I am a 46 year old male. In the last two months I have noticed that
my occasional use of Tagamet, to treat a recurring ulcer, was not as
effective as it used to be.
My heartburn seemed to be quite painful on intermittent occasions. My
internist prescribed Prilosec for the last month. It appears to be
working well most times. I have now begun to take this drug for the
second month. I have developed a fullness feeling which is relieved
by burping. I sleep with my bed elevated 6".
Sometimes I feel as though something is caught in my throat but my
appetite is good and I swallow ok. I could stand to lose 35 pounds.
Should I demand an upper GI?
Does this GERD, which was my diagnosis, last for weeks and weeks?
REPLY:
GERD (Gastro Esophageal Reflux Disease) is most certainly a chronic problem and requires life-long attention to body weight, diet, etc. if exacerbations are to be kept to a minimum.
You mention your "ulcer" and I wonder how it was actually diagnosed. Ulcers are now known to be associated with a bacterial disease and may be significantly benefited by a specialized multi-drug regimen if the bacteria is proven to be present. Certainly the "occasional" use of Tagamet is not going to heal an actual ulcer.
The persisting and changing nature of your symptoms despite a full month of treatment with Prilosec probably merits investigation. An upper GI x-ray exam is probably not the test you want. A direct look into the stomach and into the esophagus is indicated since it will rule out such entities as Barrett's esophagus, strictures of the esophagus, ulcers too small to see on x-ray, and allow for direct biochemical and biopsy testing for the bacteria H. pylori.
--
Bruce Sckolnick, M.D.
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