Managing Acid Reflux: Symptoms, Treatment, and Diabetes Concerns

Q: Managing Acid Reflux: Symptoms, Treatment, and Diabetes Concerns

Dear Mr. <br>Ellis：<br>1. <br>Nexium® (generic name： Esomeprazole) is indicated for gastroesophageal reflux disease (GERD). <br>Possible side effects include abdominal pain, constipation, diarrhea, bloating, nausea, dry mouth, headache, drowsiness, allergic reactions, fever, and

Excess stomach acid

Hello, doctor.
I previously underwent an endoscopy which showed that my gastrointestinal tract is generally fine, but I have gastroesophageal reflux disease (GERD).
I have been taking Pantoprazole for a month, but I occasionally experience acid reflux, a burning sensation in my chest, a sour taste in my mouth, and even nausea.
How long might it take for these symptoms to improve? Additionally, I have a more concerning question: could it be that excessive stomach acid is causing me to feel hungry more often? Over the past couple of months, I sometimes feel hungry shortly after eating.
My recent blood test results showed a fasting blood sugar of 106, cholesterol at 104, and triglycerides at 31.
Am I at risk for diabetes? Thank you, doctor.

Ellis, 20~29 year old female. Ask Date: 2016/07/28

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Ellis:
1.
Nexium® (generic name: Esomeprazole) is indicated for gastroesophageal reflux disease (GERD).
Possible side effects include abdominal pain, constipation, diarrhea, bloating, nausea, dry mouth, headache, drowsiness, allergic reactions, fever, and others.
Generally, these side effects will resolve on their own after some time; however, if they persist, please inform your healthcare provider.
2.
The primary treatment for gastroesophageal reflux disease (reflux esophagitis) is to avoid factors such as coffee, tea, alcohol, overeating, prolonged sitting after meals, and lack of exercise.
3.
According to the American Diabetes Association's diagnostic criteria for diabetes: a.
Fasting plasma glucose ≥ 126 mg/dl after 8 hours of fasting.
b.
2-hour plasma glucose ≥ 200 mg/dl during an oral glucose tolerance test.
c.
HbA1c (glycated hemoglobin) ≥ 6.5% (must not have any disproportionate hyperglycemia, and the testing method must meet the international certification standards of NGSP and DCCT).
The above criteria a, b, and c must be met on two separate occasions.
d.
Clinical symptoms of diabetes (such as polyuria, polydipsia, polyphagia, and weight loss) with any plasma glucose value ≥ 200 mg/dl (this condition only needs to be met once).
1.
A pre-meal blood glucose level of 106 mg/dl is indeed slightly elevated, as the normal range is below 100 mg/dl; however, this does not indicate diabetes.
Instead, it falls within the category of impaired fasting glucose (between 100-125 mg/dl), which increases the risk of diabetes.
It is recommended that you pay attention to dietary control and avoid overeating; additionally, ensure adequate sleep and regular exercise.
If possible, discuss with your healthcare provider for necessary follow-up and testing.

Reply Date: 2016/07/28

More Info

Managing acid reflux, also known as gastroesophageal reflux disease (GERD), involves understanding its symptoms, treatment options, and potential connections to other health concerns, such as diabetes. Based on your description, it seems you are experiencing typical symptoms of acid reflux, including heartburn, sour taste in the mouth, and nausea. These symptoms can be quite uncomfortable and may take some time to improve, especially if you have been experiencing them for a while.

Symptoms of Acid Reflux
The symptoms you describe—heartburn, a sour taste in the mouth, and nausea—are common indicators of acid reflux. Heartburn occurs when stomach acid flows back into the esophagus, leading to a burning sensation in the chest. The sour taste is often due to acid reaching the throat or mouth. Nausea can occur as a result of irritation in the esophagus or stomach.

Treatment Options
You mentioned that you have been taking Nexium (esomeprazole), which is a proton pump inhibitor (PPI) commonly prescribed for GERD. PPIs work by reducing the amount of acid produced in the stomach, thereby alleviating symptoms. It typically takes a few days to a week for the full effect of PPIs to be felt, but many patients report significant improvement within this timeframe. However, if you continue to experience symptoms after a month of treatment, it is essential to follow up with your healthcare provider. They may consider adjusting your medication, increasing the dosage, or exploring other treatment options.

In addition to medication, lifestyle modifications can significantly impact the management of acid reflux. These include:
1. Dietary Changes: Avoiding trigger foods such as spicy foods, citrus, chocolate, caffeine, and fatty foods can help reduce symptoms.

2. Eating Habits: Eating smaller, more frequent meals rather than large meals can prevent excessive stomach pressure.

3. Posture: Avoid lying down immediately after eating and consider elevating the head of your bed to prevent nighttime symptoms.

4. Weight Management: If applicable, losing weight can reduce pressure on the stomach and lower the likelihood of reflux.

Connection to Diabetes
Regarding your concerns about feeling hungry soon after eating, it is important to note that various factors can contribute to this sensation. While acid reflux can sometimes lead to discomfort that may mimic hunger, it is also possible that your blood sugar levels are playing a role. Your fasting blood sugar level of 106 mg/dL is slightly elevated, indicating a condition known as impaired fasting glucose, which is a precursor to type 2 diabetes.
The American Diabetes Association defines normal fasting blood glucose levels as less than 100 mg/dL. Levels between 100 and 125 mg/dL indicate prediabetes, while levels of 126 mg/dL or higher on two separate tests confirm a diagnosis of diabetes. Given your family history of diabetes and your current blood sugar levels, it would be prudent to monitor your glucose levels regularly and discuss your concerns with your healthcare provider.

Recommendations
1. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider.

2. Follow-Up: Schedule a follow-up appointment with your doctor to discuss your ongoing symptoms and blood sugar levels. They may recommend further testing, such as an HbA1c test, to assess your average blood sugar levels over the past few months.

3. Lifestyle Adjustments: Implement dietary and lifestyle changes as discussed to help manage both acid reflux and potential blood sugar issues.

In conclusion, while your acid reflux symptoms may improve with continued treatment and lifestyle changes, it is essential to remain vigilant about your blood sugar levels and overall health. Regular communication with your healthcare provider will ensure that you receive the appropriate care and guidance tailored to your specific needs.

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