Please help my miserable stomach!
February 18, 2012 1:33 PM   Subscribe

I've had pretty much constant heartburn for a few months and I've completely miserable. What can I do and do I need a new doctor?

I'm only 22. Previously I've only gotten heartburn on the rare occasion of tons of stress and coffee. I woke up one morning with pretty serious heartburn and a tight feeling in my chest. Tried tums and Zantac 75 mg for a few days, didn't do much.

My doctor gave me Nexium for a month, things slowly seemed to be getting better but I started to get horrible stomach cramps and an extremely heavy feeling in my stomach, like my food wasn't digesting. I stopped the Nexium, the stomach cramps got better. My doctor put me on Zantac 150 mg. At this point I had no symptoms for a whole week which made me ecstatic but before I could catch a break the heartburn started again. What the hell!?

I've been following the doctor's diet instructions carefully, I no longer eat tomatos, citrus, or spicy food, I've cut out alcohol and caffeine except the occasional cup of tea, stopped smoking, and now sleep on four pillows without much effect.

It also seems like I get heartburn differently than most people do - instead of getting it for a couple hours after a meal, I have it when I wake up in the morning and continuously throughout the day. Eating can sometimes make it go away for a couple hours. I also have really bad constipation, probably from cutting out orange juice and coffee.

After all this, I have a few questions:
I talked to my doctor and he told me to just follow the diet and keep taking the Zantac until I feel better. Is he full of it? Should I go get a test for h.pylori or a gastro referral?
Is there anything I can take for constipation that won't irritate my stomach?
If I do have GERD, why aren't the GERD medications and diet changes working?
Am I doomed to feel like this forever? To be honest this is making me pretty depressed, I know that GERD/heartburn gets worse with age and I'm so young. I used to be quite a partier and I don't have much of a social life anymore because I can't bear to go out and be around people drinking/smoking when I can't partake myself. I'm also in burning pain constantly and it's hard just to focus at work, it just seems that with GERD I have such a miserable life ahead of me.
posted by anonymous to Health & Fitness (15 answers total) 3 users marked this as a favorite
those two symptoms - that you *don't* get it after a meal (you wake up with it) and that eating temporarily makes it better - sound like symptoms of an ulcer, which could be h.pylori. I think you should seek a second opinion. It's your right, and you need help.
posted by toodleydoodley at 1:36 PM on February 18, 2012 [6 favorites]

It's not heartburn. There are a number of burning/cramping symptoms made better by eating that is not heartburn.

Nthing a second opinion.
posted by jbenben at 1:39 PM on February 18, 2012

My acid reflux turned out (like every other shitty health thing in my life) to be tied to a growing gluten intolerance. I cut that out, and now I can drink pretty much like I used to.

You probably should get a gastro referral and get checked out, but ask the gastro person about gluten intolerance. There are some tests they can do if you haven't eliminated it yet (they're not totally conclusive and the doc may just suggest cutting it out rather than doing the biopsy - mine did.)

Good luck with it! It's a terrible sensation - worse than a gluten free diet, in my opinion.
posted by restless_nomad at 1:42 PM on February 18, 2012

Second opinion.

I met someone who suffered from assorted stomach issues for about a year. Eventually he met a pharmacist who suggested he needed to replenish his digestive enzymes. A few doses of the enzyme pills and he was healthy again.

His symptoms were different, but it may be worth investigating. Good luck.
posted by backwards guitar at 1:46 PM on February 18, 2012

Yeah I would try a new doctor. Also two things my doc did when I had GERD was to test for H. Pylori and do an ultrasound of my abdomen (I think to check my gallbladder?).

Are you on any medications that could cause your stomach problems? For some reason it took me forever to realize that Cymbalta was making me sick.

In the meantime, restless_nomad has a good suggestion about trying a GF diet.
posted by radioamy at 1:48 PM on February 18, 2012

Please get a referral to a gastroenterologist. If it's GERD, you may still need a different medication to control it, or other strategies that someone more experienced in the condition could suggest. Furthermore, this could be indicative of a different condition, in which case, you don't want to waste any more time getting it properly diagnosed and treated.
posted by scody at 2:07 PM on February 18, 2012 [2 favorites]

Agree referral to specialist.

