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Home > Archive > Heartburn Support > August 2006 > Burning after Prilosec OTC
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Burning after Prilosec OTC
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| Blocks to Books 2006-08-13, 4:24 pm |
| I've been taking Claritin for the past three days to try to rule out an
allergy component to the cough with no increase or decrease in coughing and
mucous. I will continue it for my own diagnostic purposes in case it takes
more time to have any effect.
I began the Prilosec OTC this morning. I read on the package it could take
up to four days to have an effect. It has had no effect on the coughing or
mucous at this point. However, I am now having a behind-the-lower area of
my breastbone burning sensation that began after my noon meal and has
persisted. It's not really anything I can't cope with pain-wise but I don't
get this as a symptom of my lpr reflux - it's just been throat, sinus, and
ear symptoms in the past.
If the Prilosec has been successful in eliminating the acid in my reflux,
could any alkaline reflux now be more powerful or caustic without the acid
in it to balance it out so to speak?
I want to give the Prilosec a full two week trial for the sake of seeing if
it makes a difference or not but the burning is disconcerting. I don't want
to be doing any more damage if possible. Thanks-Blocks
www.blockstobooks.com
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| Howard McCollister 2006-08-13, 9:22 pm |
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"Blocks to Books" <news@blockstobooks.com> wrote in message
news:2JMDg.65$AP2.17@fed1read10...
> If the Prilosec has been successful in eliminating the acid in my reflux,
> could any alkaline reflux now be more powerful or caustic without the acid
> in it to balance it out so to speak?
>
Exactly.
HMc
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| Blocks to Books 2006-08-13, 9:22 pm |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44dfa29c$0$51801$bb4e3ad8@newscene.com...
>
> "Blocks to Books" <news@blockstobooks.com> wrote in message
> news:2JMDg.65$AP2.17@fed1read10...
>
>
> Exactly.
>
> HMc
>
>
I'm very disappointed to be correct about that. I really wanted to persist
in going the full two week course to see if it would make any difference.
I must have some alkaline reflux going or I don't see how my reflux could
suddenly be more symptom producing on the Prilosec than it was
before I took it. I don't feel comfortable continuing to take it unless
this
exacerbation of symptoms is a common and temporary thing when going on the
Prilosec and goes away in time.
Perhaps I did have primarily acid reflux
before and now I may have both acid and alkaline. Maybe that's why I'm
forming the mucous since my throat isn't completely sizzled raw from reflux
like it used to be when I had throat pain and throat sores a great deal of
the time before the mucous problems began.
I hope there is a reliable test that can disclose if there is significant
alkaline in my reflux. I hope my one day experience with the Prilosec can
be of benefit to the surgeon in his diagnosis. -Blocks
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| Howard McCollister 2006-08-14, 8:24 am |
|
"Blocks to Books" <news@blockstobooks.com> wrote in message
news:KAPDg.72$AP2.27@fed1read10...
>
> I'm very disappointed to be correct about that. I really wanted to
> persist
> in going the full two week course to see if it would make any difference.
>
> I must have some alkaline reflux going or I don't see how my reflux could
> suddenly be more symptom producing on the Prilosec than it was
> before I took it. I don't feel comfortable continuing to take it unless
> this
> exacerbation of symptoms is a common and temporary thing when going on the
> Prilosec and goes away in time.
>
> Perhaps I did have primarily acid reflux
> before and now I may have both acid and alkaline. Maybe that's why I'm
> forming the mucous since my throat isn't completely sizzled raw from
> reflux
> like it used to be when I had throat pain and throat sores a great deal of
> the time before the mucous problems began.
>
> I hope there is a reliable test that can disclose if there is significant
> alkaline in my reflux. I hope my one day experience with the Prilosec can
> be of benefit to the surgeon in his diagnosis. -Blocks
>
>
>
Your situation, exactly as you describe it, occurs in as much as 40% of GERD
patients. It's due to non-acid reflux. Most esophageal testing will only
look at acid reflux - register positive if the pH is less than 4. If there
is non-acid reflux, conventional ambulatory pH testing won't pick it up. It
requires *impedance* pH testing. That equipment is expensive, and there
remains a level of ignorance among gastroenterologists about this concept.
Look at some of the articles listed here
http://www.sandhillsci.com/literatu...ng/articles.cfm
HMc
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| Howard McCollister 2006-08-14, 8:24 am |
| In particular, look at this article carefully. Take it into your doctor to
read, especially if your esophageal testing comes up negative or equivocal.
