Erosive Oesophagitis

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Following a gastroscopy, I have been diagnosed with a 3cm sliding hiatus hernia and grade B erosive oesophagitis. My GP has prescribed 20mg Omeprazole, once daily.

Although I have had mild IBS for about 10 years, the gastroscopy was prompted by a feeling of congestion/lump at the bottom of my throat, which had persisted for a month. Unlike many people with hiatus hernia and GORD/GERD, I don't have any of the other acid reflux symptoms.

I am now just starting week 9 of taking Omeprazole, and have had no side effects whatsoever, and the feeling of a lump in the throat has almost gone. Due to an absence of other symptoms, it is difficult to know whether/when I can stop taking the PPIs. I discussed this with my GP, who admitted this was a bit of a conundrum. He suggested I continue taking the Omeprazole for another couple of months until (hopefully) I'm completely asymptomatic, and then wean myself off them. He expects the symptoms will then return.

Obviously, I want to ensure that the erosive oesophagitis has cleared up, and I want to prevent it coming back to reduce the risk of Barrett's. Conversely, since I'm under 50, and the hiatus hernia is not going to go away on its own, I don't want to be on Omeprazole or other PPIs for the rest of my life (although that seems a definite possibility). Regular gastroscopy procedures, apart from being slighlty unpleasant, are not something the NHS is prepared to sanction every few months just to see what's going on.

I was wondering if anyone else has a similar problem, and can offer any advice.

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19 Replies

  • Posted

    I  had very similar diagnosis to you following swallowing problems i thought were caused by acute rhinitus. I am currently getting to the end of my first month on Lanzoprisole and eating has gotten better and I am due to see doc for update on Wednesday and consultant on 17th, I am not keen on staying on these drugs too long.I have found switching to reflux diet a very hard transition but it has helped no end to manage the symptoms. I have had some side effects from pills.Constipation gas and bloating but upping my fibre and cutting out acid food had helped tremendously. It takes time to find foods that you can digest and following this route can aid recovery but it does seem that it has to be a lifestyle change . Like others on this site Jamie Kaufman book Dropping Acid is a good starter.But you have to be prepared to look into lots of foods to find what suits you and cutting out all those lovely spicy tasty foods which is hard.

    I understand from others that its really important to wean yourself off this medication over some time E.G. one a day for a while then every other day and see how it goes . I have a friend who is off hers but when she now eats out she takes a tab an hour before she eats and it helps her ,however everyone is diferent so it appears we all have to find our own way .Hope this helps. Lots of help ful info on here too.good luck

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    • Posted

      My doctor basically just said to watch my weight (I'm currently fine, BMI < 24), don't smoke (I don't) and avoid excess alcohol. He also suggested avoiding food that encourages acid, but was fairly laid-back and non-specific about it all (I've actually seen two GP's at my practise, and they both seemed to think it wasn't uncommon and not much to worry about if I take care).

      I've cut out (almost all) the spicey food, and I'm trying to displace most my coffee intake with less interesting drinks :-(   My diet is already reasonably good, since I know that certain foods like chocolate and pizza tend to exacerbate the IBS, so I hope that some relatively minor adjustments to avoid acid-inducing food will be all that's required.

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  • Posted

    Hi. First of all, I nada 3cm sliding HH aNd also aesophogitis, I too was on imeprazole then lanzoprazole. The HH will not go away without having it repaired but they will not repair it in isolation. My diagnosis progressed from mild acid reflux over 30 hrs ago to GERD, eosophogitus, reflux and the HH. I don't know why your concerned about barretts at this stage as its u
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  • Posted

    Sorry my last message was sent unfinished. As I was saying barretts is usually in severe and prolonged reflux and GERD cases but I do understand your concern over what is a pre cancerous condition

    i was on ppis for many many years until they stopped workimg 

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  • Posted

    I then started to regurgitate every mouthful of food, o couldnt sleep laying down & all the drugs stopped working.  I was referred to an upper GI specialist and for a year I had every test conceivable to see what could be done.     I was then offered a brand new procedure called LINX which is for another discussion but it saved me, now I'm off all meds for the first time in over 30 hrs, my HH was repaired during surgery for linx, I'm symptom free and feel 20 hrs younger.   So, there is hope but the solution. Is not to rely on nor stay on ppis for the long term.      Hope this helps
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    • Posted

      Thanks. That's useful information. I'm not really concerned about Barretts as such - there are plenty of other ways of getting cancer! It's more a case of wanting to get rid of the oesophagitis, and hopefully the PPIs, but since I didn't know I had it in the first place, I don't really see how I can safely stop the medication.
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    • Posted

      Hi Lovelane,

      while I cannot do the linx because of a small neuroma....the best part of the device/procedure..if it doens't work...its easily reversible.Just don't know the post consequences... many papers show its very effective..such as in your case... 20 years younger....wow.."good stuff"....indeed......but you yet gotta watch your diet ...this is why so many bypass heart surgery patients within a very few years have partial or total relapse...so you be safe/prudent OK?........Claudio

