Managing GERD Symptoms: Can Medication Alone Solve Your Discomfort?

Can gastroesophageal reflux disease (GERD) symptoms such as chest pain be resolved solely with the use of medications like Gaviscon?

Hello, Doctor.
I have been experiencing a burning sensation in my chest since April.
Initially, I thought it was a thoracic issue, so I underwent a chest X-ray, which confirmed that it was not a thoracic problem.
At that time, I was prescribed medication for gastroesophageal reflux disease (GERD), and after taking it a few times, the chest pain resolved.
Due to persistent belching and the chest pain from April, I decided to undergo a painless gastroscopy and colonoscopy in mid-June.
The results showed that my colon was healthy; however, there were multiple areas of inflammation in my stomach (all old inflammation), and there was a jet-like erosion at the gastroesophageal junction, which was diagnosed as GERD.
I then began a medication regimen that lasted over four months (during which I switched medications frequently, returning every two weeks to report any discomfort, and my doctor would prescribe new medications).

In early October, I noticed that after this period of treatment, I would experience a sensation of something stuck in my throat after eating even a small amount of sweet food (I had chosen to eat non-sweet mooncakes).
To understand the condition of my stomach during this treatment period, I requested a second gastroscopy (this time opting for a non-painless procedure).
The results of the second gastroscopy indicated that the inflammation had improved, but the area of erosion at the gastroesophageal junction had shrunk, although a wide erosion still remained (somewhat similar to Barrett's esophagus).
My doctor informed me that my gastroesophageal junction was malfunctioning.
Currently, I am taking mopride F.C.
tablets (one before breakfast and one before dinner) and rabeprazole 20 mg (one before breakfast).

During the first week of taking the medication, I did not experience any issues, but a few days ago, after having a late breakfast, I began to feel bloated.
Additionally, after eating a small amount of chives, I experienced intense burning in my chest, a gripping pain in my stomach, and a sensation of something in my throat, which lasted for three days, especially worsening after meals.
After informing my doctor about my condition during my follow-up visit yesterday, he suggested that I purchase Gastroesophageal Comfort (a non-prescription medication) and advised me to take it immediately after meals and before bedtime to help alleviate my symptoms.
I am currently adjusting my treatment and would like to ask the following questions:
1.
I feel that the two medications I am currently taking do not significantly reduce my discomfort.
Should I continue taking them, or can I just take Gastroesophageal Comfort?
2.
Since I am currently eating small meals frequently, can I take Gastroesophageal Comfort after my main meals? (I also eat a little something between meals, like congee or rice noodles, but I still feel uncomfortable.
Should I take Gastroesophageal Comfort again?)
3.
Is Barrett's esophagus curable? How long does it typically take?
4.
Is medication the only treatment for GERD or malfunctioning gastroesophageal junction? (I have been very cautious with my diet and eat light meals.
Is there a chance of natural recovery without medication?)
Thank you for taking the time to review my symptoms.
I have been on medication for five months, and there was a period when my mood was so low that I could hardly imagine it.
I really want to get rid of my discomfort and not have to take medication every day.
Thank you!

Fen, 30~39 year old female. Ask Date: 2017/11/10

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
It is advisable to discuss any medication issues with your attending physician.
There should be no major concerns, so please rest assured.
You only need to make long-term adjustments to your diet and medication.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2017/11/10

More Info

Managing gastroesophageal reflux disease (GERD) can be a complex process, particularly when symptoms persist despite medication. Your experience highlights several important aspects of GERD management, including the role of medication, dietary adjustments, and the potential for long-term healing.

1. Medication Efficacy: It’s understandable to feel frustrated when medications do not seem to alleviate your symptoms effectively. The medications you are currently taking, such as mopride and rabeprazole, are commonly prescribed for GERD. Mopride is a prokinetic agent that helps improve gastric motility, while rabeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production. If you find that these medications are not providing sufficient relief, it is crucial to communicate this with your healthcare provider. They may consider adjusting the dosage or trying alternative medications. However, it’s essential to avoid abruptly stopping any prescribed medication without consulting your doctor, as this could lead to a rebound effect, worsening your symptoms.

2. Dietary Considerations: Your approach of eating smaller, more frequent meals is a well-established strategy for managing GERD. The use of a product like "胃逆舒" (Gastric Reflux Comfort) can be beneficial, but it should complement, not replace, your prescribed medications unless advised by your doctor. It’s generally recommended to take such products after meals, as they can help neutralize stomach acid and provide symptomatic relief. If you experience discomfort between meals, it may be worth discussing with your doctor whether additional doses of the product are appropriate.

3. Barrett's Esophagus: Barrett's esophagus is a condition that can arise from chronic GERD and involves changes to the cells lining the esophagus. While it is a serious condition that requires monitoring, it is important to note that Barrett's esophagus itself does not always progress to esophageal cancer. The healing process can vary significantly among individuals. Regular follow-ups with your gastroenterologist are essential to monitor any changes and to determine the best course of action. While some patients may experience improvement in their symptoms and esophageal lining with appropriate treatment and lifestyle changes, others may require ongoing management.

4. Long-term Management: GERD and its complications, such as a malfunctioning lower esophageal sphincter (LES), often require a combination of lifestyle modifications and medication. While some individuals may find relief through dietary changes alone, many will need to continue medication for effective symptom control. It is crucial to maintain a healthy diet, avoid known triggers (such as spicy foods, caffeine, and alcohol), and practice good eating habits (like not lying down immediately after eating).
In conclusion, while medication plays a significant role in managing GERD, it is often not a standalone solution. A comprehensive approach that includes dietary modifications, lifestyle changes, and regular medical follow-ups is essential for effective management. If you continue to experience significant discomfort or emotional distress related to your condition, consider discussing these feelings with your healthcare provider, as they may recommend additional support or counseling to help you cope with the challenges of living with GERD. Remember, healing takes time, and it’s important to be patient with yourself as you navigate this process.

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