GERD and Superficial Gastritis: Treatment and Medication Insights

Gastroesophageal reflux disease (GERD) and superficial gastritis?

Dear Vice President Chen,
I underwent an upper gastrointestinal endoscopy at the hospital on July 31, 2023, and the results are as follows:
Examination time:
Start time: 10:32:06
End time: 10:36:13
Clinical Diagnosis: GERD
Indication: Acid regurgitation and/or heartburn sensation
Instrument: GIF-Q260 2857237
Pre-medication: Buscopan
Anesthesia: None
Medical history: None
Endoscopic Findings:
Esophagus: Mucosal breaks of less than 5mm were noted in the lower esophagus.

Stomach: Hyperemic patches were noted in the antrum, and two biopsies were taken.

Duodenum: No ulcers or scars were observed in the bulb and second portion.

Endoscopic Diagnosis:
Esophagus: Reflux esophagitis, lower esophagus, Los Angeles Classification Grade A
Stomach: Superficial gastritis, antrum, status post biopsy
Duodenum: Negative HP Test
Negative Complication: None
Suggestion: Please pursue pathology report
Specimens: 1 bottle
The doctor informed me that I have gastroesophageal reflux disease (GERD) and chronic gastritis (I had mentioned experiencing stomach pain during the outpatient visit prior to the examination).
The doctor prescribed a three-month course of Pantoprazole (40mg) and a three-month course of Gaviscon.
He mentioned that if I still experience acid reflux after taking Pantoprazole, I could take an additional Gaviscon tablet three times a day.
However, since starting the medication, I have only taken Pantoprazole because I felt that it was effective on its own, so I did not take Gaviscon.
I would like to ask Vice President Chen the following two questions, and I would appreciate your professional guidance:
1.
I have been taking Pantoprazole (40mg) for 7 weeks, every morning on an empty stomach.
Currently, I have not experienced any reflux, and my stomach pain has significantly improved; I have not had any noticeable pain in the last 2-3 weeks (though I occasionally feel slightly uncomfortable after eating indiscriminately).
Should I continue taking Pantoprazole, or can I stop or reduce the dosage? Or is it better to complete the three-month course of Pantoprazole as a full treatment regimen?
2.
Recently, I have been experiencing anxiety leading to anxiety disorder and insomnia.
I have been treated by a psychiatrist and prescribed Sertraline 75mg (a serotonin inhibitor), Lorazepam 5mg (a sedative), and Zolpidem 0.25mg (a sleeping pill), with one tablet of each taken before bed.
I would like to ask Vice President Chen if there is any potential conflict with my medication regimen, as I take Pantoprazole at 7 AM and the three psychiatric medications at bedtime.
Thank you for your guidance.

Jerry Lin, 50~59 year old female. Ask Date: 2023/09/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

Medication can be reduced or discontinued; this can be discussed with the attending physician without conflict.

Reply Date: 2023/09/25

More Info

Understanding GERD (Gastroesophageal Reflux Disease) and superficial gastritis is crucial for effective management and treatment. Based on your recent endoscopic findings and the medications prescribed, let's delve into your questions and provide insights into your condition.

1. Continuation of Pantoprazole (耐適恩): You mentioned that after seven weeks of taking Pantoprazole (40 mg), your symptoms of acid reflux have significantly improved, and you experience minimal gastric pain. This is a positive response to the medication, which is a proton pump inhibitor (PPI) that reduces stomach acid production. While it is tempting to discontinue or reduce the dosage of the medication due to symptom relief, it is generally advisable to complete the prescribed course of treatment, especially for a duration of three months. This allows for adequate healing of the esophageal mucosa and gastric lining, which may have been damaged due to acid exposure. Stopping the medication prematurely could lead to a recurrence of symptoms or even exacerbate your condition. Therefore, it is recommended to continue taking Pantoprazole as prescribed and discuss any changes with your healthcare provider before making adjustments.

