Resolved question:
Symptoms:
Mild Chest Pain - Sternum Area - Consistent
Throat discomfort and sourness that comes and goes
No heartburn
History:
Mild Chest pain first noticed September 2014. Conducted ECG and Stress ECG as well as blood Tests. No issues were found with the heart.
Chest pain went away.
Chest pain returned February 2015, with throat discomfort.
Conducted endoscopy March 2015, found Hiatus Hernia and moderate esophagitis.
Video of Endoscopy:
https://www.youtube.com/watch?v=_YEKxGnfLzU
Question:
Looking for a second opinion on the following:
1. Confirmation of which grade of esophagitis this is
2. Expected time to heal.
2. Advised medication, dose and timing of consumption
Submitted:
4 Days
Category:
Gastroenterologist, Medical
Hi,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
I went through your endoscopy and histopathology reports and also watched the videos.
Now answering your questions-
1. I do not see any active esophagitis. All I can see are hiatal hernia and a possible Barretts esophagus.
2. You may have to take medications for 4-8 weeks for complete relief of symptoms.
3. You can take Nexium 40 mg once daily before breakfast for 4 weeks.
I hope that answers your query.
Let me know if you have any more questions.
Regards,
Dr.R.K.
Hi Dr. R.K,
Thank you for your assitance.
I've been on Dexilant 60mg, once daily. in the morning. For 4 weeks.
When I first started Dexilant, I had abdominal pain, but It got better. (Or I got used to it). On the Dexilant, symptoms come and go. So i never had 100% relief.
I have adjusted my diet to contain minimum acid, and I never eat anything after 7pm. Here is my food diary:
https://docs.google.com/spreadsheets/d/1eXpcO7eyNi7fIDBPzcxpZ23xrsbyo7ni8DXyhdT3FZc/edit#gid=0
I've also acquired a wedge pillow to raise the top of my bed.
Following are my questions:
1. I know it's difficult to tell the size of a hernia from an endoscopy. But can you tell if it's atleast big or small? Is it big enough to cause pain on its own? or the pain must be from the reflux? (I have no heartburn, just pain) Is it the type the requires surgery? I will never consider fundoplication, it's a horrible surgery.
2. I would like to try and lower the Dexilant dosage. I don't want to stay on it indefinitly. is it fine to take 60mg every other day and then so on until am off it. I fear becoming dependant on PPIs.
3. I had the endoscopy 03/03/2015, what is the advisable minimum period before I can have another to monitor if there was any improvement.
Regards,
Hisham
Hi,
Thanks for getting back to me with more questions.
1. The hiatal hernia does not appear very big. The symptom you have is due to reflux only. You can continue taking dexilant.
2. You can take Dexilant 30 mg everyday. Later you can take it every other day.
3. There is no need to have a repeat endoscopy unless you have symptoms like painful swallowing or have developed Barretts esophagus.
I hope that answers your question.
Let me know if I can assist you further.
Regards ,
Dr.R.K.
Hi,
Thanks for getting back to me with more questions.
1. The hiatal hernia does not appear very big. The symptom you have is due to reflux only. You can continue taking dexilant.
2. You can take Dexilant 30 mg everyday. Later you can take it every other day.
3. There is no need to have a repeat endoscopy unless you have symptoms like painful swallowing or have developed Barretts esophagus.
I hope that answers your question.
Let me know if I can assist you further.
Regards ,
Dr.R.K.