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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18455
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hi, I have been suffering from heartburn since November. I

Resolved Question:

Hi, I have been suffering from heartburn since November. I was diagnosed with helecobacter and treated with antibiotics and I expected this to clear things up. However, despite continuing on omeprazole, the heartburn has persisted. I have tried to pinpoint foods that are a problem but to no avail and its bad after eating. I am also belching a lot. GP has now referred me for scope but the possibilities are causing me real anxiety as my Dad died from oesophageal ca. I have anxiety issues at the best of times. Weight loss laslast year after coming off long term mirtazapine and citalopram and have maintained 9st 6 (5ft 1) since then. No vomitting, blood in poo or coughed up blood. Gaviscon tabs do help and GP has also put me on Zantac 150 twice a day. If I could afford to go privately for scope I would - if it is anything other than cancer I can cope with it but so scared. Can you reassure me? I know the worst case scenario cannot be ruled out
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
How was the Helicobacter initially discovered?
Was another test done after the antibiotics were completed and the symptoms persisted to look for the Helicobacter?

Customer: replied 3 years ago.


helicobacer discovered after stool sample requested by GP and it came back positive


 


triple therapy antibiotics


 


symptoms did calm down for a while but didnt disappear completely


 


follow up test done around three weeks ago which was negative


 


 

Expert:  Dr. D. Love replied 3 years ago.
Very good.

It is good that there was another test to confirm eradication of the Helicobacter. The antibiotic course is very good at clearing the infection, but it does not work 100% of the time. If symptoms resolve, there is no need to check to see if the infection has cleared, but when there is persistence of symptoms, it is good to do so.

In this situation, it is statistically far more likely that this is simply persistent acid reflux than anything more serious. You are correct that it is impossible to rule out the worst case scenario based solely on symptoms, but the likelihood that someone with persistent heartburn has a more serious condition, such as oesophageal cancer is quite low. It is also less common for oesophageal cancer to arise in someone of your age. It is a cancer that is seen more often in men that are in their 60s and 70s. While it can still occur in younger people, it is certainly less likely, so again would mean that it is unlikely that your current symptoms are due to oesophageal cancer.

It is appropriate to perform an endoscopy for anyone with persistent symptoms, but the likelihood that this is from oesophageal cancer is quite low.

If I can provide any further information, please let me know.

Dr. D. Love and 4 other Medical Specialists are ready to help you
Customer: replied 3 years ago.


Really happy with the reply - one final question would be the "likely" causes of the acid reflux being persistent? Thank you very much

Expert:  Dr. D. Love replied 3 years ago.
The vast majority of cases are simply due to the condition known as acid reflux, or more properly gastroesophageal reflux disease (or GERD). The cause of GERD is an insufficient strength of the lower oesophageal sphincter, a tight muscle at the lower end of the oesophagus. The purpose of the lower oesophageal sphincter is to prevent the stomach contents from entering the oesophagus, and when the sphincter is too weak, it allows reflux to occur. The acidic stomach contents can then cause local irritation and inflammation of the lining of the oesophagus (called oesophagitis) or spasm of the oesophagus.