2. Medication Interaction: Regarding the potential interactions between Pantoprazole and the medications prescribed for your anxiety and sleep issues (Seroquel, Diazepam, and Melatonin), there is generally no direct interaction between these medications. Pantoprazole primarily acts on the stomach's acid production, while the other medications target neurotransmitter systems in the brain. However, it is essential to monitor how you feel when taking these medications together, as individual responses can vary. If you experience any unusual side effects or worsening of symptoms, it is advisable to consult with your healthcare provider. They can provide personalized advice based on your overall health status and medication regimen.

Additional Insights on GERD and Superficial Gastritis:
- GERD is characterized by the backward flow of stomach contents into the esophagus, leading to symptoms such as heartburn and regurgitation. The endoscopic findings of mucosal breaks in the lower esophagus indicate inflammation due to acid exposure, classified as Grade A reflux esophagitis according to the Los Angeles classification. Treatment typically involves lifestyle modifications (such as dietary changes, weight management, and avoiding triggers) alongside medications like PPIs.

- Superficial Gastritis is an inflammation of the stomach lining, which can be caused by various factors, including stress, certain medications (like NSAIDs), and dietary irritants. The hyperemic patches noted in your stomach indicate inflammation, and the biopsy results will provide further insights into the underlying causes.
- Lifestyle Modifications: In addition to medication, consider implementing lifestyle changes to manage GERD and gastritis effectively. These may include:
- Eating smaller, more frequent meals to avoid overloading the stomach.

- Avoiding trigger foods and beverages, such as spicy foods, caffeine, alcohol, and citrus.

- Elevating the head of your bed to reduce nighttime reflux.

- Practicing stress-reduction techniques, such as mindfulness or yoga, to help manage anxiety, which can exacerbate gastrointestinal symptoms.

In conclusion, continue your prescribed treatment while maintaining open communication with your healthcare provider regarding any changes in your symptoms or medication regimen. By combining medication with lifestyle modifications, you can effectively manage GERD and superficial gastritis, leading to improved overall health and well-being.

Similar Q&A

Understanding Gastritis and GERD: Persistent Symptoms and Treatment Options

Hello Doctor: I have been experiencing discomfort in my stomach for a long time. I previously underwent an endoscopy, and the doctor diagnosed me with gastritis and gastroesophageal reflux disease (GERD). I was advised to avoid beverages like milk and coffee and to maintain a reg...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Gastritis, gastroesophageal reflux disease (GERD), and dyspepsia can all present with similar symptoms. In addition to being mindful of dietary habits, such as chewing food thoroughly and avoiding irritating foods, it is important to maintain a positive and relaxed mood. Regardin...

Understanding GERD vs. Acid Rebound: A Patient's Journey

Hello, Doctor: I live near Shuchang but work in Taipei, and I would like to seek your advice! In June 2016, after staying up late to play cards twice, I experienced symptoms of gastric discomfort (pain near the xiphoid process, slightly to the right), along with vomiting. I went ...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello, 1. Your symptom description indeed indicates gastroesophageal reflux disease (GERD). There is no such thing as acid rebound. You should pay attention to your diet, avoid smoking, alcohol, betel nut, tea, coffee, spicy foods, fried foods, and glutinous rice. Additionally,...

Understanding Superficial Gastritis: Symptoms, Diagnosis, and Management

Hello Doctor: For the past two years, I have been experiencing discomfort in my stomach, including frequent bloating, gastric pain, inflammation, and a lack of hunger or satiety. Sometimes the inflammation causes severe discomfort, including cramping and cold sweats, and there ha...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, the gastroenterologist at the hospital generally assists in issuing long-term prescriptions, while the clinic physician may vary by individual. Changhua Hospital cares about your health. Chen Shidian.

Understanding Mild Gastritis: Symptoms, Diagnosis, and Treatment

Hello doctor, I have been feeling nauseous after meals lately, and I get full quickly even after eating a small amount. I also experience frequent burping, especially when I wake up. I went to the hospital for an endoscopy, and there were no signs of Helicobacter pylori or ulcers...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: The main ingredient of Gastric Comfort is Ranitidine, which is a medication that inhibits gastric acid secretion and can be used to treat gastritis or gastric ulcers. Additionally, you should be aware of any symptoms of dyspepsia or constipation, and inform your primary ph...