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Discussion:
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Hello .. a newbie here.

I was diagnosed with GERD around 7 years ago after going in hospital for suspected ulcer (been on omeprazole on and off since) I was diagnosed after a series of episodes which included stomack pains high up, nausea, sometimes vomiting and general discomfor of digestive system. I must stress I did not have the endoscopy while in hospital (I actively discouraged them from doing one). I have had other symtoms during this time including pain when bending forward, a feeling like something is stuck behind the breastbone, difficulty swallowing occasionally, and burning through to my back behind breastbone. These symptoms are aggrivated by spicy, hot foods, chocolate, fatty foods, over-eating, but the worst flare ups are from too much alcohol (which doesn't happen very often)
My doctor in the past said it sounds more like a HH, but how do I
know this and would the treatment be any different than regular GERD.
I will avoid an endoscopy at all costs (my worst nightmare seriously) even tho I know this would clarify things.
I am having a flare up at the moment and my dod wants me to keep a food diary and had to do a sample to test for bacteria, but yet again this seems to have originated from drinking too many wines and a few sidekicks (was at a party!). I have been invited on a few nights out over the next two months and wonder once this settles down, what sort of drink I could have while out ... the alcoholic variety of course. I would be happy to have just 2 or 3 with other drinks in a row, but don't even know what non alcoholic drinks i could have ... they all seem gassy.
Any advice, information or just an understanding hello would be appreciated :-)
Posted on 06/16/11, 02:59 pm
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Reply #1 - 06/17/11  12:29pm
" GERD just refers to chronic acid reflux. This means that your lower esophagul sphincter (LES) opens up when it shouldn't, allowing stomach contents to back up into the esophagus. Some people also experience excessive amounts of stomach acid, but this is not true for everyone. Some people actually produce too little stomach acid, and benefit from ADDING acid to their diet!

Treatments for GERD involve avoiding acidic foods (even if you don't have too much stomach acid, you don't want acid to further damage your esophagus), avoiding foods that relax the LES (spicy foods, alcohol, and chocolate all fall in this category), various medications, and sleeping in an inclined position instead of flat (so that gravity will help keep your stomach contents in your stomach!)

A hiatal hernia means that part of your stomach has herniated up through the LES and above your diaphram. Not everyone with GERD has an HH; but if your LES is loose enough to allow an HH then it's likely you have GERD too! A "sliding" HH comes and goes and can be difficult to diagnose; other HH's are permanent. In very rare occasions, a HH can become "strangulated," which means that blood supply is cut off to your stomach. This is a life-threatening situation and requires immediate emergency surgery! I don't think it's very common; however, it is a good reason to get an HH diagnosed and treat it before it gets worse :)

Most treatments for GERD will also help an HH. Also avoid things that put pressure on your stomach, like wearing tight clothing, bending over, etc. There are also surgeries that can tighten up your LES and help with GERD and HH's.

There are two main tests that I'm aware of that can diagnose an HH: an endoscopy, and a Barium swallow test. However, if you have a sliding HH, it may not show up on the day of the test. A Barium swallow test involves drinking a jug of chalky liquid, then laying on a table in various positions so that the liquid coats the inside of your digestive tract. They then take an x-rays, and the liquid allows them to see HH's and other problems in your digestive tract.

May I ask why you're so afraid of endoscopies? Most doctors use "twilight anesthesia," which is milder and much safer than general anesthesia, yet every person I've talked to (including myself!) still slept through the whole procedure and doesn't remember a thing :) The only side effect most people have is a mildly sore throat from the camera tube. Endoscopies can be very useful to diagnose various upper digestive problems, including several GERD complications such as:

* Esophagul damage / erosion in the esophagul lining, including detecting Barrett's Esophagus, pre-cancerous and cancerous cells. (Biopsies will be taken of any suspicious areas to diagnose these.)

* Esophagul strictures (narrowing of the esophagus), which can cause difficulty swallowing. There are procedures that can stretch out these strictures.

* Irritation or damage in the stomach lining, including ulcers.

* Problems in the duodenum (first part of your intestines) and the sphincter between your stomach and duodenum.

* Biopsy to test for H. pylori, a bacteria that can cause GERD. If you have H. pylori, a round of antibiotics can cure your GERD!

It sounds like you've already discovered some of the more common GERD trigger foods! Unfortunatley, alcohol is a GERD trigger so you may need to avoid it entirely. Here's some more info about GERD-friendly diets:

http://www.dailystrength.org/people...

And a few other tips for treating GERD/HH's:

http://www.dailystrength.org/people...

Hope that helps! "
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Reply #2 - 06/17/11  1:28pm
" Hello and many thanks for your informative reply .... very useful!

I was in hospital a few years ago and a girl with chrohns came in in agony late evening. They did an endoscopy there and then ... and I heard everything .... not a very pleasant experience for the girl or for me listening to it. it's the thought of having to swallow down the camera not whether i'll remember it that bothers me. I am a little bit of a scardy cat when it comes to hospitals anyway.

I do realise I may have to have something done eventually, but for the time being I am trying to totally change to a reflux friendly diet and see if things settle down again. In the past I have been ok to drink a few martinis with lemonade (without too much suffering), but to be honest I don't drink very often anyway.

I know what you mean about the tight clothing, if my jeans are too tight that can create problems, and even my bra causes pain and pressure over my breastbone.

I needed a diet overhaul anyway ... I have been ignoring symptoms for a while and my diet has consisted of too many biscuits and chocolate which always affect me ... plus the spicy foods etc.
I can easliy cope with the blander diet and just save the other foods for odd occasions. I'm hoping this will be enough. The only thing I am not happy about is taking omeprazole all the time ... I had been feeling that when I took it it was causing pain in my breastbone, so was concerned about the side effects I have read about ... that it can end up causing problems or stop working. I would like to get to a point where my diet is good enough to eliminate the need for regular medication, and maybe use something like Gaviscon advance ... which apparently is good for both conditions and soothes the LES allowing it to heal.
Maybe this is just wanting too much lol.