He should note that it is co-authored by Dr. Don Castell, a
gastroenterologist long considered to be the Guru of GERD.
HMc
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| Blocks to Books 2006-08-14, 4:23 pm |
| Thank you very much. -Blocks
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44e07467$0$74471$bb4e3ad8@newscene.com...
> In particular, look at this article carefully. Take it into your doctor to
> read, especially if your esophageal testing comes up negative or
> equivocal. He should note that it is co-authored by Dr. Don Castell, a
> gastroenterologist long considered to be the Guru of GERD.
>
> HMc
>
>
>
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| Blocks to Books 2006-08-14, 4:23 pm |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44e07467$0$74471$bb4e3ad8@newscene.com...
> In particular, look at this article carefully. Take it into your doctor to
> read, especially if your esophageal testing comes up negative or
> equivocal. He should note that it is co-authored by Dr. Don Castell, a
> gastroenterologist long considered to be the Guru of GERD.
>
> HMc
>
>
>
I'm in a big hurry this morning....It looks like the link leads me to a
number of articles that I won't be able to read or even scan them visually
until later. Is the one by Dr. Castell easy to pick out in the group so I
can print it out for the surgeon to read? I appreciate this so much. -Blocks
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| Howard McCollister 2006-08-14, 4:23 pm |
|
"Blocks to Books" <news@blockstobooks.com> wrote in message
news:3s%Dg.79$AP2.32@fed1read10...
>
> "Howard McCollister" <nospam@nospam.net> wrote in message
> news:44e07467$0$74471$bb4e3ad8@newscene.com...
>
> I'm in a big hurry this morning....It looks like the link leads me to a
> number of articles that I won't be able to read or even scan them visually
> until later. Is the one by Dr. Castell easy to pick out in the group so I
> can print it out for the surgeon to read? I appreciate this so
> much. -Blocks
>
I'm sorry, I forgot to include the link.
http://www.sandhillsci.com/docs/lit...GERD%202005.pdf
HMc
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| Blocks to Books 2006-08-14, 4:23 pm |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44e08c26$0$74416$bb4e3ad8@newscene.com...
>
> "Blocks to Books" <news@blockstobooks.com> wrote in message
> news:3s%Dg.79$AP2.32@fed1read10...
>
> I'm sorry, I forgot to include the link.
>
> http://www.sandhillsci.com/docs/lit...GERD%202005.pdf
>
> HMc
>
>
>
Thanks for the link. I've developed what feels like one of my typical
reflux throat sores that I used to get before the mucous reflux started. I
hope it will heal before any physical exam of my esophagus.
I skim read the article in the link quickly. I will read it slowly and with
more comprehension this afternoon. I have some Gaviscon tablets I've never
tried. Does taking Gaviscon provide a barrier from alkaline reflux or does
it only provide a barrier from acid reflux? Most of my heavy reflux seems to
happen during the daytime rather than at night while sleeping so the
Gaviscon might have a chance to be effective if it held things down away
from my throat during the day as long as I didn't get a rebound effect at
night when and if I didn't take it. I'd like to try it for a few days as
another tool for me to see if it has an effect on the mucous that forms on
my larynx and in my throat.
Since it seems that the majority of the medical profession (and the
insurance industry) wants to treat reflux with medications, someone has got
to come up with a medication that provides valid control of both acid and
alkaline reflux. Treating acid reflux only is doing only half the job and
could set people like me up for worse problems. I'm glad the information
about non-acid reflux is starting to get to physicians and patients. I hope
it will spur new research and treatments.
I hope I haven't let the reflux go on too long for me to be a good surgical
candidate or if it's even possible to not be a surgical candidate. I
appreciate the fact that I now have the information I need to make sure I'm
tested properly so a more accurate determination can be made on the
possibility of a surgical treatment for the reflux I deal with. -Blocks
| |
| Howard McCollister 2006-08-14, 4:23 pm |
|
"Blocks to Books" <news@blockstobooks.com> wrote in message
news:t12Eg.81$AP2.20@fed1read10...
> Since it seems that the majority of the medical profession (and the
> insurance industry) wants to treat reflux with medications, someone has
> got to come up with a medication that provides valid control of both acid
> and alkaline reflux. Treating acid reflux only is doing only half the job
> and could set people like me up for worse problems. I'm glad the
> information about non-acid reflux is starting to get to physicians and
> patients. I hope it will spur new research and treatments.
The problem is that the causative defect is in the lower esophageal
sphincter and esophageal hiatus. They are *mechanical* defects and as such
not any more amenable to treatment with medicine than, say, an inguinal
hernia.
