Is Gastroesophageal Reflux Disease Hard to Treat? Your Symptoms

Gastroesophageal reflux disease (GERD) is difficult to treat?

Hello, about six months ago, I started experiencing a sensation of something stuck in my throat, occasionally accompanied by a feeling of pressure.
I first consulted an otolaryngologist, and during the endoscopy, it was found that my vocal cords were slightly red and swollen.
It was later assessed that this might be due to gastroesophageal reflux disease (GERD).
I then continued my follow-up with a hepatobiliary and gastroenterology specialist and was prescribed a proton pump inhibitor (PPI) for about two months, but the results were not very noticeable.
The doctor later suggested that I could continue taking it if my symptoms worsened.
Recently, I visited the otolaryngologist again due to a cold.
The doctor noted that, in addition to poor sleep, I still had chronic pharyngitis caused by gastroesophageal reflux.
Therefore, I would like to ask if GERD is difficult to cure completely.
In my case, I do not have a habit of eating late-night snacks, and my three meals a day are quite normal.
However, the sensation of something stuck in my throat has been bothering me for over six months.
I am unsure how to address this symptom, and the effectiveness of the PPI has not been very good.
Although the symptoms do not significantly affect my daily life, they persist.
Should I continue to see a hepatobiliary and gastroenterology specialist, or do you recommend just monitoring the situation since it is not severe?
Additionally, an important point is that the previous doctor also thought that stress might be a contributing factor.
I do tend to be more anxious or worried by nature, but I do not feel that I have significant stress in my life, which makes me quite confused about this aspect.
I have looked for similar questions in the past but did not find any answers, so I am reaching out for advice.
Thank you very much.

Leifute, 30~39 year old female. Ask Date: 2017/12/20

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
As you mentioned, it is still caused by reflux.
You may discuss with your attending physician to adjust your diet and lifestyle.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2017/12/20

More Info

Gastroesophageal Reflux Disease (GERD) can indeed be challenging to treat effectively, and your experience reflects a common scenario faced by many individuals dealing with this condition. GERD occurs when stomach acid or bile flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and in your case, a sensation of a lump in the throat (globus sensation) and chronic laryngitis.

Understanding GERD and Its Treatment Challenges
1. Complexity of Symptoms: GERD can manifest in various ways, including throat discomfort, cough, and even respiratory issues. The symptoms can be exacerbated by factors such as diet, lifestyle, and stress. In your case, the sensation of a lump in the throat and the diagnosis of chronic laryngitis suggest that the reflux may be affecting your throat and voice box, which is not uncommon.

2. PPI Effectiveness: Proton Pump Inhibitors (PPIs) like Omeprazole and Lansoprazole are commonly prescribed to reduce stomach acid production. While they are effective for many patients, some individuals may not experience significant relief. This could be due to several factors, including the severity of reflux, the presence of bile reflux (which PPIs do not address), or even the psychological aspects of stress and anxiety that can exacerbate symptoms.

3. Lifestyle Modifications: Although you mentioned that you do not have a habit of late-night snacking and maintain regular meal times, other lifestyle factors can contribute to GERD symptoms. These include:
- Diet: Certain foods (spicy, fatty, or acidic foods) and beverages (caffeine, alcohol) can trigger reflux.

- Weight Management: Excess weight can increase abdominal pressure, leading to more reflux.

- Sleep Position: Elevating the head during sleep can help reduce nighttime symptoms.

- Stress Management: Since stress can exacerbate GERD symptoms, incorporating relaxation techniques such as mindfulness, yoga, or cognitive behavioral therapy may be beneficial.

4. Follow-Up Care: Given that your symptoms have persisted despite treatment, it would be prudent to continue follow-up with a gastroenterologist. They may recommend further diagnostic tests, such as an esophageal pH monitoring study or an upper endoscopy, to assess the severity of your condition and rule out other potential issues.

5. Psychological Factors: You mentioned that stress might be a contributing factor. Psychological stress can indeed impact gastrointestinal function and exacerbate symptoms of GERD. It may be helpful to explore stress management techniques or even consult with a mental health professional if anxiety is a significant concern.

Conclusion
In summary, while GERD can be difficult to manage, a comprehensive approach that includes medication, lifestyle modifications, and possibly psychological support can lead to better symptom control. It is essential to maintain open communication with your healthcare provider about your symptoms and treatment efficacy. If your symptoms continue or worsen, further evaluation and possibly a tailored treatment plan may be necessary. Remember, managing GERD often requires a multifaceted approach, and what works for one person may not work for another. Your proactive approach to seeking help and understanding your condition is commendable and will serve you well in managing your health.

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