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  • Posted

    Hi Dave,

    I'm sure you've checked both linx and nessen....I was offered linx but passed because I have a small tumor pressing against by brain stem...has affected only my hearing...have routine annual MRI's...so with a bunch of magnets...out of the question....I've had my HH since my 40's... never have taken PPI's but papers seem to reflect 40 to 60% effectiveness. I've apparently been able to repair the

    errosive damage via diet and careful positions over the years....after 30 years I yet will get the "sense" of acid but no burning...and 99.9% of the time it's caused by overeating and/or stupid physical actvity immediately after eating. Your dr's opinion is probably correct about recovery and then recurrance...a slidding H can only be repaired via surgery...some deep breathing exercises were in play in the 50's...probably as effective or ineffective as other non invasive treatments without potential negative side effects. If you haven't already..google linx vs nissen...our National Institutes of Health (pub med) has a paper on the two abovementioned procedures...My thoughts re PPI's...they stop the stomach's secretiion of HCL..therefore the ratio of stomach acids change....any refulx would contain less HCL and "maybe" greater Pepsin....but?? I have consumed plenty of tap water to dilute my perceived "excess: acids over the years...was inconvenient...but had to repair throat damage at all costs....and then keep reflux out of my throat...including using a rice pillow for head and shoulder elevated. Its by no means a cure..Claudio

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    • Posted

      Thanks Claudio. I will check out linx/nissen, but surgery does seem like overkill - from what I've read many (most?) people with a hiatus hernia don't even realise they have one, and I believe the UK NHS treat surgery as a last resort. I do have private health insurance, but frankly I'm not keen on surgery in any case!

      It good to know that you've managed to repair the erosion just through "common sense" rather than medication. I was worried that I might have to take PPI's for the next 30 years or so (if I'm lucky to last that long). I don't mind taking medication for a few months, but  it seems to me that it can store up long term problems, even if you don't have any obvious side effects.

      I'm still left with the question as to how I know the errosion is repaired, but I guess if I get to be asymptomatic and watch my diet and weight there is probably no significant cause for concern.

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  • Posted

    Hi Dave, by chance found out had Barretts Oesophagus and Hh a year ago, 2 cm erosion and I was told to eat low fat and leave out all spicy/hot and acid foods. On 2 year check ups part of on going trials. Already diagnosed with severe diverticulitus, IBS so two months ago had gallstones found. It all gets took much so have to sort one issue at a time. So this week gallbladder sorted so one down. Do not know much about systems of BO so ant info would be greatly appreciated. I do the fodmap diet which has helped a lot. What is gord/gerd and Ppls? And can erosion bee repaired? My age is 63 years and would like to be healthy. Also on tabs as yourself and issues. No acid anymore. I wish you all the best and learning through your answers.
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    • Posted

      I'm not an expert...

      GORD just stands for Gastro-Oesophageal Reflux Disorder (GERD is the US spelling), and just means you've got too acid escaping up the oesophagus. PPI's are Proton Pump Inhibitors, which are a medication that reduces the strength of the stomach acid.

      I hope erosive oesophagitis can be repaired, otherwise I'm wasting my money/time with the medication, although according to Claudio in this thread, it can be, just by adjusting your diet. My understanding is that your gullet is tolerant to some acid, but too much and it reacts or gets inflamed, leading to the various symptoms.

      In a small number of cases oesophagitis leads to Barret's Oesophagus (not sure whether you can get it without going through the oesophagitis step). I have a colleague with BO (that doesn't sound right!) who discovered she had it almost by accident and she's on a regime of PPI's and periodic gastroscopy examinations.

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    • Posted

      Thank you Dave, I love this site as everyone is so friendly and helpful. Never thought that I would be having to find out about so many different body issues. I know that Barretts Oesophagus can lead to cancer by what I read, so hoping by the way I am doing my diet will help repair the unknown damage I have, just goes to show that even though I have been conscious of what I eat there are so many hidden things in our food. Feed back appreciated.
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  • Posted

    from my perch...your wise to avoid surgery...while some few are worthwhile...too many others have consequences beyond the original problem. And that includes medications.

    I knew the errosion was gone by "sense" but took no chances, maintained my diet for a few years...gradually got back to a few (not all) my native food but in very very small portions..difficult big time...chilli's been replaced with mild curry's watered down with coconut milk, with added celery and carrots...Was an avid "runner"...now stomach must be empty...only some water..and dramatic reduction in time/distance.Still do 3 miles but like a drunk snail.

    I think you have an excellent handle on your condition and remedy... and your good intellect will get the job done...Claudio

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  • Posted

    One final question... over the years the IBS as manifested itself in a variety of intriguing ways, but mostly as excess gas. I haven't been particularly concerned with this, and have only resorted to mebeverine when the symptoms have become annoying.

    It occurs to me that excessive stomach gas isn't going to be good for the hiatus hernia (could that have caused it in the first place... my GP suggested I should avoid upward pressure on the diaphragm), and belching is not going to be good for the acid erosion.

    I guess therefore it's wise to take the mebeverine until the acid is well under control?

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    • Posted

      Agree would be wise. HH are usually caused by persistent cough, vomiting (dry heaving) straining during difficult bowel movement/s and even lifting something

      heavy. Calcium is a player in IBS..some muscle relaxing meds block the reabsorption in the intestines.

      IMO if calcium is significant in IBS then VIT D pl

      us Vit K2 might be deficient. ?..claudio

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    • Posted

      Hi Dave

      Have you tried a probiotic to line your stomach in the mornings and then something like deflatine or bisodol after each meal - this really helps control the gas and any bloating! 

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    • Posted

      I've started taking probiotic tablets in the morning as an experiment, along with the mebeverine and omeprazole... barely any room left for breakfast :-) ... but I presume you're refering to the yoghurt drinks? I might give them a try. I usually have Oatibix for breakfast (with plenty of milk, and I'm now trying to persuade myself that skimmed is palatable).

      For the last couple of nights I've tried a slightly larger pillow and sleeping on the my left side - I'm normally a right side person (or back when my wife is not within snoring range). My throat has been noticeably improved, but this could be a concidence.

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