Just FYI, heartburn in the a.m. is not weird. The stomach is empty so the acid has free rein. Then your non-acidic breakfast dilutes it.
posted by JimN2TAW at 3:07 PM on February 18, 2012

You should see another doctor, but in the meantime, try taking Prilosec right when you wake up every day for a few weeks. Don't eat for 30 minutes after taking it. Prilosec completely eliminated my daily heartburn.
posted by PSB at 3:19 PM on February 18, 2012

I agree that you should ask your doctor for a referral to a gastroenterologist. I suffered from pancreatitis that my primary care physician was unable to diagnose (not that I am suggesting that this is what ails you). The gastroenterologist she referred me to is also an internist so I know see him for primary care stuff, as I'm particularly prone to GI distress.

Anecdotally I would recommend omeprazole (Prilosec). My doc ended up putting me on twice a day and it works wonders.
posted by brown hound at 3:27 PM on February 18, 2012

I'd get a second opinion. You can at minimum try a different antacid (there are many PPIs and H2 blockers to choose from). Also a good idea to get tested for h. pilori or try antibiotic treatment for it. If none of that is any use you would want to rule out other causes.

Also, one of the best things I learned while working on health ed materials about ulcers, advice given from a doctor reviewer - if cutting out one of those supposedly triggering foods doesn't help - then for god's sake don't keep avoiding it. You'll be left with nothing to eat for no good reason. Only cut out foods that you have clearly established are actually making things worse.
posted by latkes at 3:38 PM on February 18, 2012

Oh, two other ideas: Some people actually prop up the feet of the head-side of the bed which seems to work better for some than pillows alone. (I actually had to sleep partially upright some nights when I was pregnant so the bed propping may not be enough.)

Another idea: a folk remedy that is at minimum harmless is using apple cider vinegar. I found it helpful anyway. Drink a teaspoon mixed with water at the time of day you are usually having the problem. No idea why it helped me but it did.
posted by latkes at 3:40 PM on February 18, 2012

When I get this, the only solution for me is to cut out what you mentioned, plus tomatoes. Also, if I eat at Panda Express for a couple days straight, plus yogurt, plus not eating less than a couple hours before bed, it tends to go away.

(Also, it wasn't caffeine so much as coffee that caused my heartburn. Something in coffee, whether decaf or regular, causes it for me.)

Also, bottled water. Whatever crap they put in my city water is, it causes all sorts of digestive troubles for me.

Other things: Zantac gave me constipation too. Psyllium pills fixed that.
posted by gjc at 3:43 PM on February 18, 2012

Mike is the best cure for the Hurt burn, it works better than tums.

Not for everyone. Dairy products are one of the worst triggers for heartburn for me.

How are you taking the Zantac? I have the same problem with heartburn in the mornings. I'm more prone to have heartburn when I haven't eaten than I am when I have (unless I'm eating dairy or oranges). I'm supposed to take 150 mg in the morning and 150 mg at night, but I often don't. Basically, I wait until I have symptoms, but it's better to just take it regularly and preventatively.

Nexium and Prevacid both gave me the bloated stomach and abdominal pain you describe. I just figure my stomach needs more acid that PPI's allow, but less than it is apt to make on its own.

I'd get a second opinion, definitely, but in my experience (I also started having issues in my early 20s) they end up just shrugging and offering a prescription antacid. The other thing that makes a big difference for me is weight gain or less. I put fat on around my middle and when I'm heavier, I have more hearburn.
posted by looli at 5:03 PM on February 18, 2012

I second what restless_nomad says:

I was having awful heart burn that would turn into late night heart palpitations and terrible stomach issues. I was munching Tums and Zantac and Pepto for months before I found a doctor who suggested a gluten intolerance.

I went Gluten Free cold turkey and within three days, I was back to 100% -- so much better than I had been feeling for months and months!

I was referred to a gastroenterologist who wanted to take a biopsy of my small intestine, but I was already convinced of my diagnosis.

Good luck and FEEL BETTER! It really really really sucks to feel so terrible all the time.
posted by beloveddoll at 10:48 PM on February 18, 2012

Definitely get a second opinion and quickly - if it's an ulcer, which it probably is, it will be getting larger and deeper while you're trying to figure out what it is and how to make it stop. I've had GERD for at least 20 years, use Nexium daily and would hate to be without it, but I also had an ulcer that was nearing perforation when I was in my 20s, and your description could be either, but I'd bet on the ulcer. I'd recommend you see another doctor, and soon.
posted by aryma at 12:12 AM on February 19, 2012

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