Thanks
Jo "
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Reply #3 - 06/19/11  2:49am
" Hi Jo, I also have had to give up my fave foods, no more fry-ups, roast pots, crisps, ice-cream or chocky!! Now have bacon butty, mash pot, baked crisps, have found I can eat milky way without it upsettin me!! Its gutting but on the plus dropped a dres size!!! Ive had H/H nearly a year and Im slowly learnin how to cope with it, hope you do to :-) "
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Reply #4 - 06/20/11  9:43am
" I quit taking PPI's (Nexium, in my case) about 2 months ago and I honestly don't see any change in my symptoms, I think my diet is doing all the work! (Well, that and the wedge pillow I sleep on!) But if I cheat on my diet, I always end up paying for it :(

I also forgot to mention that you may want to join the GERD & Heartburn support group too, since that board is a lot more active. There's even a thread on the first page about how PPI's like omeprazole can cause nutriton malabsorption problems that may interest you. There's also a lot of natural remedies you can try as an alternative to PPI's -- I haven't tried many, but there are other users on the GERD forum that have! "
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Reply #5 - 06/21/11  4:26am
" Hi Lisa .. thanks for your reply. It's certainly a plus point to drop a dress size ... I was about 2 stone over ideal weight, and I have lost around 10lb over the last 2/3 weeks which is a good start. It was my birthday on Saturday and although I didn't feel too well on the morning, I did start feeling a little better by afternoon so I did cheekily eat some chocolate ... well it was my birthday :-).
On the night I did have that slight feeling of not being able to swallow properly and a feeling that something was stuck behind breastbone ... and a lack of silava in my throat. Another wierd symptom I had had for a few days, was that it felt like I couldn't yawn .. I was yawning frequently, but not doing a full yawn. I have also been diagnosed with asthma, which the symptoms seem worse when I have a flare up ???
I have actually been sleeping on the couch propped up with loads of pillows .. tried to make it so it was a gentle incline, and for last two mornings have woke up with no symptoms, so I may invest in a wedge pillow.

Geekchick: I agree, I don't really see too much difference with or without the omeprazole so I am going to try some more natural remedies including a modified diet. I have been to the health shop
yesterday and bought some Aloe vera juice, I also have papaya enzymes. The lady at the the health shop said to take the aloe vera juice before meals and papaya afterwards .. she said the papaya soothes the esophagus too. I don't mind using gaviscon advance if needed. There is a few articles about that version being especially good on the internet. It has different components in it than the regular versions which have been proven to heal the esophagus apparently ... great for GERD and HH.

I will join the GERD board too, sounds like some interesting reading.

Cheers
Jo "
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Reply #6 - 06/21/11  12:08pm
" Asthma and GERD can be linked, and GERD can make asthma worse. When you have GERD, sometimes your body produces more mucus to help protect your esophagus and throat from the refluxing stomach acid, which in turn can make asthma worse or cause other respiratory symptoms.

I think the main benefit to PPI's is that they drastically reduce the amount of stomach acid, so that when you reflux, there won't be as much acid to damage the esophagus. And if your esophagus is already damaged, PPI's can give your esophagus time to heal. However, there's a lot of side effects with PPI's (we've discussed it a lot on the GERD forums!) so you'll need to weigh the benefits against the risks! "
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Reply #7 - 06/27/11  12:25pm
" Hi, Ive propped my mattress up a few inchs and that helps me also. If you miss chocky ( I do!!) try a milky way their a lot lower in fat I found I can eat 2 without it upsetting my stomach! Worth a try, Unfortunatly with food now its all hit or miss some work some feel like my throat is gonna shut down! Im about 90% sure what I can and cant eat now. Ps happy late birthday :-) "
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Reply #8 - 06/27/11  3:25pm
" Oooh, thanks for the tip, I might have to try a little Milky Way :) Although I think the main problem with chocolate is that the cocoa bean contains a chemical that relaxes the LES, it's not just the fat. (Dark chocolate is lower in fat than milk chocolate, yet it's worse for GERD, for me at least!) I've found that I can handle a small amount of chocolate baked goods like cake, as long as it doesn't have chocolate frosting or something -- I guess there's such a small amount of cocoa powder in a small slice of cake that it doesn't usually bother me.

White chocolate is usually safe for GERD, because it is made only from the cocoa butter (the fat of the bean) and not the rest of the bean like regular chocolate is; apparently that chemical is not present in the fat. (Incidentally, coffee and tea, including decaf, also have this chemical!) White chocolate's definitely not the same as regular chocolate, but it'll work in a pinch ;) "
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Reply #9 - 06/27/11  5:31pm
" Thanks Lisa .. I would miss chocolate big time .. And I got a few choccys for my birthday (thanks for the birthday wish :-)) I am trying to have one choc now and again - I will try the milky way and White choc too .. I love White chocolate mice and milky ways so that's a bonus!

I would defo struggle to cut out tea too .. I don't function well without it .. It's a comfort to me.

A really annoying symptom at the moment is very loud stomach noises .. Wind and gurgling along with bloating .. Any tips?

Jo :-) "
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Reply #10 - 06/27/11  6:34pm
" Jo, some herbal teas are safe for GERD and may even help alleviate GERD symptoms -- check out this thread on the GERD forum:

http://www.dailystrength.org/c/GERD...

I just know that "regular" (black/white/green) tea contains that LES-relaxing chemical. Some people find that mint teas are a GERD trigger, but mint is actually used to treat GERD in eastern medicine so who knows... "

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