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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55500
Experience:  GP in the United States
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A couple of years ago I was on Ibuprofen for one month

Resolved Question:

Hi A couple of years ago I was on Ibuprofen for one month taking the medication 3-4 times daily. This left me with very bad acid reflux. For the past 2 years I have been on/off various acid reflux medication with no real improvement. I have a camera down my throat 1 year ago which didn't identify any problems. My symptoms are discomfort around the upper chest and throat (Golf ball in the throat) & occasional nausea. My diet is good and I cant find any food triggers. Could you advice anything I can do to improve my symptoms.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. Phil, MD replied 10 months ago.

Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Expert:  Dr. Phil, MD replied 10 months ago.

what meds have you tried?

Customer: replied 10 months ago.
Omeprozole
Ranitidine
Expert:  Dr. Phil, MD replied 10 months ago.

what doses?

together?

Customer: replied 10 months ago.
40mg or 20mg of omeprozole at various times
Ranitidine 150mg
Customer: replied 10 months ago.
not together
Expert:  Dr. Phil, MD replied 10 months ago.

Okay. I don't think you were on max medical therapy at all

I would recommend two things

1)first switch from omeprazole to another PPI. I use nexium 40 mg daily. Then twice a day.

2)if this doesn't work add ranitidine 300 mg at night.

If that doesn't work, then we need to start looking at other problems like non acid reflux.

Let me know if you need more details

Customer: replied 10 months ago.
Thank you for your recommendation. Just to clarify I should use nexium 40mg once a day? Then add ranitidine if needed?
Thanks
Expert:  Dr. Phil, MD replied 10 months ago.

do it once a day

then go to twice a day

then add ranitidine

step wise

Customer: replied 10 months ago.
Thank you. Last question when I go to twice a day should I take them together or at different intervals. Also when should I wean off from the medication.
Expert:  Dr. Phil, MD replied 10 months ago.

I would take them at different intervals. 8-12 hours apart

When the symptoms are in remission for at least 3 months

let me know if you have other questions.

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Customer: replied 10 months ago.
Thank you very much
Will do