Check Up: Acid reflux problematic for 58-year-old woman


February 28, 2017

Dear Readers,

JB is a 58-year-old woman who suffers with rheumatoid arthritis and takes a non-steroidal anti-inflammatory drugs (NSAID, an aspirin-like drug) along with several other medications for her pain and discomfort. Some time ago, she experienced sore throat and hoarseness while finding it difficult to maintain her singing voice for church.

She visited her doctor and was diagnosed with acid reflux and was placed on a proton pump inhibitor (like Nexium, Omeprazole, Pantecta, Omez, Lanzap, etc). She has been taking these medications for some time now, but did not discontinue her arthritis medications.

In recent months, JB has noticed that she is always having problems clearing her throat and swallowing a lump in her throat. She is also experiencing a dry cough. JB suspects that her acid reflux is worsening despite using medications, but she is fearful of something even worse afflicting her. She has also tried stopping her NSAID painkillers, but suffers severe pain when she does so. She is tormented with pains and a burning sensation to both her feet when she stops taking her arthritis medications. JB asks Check Up for help with treating her acid reflux.

JB's situation is a difficult one to solve as the treatment for the arthritis can worsen the acid reflux (GERD). Ideally, she should visit both a rheumatologist (or rheumatology clinic) to try to sort out her arthritis using medications which will not worsen her GERD, and she should also see her ear nose and throat doctor or a gastroenterologist (or visit those specialty clinics) to obtain specialist treatment for the GERD.

Check Up will also make some suggestions as to how to treat GERD.

At the lower end of the oesophagus (gullet), where the food enters the stomach, is a muscular sphincter which functions as a one-way valve, preventing stomach acid from entering the oesophagus by a backflow from the stomach. The tissues of the oesophagus are much less resistant to the stomach acid which will burn them. When this one-way valve begins to leak (sometimes referred to as a hiatus hernia), acid flows back from the stomach to the oesophagus, giving rise to a possible multitude of symptoms in the chest region and throat.

One effective way to treat GERD is to avoid foods and beverages which trigger the condition and eat smaller meal portions more frequently throughout the day. If obese, lose weight and don't wear tight clothing. Also, elevate the bedhead at night-time with blocks. Healthy lifestyles is one key to improving GERD symptoms.

In many cases, lifestyle modifications along with over-the-counter medications such as antacids (Dica, Maalox, Riopan, Relcer gel, etc) are all that is needed to settle GERD, as they neutralise stomach acid. When antacids don't work, prescription drugs such as H2 receptor blockers like Zantac, or Proton pump inhibitors like Nexium, Pantecta, Omeprazole or Lansoprazole can be regularly prescribed as these block the production of stomach acid.

Alternative treatment for GERD would include a low-carbohydrate diet as well as several fruit source antioxidants, including lemon or lime, papaya, soursop leaf tea and aloe vera juice.

When lifestyle changes and medications don't work, surgery can be considered to tighten the leaking sphincter 'valve' between the stomach and oesophagus. This procedure is only considered as a last resort when all other treatments have failed.

JB is advised to set visits for review with specialist clinics to obtain a proper resolution to her unique situation.

Write Check Up:

PO Box 1731




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