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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56501
Experience:  GP in the United States
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I have been diagnosed with small hiatus hernia, mild gastritis

Customer Question

Hi, I have been diagnosed with small hiatus hernia, mild gastritis and duodenditis in September. I have been suffering from heartburn and indigestion constantly for the past 10.5 months and on and off all my life. I have tried Omeprazole for 8 months and it didn't provide any relief, it gave me stomach ache, bloating, gas, headaches. Then I've been put on Raniditine and although there were no side effects, it didn't work on my heartburn. 2 weeks ago I have been switched to Lansoprazole and have terrible stomach ache from it as well as gas and bloating and no improvement for heartburn and indigestion. I have made all lifestyle changes last year, lost 56 pounds in weight, BMI is now normal, only able to eat cooked fruit, veg and grains. No coffee, no alcohol, no chocolate or spicy food. I don't smoke. Have bricks at the head of my bed, eat dinner at 6 pm and nothing after that. And still feel really unwell and have a lot of heartburn. Is there a drug out there that works better for hiatus hernia without all the horrible side effects? What other options do I have if none of the drugs worked so far?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
Thanks for this question.I'm Dr. Phil and I'm ready to helpI would recommend you try esomeprazole or dexilant.Both of these work very wellAnd if this doesn't work, try famotidine. In that order
Expert:  Dr. Phil, MD replied 1 year ago.
Please don't forget a positive rating.If you have more questions, just reply
Customer: replied 1 year ago.
The first two drugs you mentioned are both PPI's and when I looked their side effects up they are pretty much the same as omeprazole and lansoprazole. Are the two you mentioned likely to have less severe side effects? For me the side effects of the PPI's I have tried have been worse than the actual heartburn and indigestion. What is the difference between different types of PPI's?
Expert:  Dr. Phil, MD replied 1 year ago.
Yes, I have found these to be better tolerated in practice than the othersThey are often isomers or different formulations of the same molecule that can have different side effects
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Customer: replied 1 year ago.
Thanks so much for the info, I really appreciate it.
Customer: replied 1 year ago.
My doctor has tried me on esomeprazole, no side effects whatsoever which is great but unfortunately it doesn't work on my heartburn. I am only on 20 mg taken in the morning half an hour before breakfast. Is that sufficient dose for Gerd? He has referred me for a nissen fundoplication surgery.
Expert:  Dr. Phil, MD replied 1 year ago.
Yes, that is a small dose of esomeprazole. Generally I use 40 mg per day