GERD: Your Questions Answered by a Gastroenterologist

Q: GERD: Your Questions Answered by a Gastroenterologist

Hello： If you have already undergone two gastroscopies and have taken PPIs, the underlying issue may lie in your diet or lifestyle habits, such as consuming tea, coffee, soda, chocolate, sweets, glutinous rice products, high-fat/high-protein foods, eating until very full, smoking

Inquiry about gastroesophageal reflux disease (GERD) examination?

Hello Dr.
Tsai, I have been experiencing symptoms of gastroesophageal reflux disease (GERD) that come and go.
I have undergone two gastroscopies, but I feel that the effects of the Western medications, particularly PPIs, are not very good.
I would like to schedule an appointment with you and have a few questions to ask:
1.
Since I work Monday to Friday and find it difficult to take leave, and your weekend appointments are limited, could you please let me know the latest check-in time for your afternoon clinic? I finish work at 5:30 PM.

2.
If I need to have a gastroscopy, can I have it done on the same day after the consultation? Are there options for painless or transnasal gastroscopy?
3.
Do you have arrangements for gastroscopy examinations on weekends?
Thank you for your assistance with these questions.

Awei, 30~39 year old female. Ask Date: 2016/11/13

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you have already undergone two gastroscopies and have taken PPIs, the underlying issue may lie in your diet or lifestyle habits, such as consuming tea, coffee, soda, chocolate, sweets, glutinous rice products, high-fat/high-protein foods, eating until very full, smoking, drinking alcohol, chewing betel nut/gum, experiencing emotional stress, or being overweight.
It is important to address these factors; otherwise, gastroesophageal reflux disease (GERD) may easily recur and be difficult to treat.
If you need to work during the day, you can schedule an evening appointment.
After a detailed consultation, we can arrange appropriate tests for you.
If a gastroscopy is necessary, you can choose a Saturday when you are not working to undergo the procedure.
If you are concerned about discomfort, you may consider a painless gastroscopy.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/11/13

More Info

Hello! Thank you for your questions regarding GERD (Gastroesophageal Reflux Disease) and your ongoing symptoms. It’s important to address your concerns comprehensively, especially since GERD can significantly affect your quality of life.

1. Understanding GERD Symptoms: GERD is characterized by the backward flow of stomach acid into the esophagus, leading to symptoms such as heartburn, regurgitation, and discomfort in the chest or throat. However, it’s crucial to note that symptoms can vary widely among individuals. You mentioned experiencing symptoms that fluctuate, which is common in GERD. The fact that you have undergone endoscopy twice suggests that your healthcare provider is monitoring your condition closely. If you are experiencing persistent discomfort despite PPI (Proton Pump Inhibitor) therapy, it may indicate that your GERD is not fully controlled, or there may be other underlying issues that need to be addressed.

2. PPI Therapy and Its Efficacy: PPIs are effective in reducing stomach acid production and are often the first line of treatment for GERD. However, some patients may find that their symptoms persist despite treatment. This could be due to several factors, including diet, lifestyle, or the presence of other gastrointestinal conditions such as gastritis or esophagitis. If you feel that the PPI is not providing sufficient relief, it’s essential to discuss this with your gastroenterologist, who may consider adjusting your medication or exploring other treatment options.

3. Scheduling and Procedures: Regarding your inquiry about scheduling appointments, it’s best to contact the clinic directly to confirm the latest time for afternoon appointments. Typically, many clinics allow patients to check in until around 5:00 PM or 5:30 PM, but this can vary. As for endoscopy, many facilities offer same-day procedures if you are evaluated by a physician beforehand. It’s also worth asking about the availability of non-invasive options like transnasal endoscopy, which can be more comfortable for some patients.

4. Weekend Appointments: If you are looking for weekend appointments for endoscopy, it’s essential to check with the clinic directly, as availability can vary significantly. Some gastroenterology practices do offer weekend services, but it’s not universally available.

5. Follow-Up and Monitoring: Given your history of GERD and the symptoms you are experiencing, regular follow-up is crucial. Your gastroenterologist may recommend periodic endoscopies to monitor for any changes in your esophagus, especially if there are concerns about Barrett's esophagus or other complications. The frequency of these follow-ups will depend on your specific situation and the findings from your previous endoscopies.

6. Lifestyle Modifications: In addition to medication, lifestyle changes can significantly impact GERD symptoms. Consider dietary adjustments, such as avoiding trigger foods (spicy, fatty, or acidic foods), eating smaller meals, and not lying down immediately after eating. Weight management and avoiding tight clothing can also help alleviate symptoms.

In conclusion, it’s essential to maintain open communication with your healthcare provider regarding your symptoms and treatment options. If you feel that your current treatment is inadequate, don’t hesitate to express your concerns during your next visit. Your health and comfort are paramount, and your gastroenterologist is there to help you find the best management plan for your GERD. Thank you for reaching out, and I wish you the best in your health journey!

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