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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29168
Experience:  MD
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I was diagnosed with NERD seven years ago, where |I lost a

Customer Question

I was diagnosed with NERD seven years ago, where |I lost a lot of weight as I was afraid to eat, however, after many test which proved negative my Doctor prescribed citilipram and Nexiumfor two or three months then changed to lansaprazole, I improved rapidly and was fine for a further three years, when it happened again, but that time I tried to eat and recovered after three months.
I had the acid burning in my stomach early last year, I had a gastrophscopy which proved normal, apart from the helicobacter which was positive and was treated with antibiotics and Nexium, I also had an endoscopy, which was fine except for a polyp. also a barium meal in my small intestine which was also fine,together with blood tests which were also fine.
Recently in October I have had a my right hip replaced, and I am now waiting for a further operation to replace my left hip, and I am suffering with anxiety and depression, for which I have been prescribed Mirtazapine 45mg, I once again started with the acid Reflux around six weeks ago, I consulted my ~Doctor, who has now put me on Nexium x 2 and Ranitidine x1 at night, it seems to be taking some time to settle down, and once again I have lost the weight, as for two to three weeks, I could hardly eat anything.
I am now starting to eat better, but I still have this uncomfortable feeling after I have eaten, Please can you tell me How long it could be before it will settle down ? I have now been on the nexium x2 almost three weeks.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Dr Basu :

Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

It is reassruing that your gastroscopy and barium swallow test were normal.

Dr Basu :

You likely have severe acid relfux problem.

Dr Basu :

Nexium dose should be at least 40 mg daily.

Dr Basu :

The symptoms will improve over 6 weeks.

Dr Basu :

However, we also suggesting adding Ranitidine 300 mg before bedtime daily along with nexium for better acid supprssion.

Dr Basu :

i see you started at but make sure it is 300 mg ranitidine daily

Dr Basu :

Also another medication can be added to help with your symptoms.

Dr Basu :

Domperidone can be added 10 mg 2 times daily along with these medications.

Dr Basu :

Please also watch your your diet.

Dr Basu :

You should void any caffeine, alcohol, spicy food.

Dr Basu :

Also low fat diet is desirable.

Dr Basu :

Avoid acidic foods.

Dr Basu :

You should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

Please also include prebiotics like Inulin daily to keep your colon acidic which prevent gas producing bacteria.
Also take a probiotic ( lactobacilli, bifidobacterium) daily.

JACUSTOMER-r5u3ohcx- :

I have been doing all these things,with the exception of Domperidone, which I believe is fro emptying the stomach quicker?

Dr Basu :

that is correct

Dr Basu :

and that will usually help since these medications are taking time to control your symptoms.

JACUSTOMER-r5u3ohcx- :

I am concerned as to me diet as I do not want to lose any more weight, My doctor has referred me to a dietcicin, is it possible that the ant -depressants can contribute to my acid?

Dr Basu :

that is possible

Dr Basu :

however you are on medications for acid control.

Dr Basu :

Should not be that significant

JACUSTOMER-r5u3ohcx- :

Yes ! I was just concerned how long it would take to settle down. I thank you for your time, and reply.

Dr Basu :

very welcome

Dr Basu :

it will settle down but be patient for at least 6 weeks.

Dr Basu :

Domperidone should be added

Dr Basu :

Best wishes and Happy and Prosperous New Year,
It was my pleasure to help you today.
I am Dr Basu experienced in Metabolic Diseases.
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