It's possible to stop acid secretion because it comes from and is located
only in the stomach, which is where the medications target. It's not
possible to stop alkaline secretions because they are generated in other
organs - bile in the liver, pancreatic secretions in the pancreas - and
THOSE secretions are critical to the digestive process . Only hope is
pro-motility agents to theoretically move things along the esophagus faster,
maybe increase the tone of the LES, but those kind of smooth muscle
stimulants are not selective - no possible way to just target the esophagus
and/or LES. Furthermore, if a hiatus hernia is contributing to the GERD,
well, as I mentioned, there is NO medicine that will fix a hernia.
>
> I hope I haven't let the reflux go on too long for me to be a good
> surgical candidate or if it's even possible to not be a surgical
> candidate.
That's unlikely, IMHO. It's conceivable that esophageal shortening or a
hiatus hernia might prevent you from being a Stretta candidate, but I don't
think I've ever seen someone NOT a candidate for a Nissen (with the
exception of morbidly obese patients - they would not be candidates for
Nissen)
HMc
| |
| Blocks to Books 2006-08-14, 4:23 pm |
| "Howard McCollister" <nospam@nospam.net> wrote in message
news:44e0b76c$0$74498$bb4e3ad8@newscene.com...
>
> "Blocks to Books" <news@blockstobooks.com> wrote in message
> news:t12Eg.81$AP2.20@fed1read10...
>
>
> The problem is that the causative defect is in the lower esophageal
> sphincter and esophageal hiatus. They are *mechanical* defects and as such
> not any more amenable to treatment with medicine than, say, an inguinal
> hernia.
>
> It's possible to stop acid secretion because it comes from and is located
> only in the stomach, which is where the medications target. It's not
> possible to stop alkaline secretions because they are generated in other
> organs - bile in the liver, pancreatic secretions in the pancreas - and
> THOSE secretions are critical to the digestive process . Only hope is
> pro-motility agents to theoretically move things along the esophagus
> faster, maybe increase the tone of the LES, but those kind of smooth
> muscle stimulants are not selective - no possible way to just target the
> esophagus and/or LES. Furthermore, if a hiatus hernia is contributing to
> the GERD, well, as I mentioned, there is NO medicine that will fix a
> hernia.
>
>
>
>
> That's unlikely, IMHO. It's conceivable that esophageal shortening or a
> hiatus hernia might prevent you from being a Stretta candidate, but I
> don't think I've ever seen someone NOT a candidate for a Nissen (with the
> exception of morbidly obese patients - they would not be candidates for
> Nissen)
>
> HMc
>
>
>
Thanks for explaining why meds aren't a solution for bile reflux and thank
you especially for assuring me that I can't be ruled out as a surgical
candidate. I may be ruled out as a Stretta candidate but at least I'm
underweight so no danger of obesity ruling me out for a Nissen if that
becomes my only viable option. - Blocks
| |
| Blocks to Books 2006-08-15, 9:22 pm |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44e0b76c$0$74498$bb4e3ad8@newscene.com...
>
> "Blocks to Books" <news@blockstobooks.com> wrote in message
> news:t12Eg.81$AP2.20@fed1read10...
>
>
> The problem is that the causative defect is in the lower esophageal
> sphincter and esophageal hiatus. They are *mechanical* defects and as such
> not any more amenable to treatment with medicine than, say, an inguinal
> hernia.
>
> It's possible to stop acid secretion because it comes from and is located
> only in the stomach, which is where the medications target. It's not
> possible to stop alkaline secretions because they are generated in other
> organs - bile in the liver, pancreatic secretions in the pancreas - and
> THOSE secretions are critical to the digestive process . Only hope is
> pro-motility agents to theoretically move things along the esophagus
> faster, maybe increase the tone of the LES, but those kind of smooth
> muscle stimulants are not selective - no possible way to just target the
> esophagus and/or LES. Furthermore, if a hiatus hernia is contributing to
> the GERD, well, as I mentioned, there is NO medicine that will fix a
> hernia.
>
>
>
>
> That's unlikely, IMHO. It's conceivable that esophageal shortening or a
> hiatus hernia might prevent you from being a Stretta candidate, but I
> don't think I've ever seen someone NOT a candidate for a Nissen (with the
> exception of morbidly obese patients - they would not be candidates for
> Nissen)
>
> HMc
>
>
>
I feel so much better after discontinuing the Prilosec OTC. All burning
behind my breastbone is gone. My throat feels much less sore and is getting
better as time goes by. The productive coughing after meals and with
postural changes remains and was never significantly changed.
