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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18673
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I was diagnosed with mild gastritus & mild oesophagitus and

Customer Question

I was diagnosed with mild gastritus & mild oesophagitus and have a small hiatas hernia. Was on tagamet 1st, and now ppi's once a day. Have also recently had thyroidectomy and am recovering. I am experiencing stomach pain daily and feel like ppis are not working? I sometimes feel like there is a golf ball stuck in my throat and have also been in pain in chest and between shoulder blades and down left arm. Had heart checked out and this seems ok but am worried as things are not getting any better. In the last few years I have also had extensive endometriosis removed and part of my bowel was stuck behind my belly button and bladder problems with this. My bladder has flared up again in the last week or so again and this had been fine for a few years. I feel like it is 1 step forward and then 6 back all the time, please can you advice me.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
Did you have an endoscopy done?
Have you had any evaluation for H. pylori? If so, what test was done?
Has any other evaluation been done?
Expert:  Dr. D. Love replied 2 years ago.
I had asked for some additional information and have not heard back.
If an endoscopy has not yet been done, then it would be appropriate to do so. An endoscopy is better at confirming the diagnosis of gastritis and also can identify some of the less common types of gastritis.
Similarly, if testing for H. pylori has not yet been done, then it would be appropriate to do so. Infection of the stomach with Hy. pylori is the most common reason why gastritis or an ulcer does not respond to a PPI.
If these tests have already been done, then it would be appropriate to consider tests for other associated conditions, particularly tests to look for esophageal spasm. This can be done by esophageal manometry.
It also would be appropriate to augment the PPI with a liquid antacid, such as Maalox or Mylanta.
If I can provide any further information, please let me know.
Customer: replied 2 years ago.
I had endoscopy late last year and they found mild gastritus and mild oesophagus, I was diagnosed as having a very small hiatal hernia approx 2 years before that and had been experiencing oesophagul spasms. On endoscope they also found this time that my oesophagus was tortous and when I asked if this could be causing problems, unlikely was my answer. I have been taking iberogast in last few days which seems to be helping,pls advice
Expert:  Dr. D. Love replied 2 years ago.
You do not mention whether you have been checked for H. pylori, and if this has not been done, then this would clearly be the next step, since it is the primary reason someone does not respond to a PPI.
While a tortuous esophagus is not likely to cause symptoms, esophageal spasm certainly can cause pain or a sensation of a golf ball, and if the previous evaluation showed esophageal spasm, then it should be considered as a contributing factor to the current symptoms. The usual first line treatment for esophageal spasm are calcium antagonists, such as diltiazem.