GERD: Symptoms, Treatment, and When to Seek Help - Gastroenterology and Hepatology

Q: GERD: Symptoms, Treatment, and When to Seek Help

Hello： <br>1. <br>Based on your symptoms, it is indeed likely that you have gastroesophageal reflux disease (GERD). <br>However, abdominal pain (gastric pain) may also warrant attention for possible concurrent gastritis or peptic ulcer disease, although the treatment medications

Gastroesophageal reflux disease (GERD)

Hello, doctor.
Last week, I experienced discomfort and pain in my stomach, so I visited a clinic where I was diagnosed with gastroesophageal reflux disease (GERD).
At that time, I indeed felt bloated, had a slight sore throat, and a sour taste in my mouth.
After taking the prescribed medication, I felt some relief.
Now, aside from a slight itch in my throat, the bloating and acid reflux have improved significantly.
However, a few days ago, I suddenly experienced severe stomach pain in the middle of the night (though it was very painful, it was still bearable).
I managed to wait until morning and went back for a follow-up appointment.
The doctor prescribed me similar medication again, which provided significant relief while it was effective, but once the effect wore off, I still experienced intense stomach pain accompanied by severe abdominal pain (pure abdominal pain, with no urge to use the restroom).
Additionally, I have been dealing with constipation, and in the past few days, my bowel movements have not been substantial.
I have been trying to drink more water (currently about 1000cc a day, which I know is insufficient).
Could the recurring stomach pain and abdominal pain also be symptoms of GERD? Should I consider switching to another clinic for a consultation? Also, I have another question: when I woke up today, I suddenly felt something strange in my ear; the sounds I hear seem lower than usual, and music sounds like it's a key lower than normal.
Could this be related to the medication I am taking? I would appreciate your guidance.
Thank you.

Miss Yan, 20~29 year old female. Ask Date: 2021/06/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello:
1.
Based on your symptoms, it is indeed likely that you have gastroesophageal reflux disease (GERD).
However, abdominal pain (gastric pain) may also warrant attention for possible concurrent gastritis or peptic ulcer disease, although the treatment medications are generally similar.
You should be more cautious with your diet, avoiding tea (black tea/green tea/milk tea), coffee, spicy foods, fried foods, and high-fat or high-protein foods.

2.
For abdominal pain, the specific location is important.
If there is a buildup of fecal matter, it can also cause intermittent abdominal pain in various locations.
The pain associated with gastroesophageal reflux is typically a dull pain in the epigastric region, while pain in other areas may have different causes.

3.
Severe gastroesophageal reflux can lead to pharyngitis, and sometimes it may affect the Eustachian tube, causing changes in auditory perception.
However, it is also important to consider the possibility of a viral infection (which may present with headache, fever, and muscle aches).
If symptoms do not improve, you should consult an otolaryngologist.
If you continue to experience symptoms, it is advisable to return to your original physician, as the ongoing changes in your condition are crucial for accurate diagnosis.
You may also inquire about further recommendations, such as endoscopy or other examinations.

Changhua Hospital cares about your health.

Dr.
Tsai An-Shun

Reply Date: 2021/06/06

More Info

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the backward flow of stomach contents into the esophagus, leading to a variety of symptoms and complications. Understanding GERD involves recognizing its symptoms, treatment options, and when to seek medical help.

Symptoms of GERD
The symptoms of GERD can vary widely among individuals, but common manifestations include:
1. Heartburn: A burning sensation in the chest, often after eating, which may worsen at night or when lying down.

2. Regurgitation: The sensation of acid backing up into the throat or mouth, which may leave a sour or bitter taste.

3. Dysphagia: Difficulty swallowing, which can occur if the esophagus becomes narrowed or inflamed.

4. Chest Pain: This can mimic heart-related pain, making it essential to differentiate between the two.

5. Chronic Cough: A persistent cough, especially at night, can be a symptom due to irritation of the throat.

6. Hoarseness or Sore Throat: Acid reflux can irritate the vocal cords and throat, leading to discomfort.

7. Nausea: Some individuals may experience nausea, particularly after meals.

In your case, the symptoms of stomach pain, bloating, and throat discomfort align with GERD. However, the sudden onset of severe abdominal pain and constipation may indicate other underlying issues that should be evaluated.

Treatment Options
Treatment for GERD typically involves lifestyle modifications and medications:
1. Lifestyle Changes:
- Dietary Adjustments: Avoiding trigger foods such as spicy dishes, citrus, chocolate, caffeine, and fatty foods.

- Weight Management: Losing weight if overweight can significantly reduce symptoms.

- Elevating the Head of the Bed: This can help prevent nighttime symptoms.

- Avoiding Late Meals: Eating at least two to three hours before lying down can help.

2. Medications:
- Antacids: Over-the-counter options can provide quick relief by neutralizing stomach acid.

- H2 Blockers: These reduce acid production and are available both over-the-counter and by prescription.

- Proton Pump Inhibitors (PPIs): These are more potent acid reducers and are often prescribed for chronic GERD.

If your symptoms persist despite treatment, it may be necessary to explore further diagnostic options, such as an endoscopy, to assess for complications like esophagitis or strictures.

When to Seek Help
You should seek medical attention if you experience:
- Severe or persistent abdominal pain that is not relieved by medications.

- Difficulty swallowing or persistent nausea/vomiting.

- Unexplained weight loss.

- Symptoms that worsen or do not improve with treatment.

Given your recent experience with severe abdominal pain and constipation, it may be prudent to consult a different healthcare provider for a second opinion. This is especially important if your symptoms are not improving or if you have concerns about the effectiveness of your current treatment plan.

Regarding Ear Symptoms
The sudden change in your hearing, such as perceiving sounds at a lower volume, may not be directly related to GERD or the medications you are taking. However, some medications can have side effects that affect hearing or balance. It is essential to discuss this new symptom with your healthcare provider, as it may require further evaluation to rule out other conditions.

In summary, while GERD can cause a range of gastrointestinal symptoms, the presence of severe abdominal pain and changes in hearing warrants further investigation. It is advisable to communicate openly with your healthcare provider about all your symptoms to ensure comprehensive care.

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