Does the scope they do down the esophagus also visualize the larynx? If not,
I may have to make an ENT appt. to make sure there isn't a problem there.
My symptoms act just like my typical lpr reflux always have and I'm sure I
will show up as having reflux, even if a problem has developed on my larynx.
If the larynx is what is behind the mucous, I'd like to know. It feels like
the mucous is lodged in that area. My voice is no more hoarse than it
always is and has been my entire life - which is extremely hoarse. -Blocks
www.blockstobooks.com
| |
| Howard McCollister 2006-08-15, 9:22 pm |
|
"Blocks to Books" <news@blockstobooks.com> wrote in message
news:QqrEg.110$AP2.33@fed1read10...
>
>
> Does the scope they do down the esophagus also visualize the larynx? If
> not, I may have to make an ENT appt. to make sure there isn't a problem
> there. My symptoms act just like my typical lpr reflux always have and I'm
> sure I will show up as having reflux, even if a problem has developed on
> my larynx. If the larynx is what is behind the mucous, I'd like to know.
> It feels like the mucous is lodged in that area. My voice is no more
> hoarse than it always is and has been my entire life - which is extremely
> hoarse. -Blocks
Yes, the larynx can be visualized during an EGD, but that's not likely to be
helpful. It could conceivably show inflammation of the larynx, but would
give no insight into what's causing that inflammation. - whether it's LPR or
something related to the posterior pharynx itself. The most logical approach
is to determine whether or not gastric regurgitation is making its way that
far up, and that's usually done with a multichannel pH probe. That would be
a multichannel pH catheter, placement of a Bravo capsule in two locations in
the esophagus, or impedance pH testing - depending on how sophisticated the
equipment of physician doing the testing. This is a much more accurate
diagnostic maneuver - there is no way of determining the cause of the
hoarsness. An ENT doctor would only be able to approach the problem
empirically by trying this medication, then that medication - ad nauseum -
and only concluding the posterior pharynx as a source if he/she happens to
hit on a medication that works. I see patients every single day that have
been screwing around with ENT doctors for months, only to come see me after
the hit-or-miss approach fails to generate any improvement and therefore
make a diagnosis.
HMc
| |
| Blocks to Books 2006-08-15, 9:22 pm |
|
"Howard McCollister" <nospam@nospam.net> wrote in message
news:44e24f02$0$51770$bb4e3ad8@newscene.com...
>
> "Blocks to Books" <news@blockstobooks.com> wrote in message
> news:QqrEg.110$AP2.33@fed1read10...
>
> Yes, the larynx can be visualized during an EGD, but that's not likely to
> be helpful. It could conceivably show inflammation of the larynx, but
> would give no insight into what's causing that inflammation. - whether
> it's LPR or something related to the posterior pharynx itself. The most
> logical approach is to determine whether or not gastric regurgitation is
> making its way that far up, and that's usually done with a multichannel pH
> probe. That would be a multichannel pH catheter, placement of a Bravo
> capsule in two locations in the esophagus, or impedance pH testing -
> depending on how sophisticated the equipment of physician doing the
> testing. This is a much more accurate diagnostic maneuver - there is no
> way of determining the cause of the hoarsness. An ENT doctor would only be
> able to approach the problem empirically by trying this medication, then
> that medication - ad nauseum - and only concluding the posterior pharynx
> as a source if he/she happens to hit on a medication that works. I see
> patients every single day that have been screwing around with ENT doctors
> for months, only to come see me after the hit-or-miss approach fails to
> generate any improvement and therefore make a diagnosis.
>
> HMc
>
>
>
If they can see my larynx during a scope test then perhaps they will be able
to see if there is something obviously wrong with it that could be producing
copious mucous, such as a big tumor, etc. The hoarseness is of no concern
and has remained the same my entire life.
I still believe the source of all my problems is most likely lpr. Having
the added component of a productive cough for the last year got me concerned
something new was going on but I hesitated to pursue it with an ENT for the
reasons you mention above.
If stopping the reflux will stop the productive cough, then I'll be
thrilled. If the productive cough continues once the reflux is stopped,
then I'll need to pursue diagnosis and treatment for it.
I'm hoping the change in the cough from dry to productive is because: the
nature of the reflux has changed or my sphincter has gotten looser or any
hiatal hernia I may have has gotten bigger or my gall bladder has problems -
or possibly all of the above. From what I've learned it seems that
non-surgically treated reflux can be a progressive condition that can change
and get worse with time and the aging process. -Blocks
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