Greetings. My GI doc tells me I have GERD. I tried Prilosec for 4 weeks,
but nothing changed. I tried Cisapride - no help. This thing came on
literally in a 2 day period and I am questioning his diagnosis. He did an
endoscopy (everything was fine) and a motility test (everything was
fine). I tried a 24hr probe but couldn't tolerate the tube up my nose.
I've tried everything - any suggestions - my GI guy told me today that it
must be stress and to live with it! Thanks in advance.
P.S. Is Decaf Coffee OK with GERD?
REPLY:
GastroEsophageal Reflux Disease (GERD) is certainly one of the hot topics in medicine now that we have powerful technologies to diagnosis it and potent medications to treat it. Newer surgical techniques have also changed the way we approach cases resistant to aggressive medical therapy.
It is certainly possible that you do not have reflux related symptoms given the poor response to conventional treatment and the results of the tests you mention in your letter. You may want to ask your doctor to consider another trial of Prilosec in a higher dose (one pill twice daily or even more than this) since some folks with true reflux require more treatment than others to respond.
The limitations of Internet medicine make long-distance diagnosis difficult, if not impossible, as well as dangerous. While "stress" may certainly be among the causes of your symptoms you may want to sit down again with your primary doctor or with your gastroentero- logist to explore "where do we go from here?"
While we usually focus on caffeine containing beverages as among those things which worsen reflux drinking decaf to excess would also tend to worsen symptoms. As in so much else of life "moderation" is the key to feeling better. Yes, decaf is probably better but not if you plan to drink the whole pot!
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Bruce Sckolnick, M.D.
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