Should I Resume Medication for My Acid Reflux Symptoms?

Should I continue taking medication for gastroesophageal reflux disease (GERD)?

I previously experienced symptoms of gastroesophageal reflux disease (GERD) and underwent an endoscopy, during which my doctor prescribed medication.
The doctor advised that I should take the medication only when symptoms occur and can stop when there are no symptoms.
I had symptoms such as chest tightness, difficulty swallowing, and excessive stomach acid.
After taking the medication, my condition improved significantly, and I stopped taking it.
However, recently I have been feeling an increase in stomach acid before meals, along with chest tightness.
After eating, the symptoms improve, and I do not have difficulty swallowing, but after digestion begins, I again experience chest tightness and sometimes a sensation of a foreign body in my throat, along with increased phlegm.
However, these symptoms tend to improve after half an hour to an hour post-digestion.
Additionally, I notice significant chest tightness or a sensation of a foreign body in my throat after exercising, but these symptoms also resolve after half an hour.

Could you please advise if this constitutes a recurrence of symptoms, and whether I should resume taking medication? My doctor prescribed me "Gastric Protector" once a day, along with "Gastric Antacid" and "Moshugaiqing" before each meal.
Furthermore, I was previously infected with Helicobacter pylori, but after treatment and follow-up blood tests, it was confirmed that the infection was cleared.
I am unsure if there is a connection between GERD and Helicobacter pylori.
Should I consider getting another blood test?

Qiang Qiang, 20~29 year old female. Ask Date: 2010/04/25

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, you are experiencing typical recurrent gastroesophageal reflux disease (GERD), which is a condition that is prone to recurrence.
It is not directly related to Helicobacter pylori.
Wishing you good health, Dr.
Chen Qi-Feng, Taoyuan Hospital, Department of Health.

Reply Date: 2010/04/25

More Info

Based on your description, it seems that you are experiencing a recurrence of symptoms related to gastroesophageal reflux disease (GERD). Your previous treatment was effective, and you were advised by your physician to take medication only when symptoms arise. However, given your current symptoms—such as increased gastric acid before meals, chest tightness, and a sensation of a foreign body in the throat—it may be prudent to consider resuming your medication.

Understanding Your Symptoms
Your symptoms of chest tightness and difficulty swallowing, especially after meals, are common in GERD. The fact that you feel better after eating suggests that food may temporarily buffer the acid, but as digestion progresses, the symptoms return. This pattern indicates that your esophagus may still be sensitive to acid exposure, which can lead to inflammation and discomfort.

Medication Considerations
You mentioned that your doctor prescribed "護胃康" (which is likely a proton pump inhibitor or PPI) and "加絲克兒" (an antacid) along with "摩舒胃清" (which may be a prokinetic agent). These medications work in different ways:
1. Proton Pump Inhibitors (PPIs): These reduce the production of stomach acid, providing relief from GERD symptoms and allowing the esophagus to heal.

2. Antacids: These neutralize existing stomach acid and provide quick relief from heartburn.

3. Prokinetic Agents: These help in moving food through the digestive tract more efficiently, which can reduce the likelihood of reflux.

Given your current symptoms, it may be beneficial to resume the PPI, especially since you have a history of GERD. The antacid can be used as needed for immediate relief, while the prokinetic agent can help with digestion.

Monitoring Your Condition
Since you have previously been treated for Helicobacter pylori (H. pylori) infection, it's important to note that while H. pylori can contribute to gastritis and peptic ulcers, it is not directly responsible for GERD. However, if you have ongoing symptoms, it may be worth discussing with your doctor whether a follow-up test for H. pylori is necessary, especially if you have concerns about your stomach health.

Lifestyle Modifications
In addition to medication, consider implementing lifestyle changes that can help manage GERD symptoms:
- Dietary Changes: Avoid trigger foods such as spicy, fatty, or acidic foods, and limit caffeine and alcohol intake.

- Eating Habits: Eat smaller, more frequent meals instead of large meals, and avoid lying down immediately after eating.

- Weight Management: If applicable, losing weight can significantly reduce GERD symptoms.

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

Conclusion
In summary, based on your current symptoms, it is advisable to resume your medication as prescribed by your doctor. Monitor your symptoms closely and maintain open communication with your healthcare provider regarding any changes or concerns. If symptoms persist or worsen, further evaluation may be necessary to rule out other underlying conditions. Always consult your physician before making any changes to your medication regimen or if you have concerns about your health.

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