grains, etc. I know, the kind of diet that most young people eat a lot of and don’t want to give up. Eating a “clean” diet free from excessive carbs certainly won’t hurt and might help.
I’d ask for a referral to a gastroenterologist (GI), if the insurance plan needs a referral. Is he away at college? Can he have a friend come with him as advocate? Any doc can order a barium swallow with fluoroscopy, where they check how you swallow and watch the reflux and then the GI doc can discuss the options for treatment. If he’s a minor, there are a few pediatric GIs.
There are several different medications. I took Prilosec (nearly identical to Nexium) for many years with no problems–stopped because I stopped having reflux.
Your S may not have made it clear to the internist that the reflux I’d bad enough to interfere with his sleep, as well as how frequently it occurs.
Here is my anecdotal evidence. Dropping weight and eliminating sugar and processed carbs from my diet definitely helped me! I used to have a horrible reflux no matter how late or early I ate, how high I propped myself up in bed, etc. I did not even think the clean up of my diet would help with heartburn, but it did. Mr. reports the same thing happened to him (he obviously eats the same stuff).
He is a new graduate and navigating insurance for the first time. I am sure he has no idea whether he needs a referral to go to a GI doctor. He did have some sort of test where he breathed into a machine.
He can call the phone # on his insurance card to ask if he needs a referral. They will answer his Qs.
Agree that for folks who are overweight, losing weigh and not wearing tigh clothing can really help. There are a few other measures he can take that don’t involve any medications. Here is a reference with more info, including tests, treatments, lifestyle suggestions. https://www.nationaljewish.org/healthinfo/conditions/gerd/lifestyle-management
And “overweight” could be just a few extra pounds that would not even take you out of the “normal” BMI range. It is amazing what weight loss and clean diet can do.
Yes, reflux means that acid is coming up from the stomach and can cause erosion in the esophagus and potentially (long term) cancer. Acid is caustic and needs to either be neutralized with meds or stay where it belongs in the stomach.
Some folks need stronger amounts of medications. Not lying down for 3+ hours after eating, elevating the head of the bed, avoiding spicy food and caffeine can all help.
I definitely can cause other issues. Esophageal lining is not designed to withstand the acidic pH of the “juices” that spill into it from the stomach. Eventually, it can get “corroded” to the point of developing Barrett’s.
I’ve had GERD for several years. I’ve been on Omeprazole (Prilosec) for quite a while with no side effects.
Luckily, most cases of GERD are pretty easy to control. It should be pretty easy to find out if one needs a referral by calling their insurance company. He needs to go see a GI just to make sure the GERD isn’t being caused by something more serious.
GI docs can also be pretty busy. I called recently and was given an appointment in July, as his 1st non urgent available!
Breathing into a machine was likely to test how well his lungs are working, especially if he is having any breathlessness or history of asthma. Have never had any breathing tests related to GERD or reflux.
My friends daughter suffered from horrible GERD throughout college. Went to dr., had all the tests,changed her diet, took meds. There was nothing to her. Very slight, athletic runners build.
She didn’t get better until she started counseling. Apparently, it was stress related.
Also try to figure out if he has any food allergies or is lactose intolerant. My husband is both and if he gets something that he is allergic or eats something with dairy in it by mistake his GERD really flairs up.
GERD can also cause respiratory problems, including pneumonia, so don’t ignore.
The internist can order a barium swallow with fluoroscopy–mine was ordered by my allergist.
It has a radiologist (MD) watch you swallow some solution which shows up on X-ray to see whether you are refluxing and if you have any mechanical problems with swallowing in various positions.
Agree, stress can make all issues, including reflux worse. Don’t ignore the role tight clothing CAN play in reflux as well, especially if it presses on your belly.
Definitely be more insistent that Drs. take your son’s problem more seriously! I began having acid reflux issues when I was in my mid-teens (and at that time, in no way overweight!), and no one knew to take it seriously. I would go through periods of frequent scalding heartburn, which I treated by quickly downing a baking soda and water solution. It did the trick for quite a number of years. Eventually though (by age 40+), I began needing stronger meds, and so was put on a med similar to Prilosec. A couple of years ago, my Gastroenterologist performed an endoscopy, which revealed I have Barrett’s Esophagus, a serious condition whereby the lining of the throat is eroded by years of unchecked acid reflux. It’s considered a pre-cancerous condition, so must be monitored periodically. Now, I take a once daily pill called Dexilant, because the generic Prilosec was no longer reliably effective. I wish I’d known then what I know now. Please stress to your son that his problem is nothing to mess around with!
I found relief by eating smaller portions and drinking a mug of Yogi ginger tea every night after dinner. Might be hard for a young person, but I had side effects from the prilosec (low iron and B vits.) So happy to be off the meds, and glad to have a more natural remedy. He might try ginger tea until he can see a primary care physician.
Two of the worst offending foods are chocolate and peppermint and a combination can be miserable, which can be confusing because many resources will say if you have an upset stomach, use peppermint in its various forms. Some people not familiar with reflux think, “Oh, upset stomach; I read somewhere that peppermint is good for stomach issues.” Peppermint will further relax, I think, the sphincter muscles, allowing acid/food to come back up. So big no-no on chocolate/mint combinations. When I do allow myself to have these two (which I love), I try to do it no later than late afternoon.