Anthony Bray, MD : Hello!
Anthony Bray, MD : it sounds that you may have a step beyond reflux as problem--- you may have esophagitis ( irritation of the wall of the esophagus)
hi again doctor
i have spoke to you before
Anthony Bray, MD : you may benefit to try Zantac ( over the counter is 75 mg twice a day but prescription is 150mg twice a day)
Anthony Bray, MD : Zantac is different class of medicine than Dexilant ...
ive taken zantac
it helps, but not like i want it to
Anthony Bray, MD : It might be combined with a second agent such as Carafate--- good to speak with you again!!....
Anthony Bray, MD : observe reflux precautions.... Wait 1.5 hours after you eat before you lie down ... Evate head of bed with blocks 4 to 6 inches under bedposts....
well, if you recall
i was the young male concerned about pancreatic cancer
and now that i get pain in the upper abdomen after meals, im scared
Anthony Bray, MD : With you taking Zantac and still having problems you should follow up with a gastroenterologist...
Anthony Bray, MD : the poor response to treatment is reason to evaluate the problem further... You should probably have upper endoscopy to check the esophagus!!
i had that done in march
everything was fine
like right now, i just had dinner about 30 mins ago
and i dont feel much of anything
Anthony Bray, MD : Ok I see... Yes I remember ...
i took a zantac 150 after lunch and it did help
it just has been a constent for almost 2 weeks now....like comes and goes
Anthony Bray, MD : evaluation with Ct scan of chest / abdomen might be considered with ongoing symptoms.... They can check amylase and lipase levels to look for inflammation of the pancreas ...
Anthony Bray, MD : ruling out gallstones may be worthwhile as well...
i had a abdominal ct scan on september 7th with contrast
came back normal
Anthony Bray, MD : if doctor tries GI cocktail ( Mylanta and viscous lidocaine which numbs up tissue that it contacts) then pain relief with this helps to ascertain diagnosis as well....
Anthony Bray, MD : Ok well that is good....
Anthony Bray, MD : reflux would not show on the tests except that it MIGHT be observed to occur with endoscopy ....
Anthony Bray, MD : reflux could have led to further irritation since your endoscopy for example...
im having a hard time believing that something wasnt missed in that CT scan
Anthony Bray, MD : Well the CT scan would pick up problems of certain nature BUT not others!!
Anthony Bray, MD : it would not have detail to see tissue irritation of the esophagus or stomach for example ...so esophagitis or ulcers would not show on a Ct scan.... Gallstones or tumors of enough size would show...
Anthony Bray, MD : Your fear with pancreatic cancer should be alleviated if normal CT scan/ amylase/ lipase...
well i had blood work done in march too on my pancreas and that came back normal
Anthony Bray, MD : Ct scan good at picking up structural problems but microscopic level and very small such as tissue irritation it can't detect...
so your saying that this not cancer realted?
Anthony Bray, MD : That is good. That is very reassuring that you do not have pancreatitis or pancreatic cancer...
Anthony Bray, MD : Right there is no evidence to suggest cancer at this time!!
Anthony Bray, MD : We can never have absolute guarantees in this regard... You or I could POSSIBLY harbor cancer cells but this is always true...... It is VERY UNLIKELY IN YOUR CASE ... I would be at much higher risk due to my age (51) vs you...
Anthony Bray, MD : your age corresponds with very low risk if most cancers...
yes i know that
there are never gurantees
Anthony Bray, MD : It sounds like reflux and possible esophagitis.... Possible gastritis... Esphogeal spasms could relate to your pain...
could reflux like this happened since march
since i had that endo down in march, could this have developed since then?
Anthony Bray, MD : So trial of continuing Zantac and may ask about Carafate from doctor ....
Anthony Bray, MD : avoid GI irritants--- no alcohol or coffee... Avoid too much caffeine...
Anthony Bray, MD : avoid hot spicy foods and acidic foods ... Especially for maybe next two months and hope to see healing and improvement...
Anthony Bray, MD : certainly possible to have worsening if condition such as ulcer disease in the months since your endoscopy
Anthony Bray, MD : Watch out for tomatoes, onions, peppers, citrus fruits....
thank you for all your advice
Anthony Bray, MD : You are very welcome!
Anthony Bray, MD : i hope that you feel better soon !!
Anthony Bray, MD : Take care and best regards XXXXX XXXXX!
Anthony Bray, MD : let me know if you have further questions!
Anthony Bray, MD : you can reach me any time at my profile page on this site--- http://www.justanswer.com/medical/expert-anthonybraymd/..... Then type question or comment in the box on that page and it will come to me....
Anthony Bray, MD : Take care!!
Anthony Bray, MD : Anthony Bray MD