Moving Forward

Digestive health
1

Hey there all

So I have some questions I would like to ask in order to better understand my situation. Thank you all in advance for your patience in reading this

So I am a 35 year-old male who is very fit (weightlifter/basketball player for years) and active who has never drank alcohol or smoked. In all my life, I cannot remember even once having "heartburn," in the typical sense. Neither can I remember ever having any cases of chest heaviness or reflux. That being said ....

In January I became very ill. I was placed on Doxycycline for 10 days which only seemed to worsen these symptoms:

- Chest heaviness, chest pain, hoarse voice, coughing, throat clearing, neck pain, ear pain, throat pain, shoulder pain, back pain (right in line with the esophagus), trouble swallowing, excess mucus, and post nasal drip.

After a month+ of no improvement along with treatments of Doxy, Ibprofin, Azithromycin, Flonaze, and nasal rinses, my doctor referred me to an ENT who did a nasal endoscopy and a neck CT scan. Both tests were unremarkable. The ENT then referred me to a GI for a full endoscopy.

The results of the endoscopy were as follows

- Ringed appearance mucosa in the esophagus. Biopsied.

- Z-line variable, 38 cm. from incisors. Biopsied.

- Erythematous mucosa in the gastric body and antrum. Biopsied.

- 2cm. hiatal hernia.

- Normal examined duodenum.

All the biopsies came back negative and the GI doctor said my case was not bad at all and had me on Omeprazole 40mg for 3 months. I also stopped eating right before bed, raised the head of my bed by 8 inches, lowered considerably my intake of caffiene/carbonated beverages (though I still have them a bit ), and stopped doing situps, dead-lifts, crunches, and flat bench chest presses because of the hiatal hernia. He said I would improve over time and indeed it did.

So now it is August and I had my follow-up visit with my GI. Since my symptoms were 90% gone, he took me off the PPI and I can honesty say that I am feeling pretty good. Indeed, almost back to normal .... which is what confuses and worries me.

When I talked to my GI recently, he said my z-line was wavy, which was evidence of reflux. He said "don't worry, we all reflux." I asked him how it was possible that I had an irregular, wavy z-line which is evidence of reflux damage, but never had felt heartburn? He said simply that "some people just don't." He said that due to my 2cm hiatal hernia, I was more at risk that other people to reflux. But he did not say I had full-blown GERD and certainly not anything like Barretts.

So prior to my getting sick this year and having these symptoms, I never had heartburn or reflux in my life. Nonetheless, the evidence suggests that I was indeed refluxing and creating an irregular z-line. Now that I am feeling so much better, how do I know I will not continue to reflux without feeling it thereby causing further damage and setting myself up for some serious health issues? Moving foward, if I have no symptoms, how do I know if I get Barretts? Why would my GI doctor look down my throat again if I am not feeling bad?

I understand this all may seem unfounded and anxiety-driven, but how do I move forward wisely with this? I will continue to adjust my life in ways that are more reflux-friendly, of course. But even my GI doctor was very casual about it. He even said I could keep drinking caffienated/carbonated energy drinks in moderation (1 per day, 2 occasionally). Buttttt .... if I have no symptoms, how do I know I am not making my z-line more ... wavy lol.

Thank you all so much for your time and advice. Cheers!

2

From what I have read some ppl have silent reflux. I never had it before I am a 35 yr old female. A tad overweight but nothing major. I was getting reflux so bad out of the blue I had my gallbladder removed and it didn’t improve. I also have a small hiatal hernia which most of us do but mine doesn’t need surgery. Was told not to worry. Anxiety and lots of antibiotics I believe have me gastritis. I am taking meds for that and nexium for reflux. Just trying to adjust my diet to heal my gut. I hope I get to have no symptoms like you one day. Sorry I can’t answer your question but I am very curious so please keep us updated and I wish you the best of luck. 

3

Not everyone is having heartburn. My main symptom is burp, for example. In first year of GERD there wasn’t heartburn at all, and even now I have it very rarely.

As for the rest, happy to hear that you feel good! But I would advise you don't relax too much and be careful with your lifestyle from now on

4

Doxycycline and and Iborifin  are a big trigger for reflux and stomach problems avoide the completely I had Docycline and that was the start of my problems and I've suffered eith reflux and dreadful heartburn ever since read the side affects of this drug not  good for the digestive track and just be kinfolk of what you eat and drink I would stop drinking the fizzy drinks the will irritate 

5

If you have reflux you have to seriously limit fizzies and caffeine , I had no heartburn ever and only painful feeling was gas in chest (very painful chest so took ibuprofen )and inability to burp. I finally gave in to pressure from family to get it diagnosed and endoscopy showed GERD, gastritis, esophagitis , Barretts (metaplasia) Had 3 months of ppis and various other meds (for digestive issues) # months later endoscopy showed minimal Barretts. So taken off all meds. My symptons of gas in chest slowly returned. Last endoscopy last month (3 years after initial diagnosis) showed no Barretts and mild gastritis and no inflammation . I was told not to take NSAIDs at all and for pain to take solpadeine ( has codeine, paracetamol and some caffeine ) and also not to take sodium bicarbonate for producing burps as this compound is corrosive. However I was told I have bile reflux and focal white plaques in fundus and was given 2 weeks of anti sickness med. When I asked the gastro how do I stop bile reflux he said use gav-  is-  con advance ( connect the 3 small words)  However, I will go back in another couple of years time to get an endoscopy just to monitor.  Perhaps you should also as you are symptomless.   

6

Yaaaaaaaa .... my GI laughed when I told him my primary care physician out me on those medicines. To be fair, my PcP thought I just had some kind of bacterial infection. But my GI said those medicines certainly played a role in worsening my symptoms.

7

So you actually developed Baretts with minimal symptoms and no idea it was happening. Wow. That is what I am concerned about though my GI was hardly concerned.

8

Ya, not becoming complacent seems to be the wise course of action regardless of how I feel. I am getting the sense from people on this forum that the condition can progress without you even realizing it lol.

9

Hang in there! It took me months to feel normalish again. The ENT I saw said that he often tells his patients tat it can take over 6+ months to feel even 80% better, especially if there was damage to the esophagus. So don't be discouraged. You'll get there

10

The chances of metaplasia Barretts turning dysplasia (and progressing to cancer) and almost negligible. But precaution is always better than cure, so endoscopy every couple of years seems the way to go ...especially if you are symptomless (or have minimal symptoms)  

11

I too, had the same issues. I've never suffered from heart burn, but have all the symptoms you had. I say the same thing. If your off the meds, how do you know if it's acid isn't silently destroying your insides. If you don't feel the symptoms, maybe they're not there. Eat right and continue doing what you did, to get you to where you are. 90 percent better

12

I too, had the same issues. I've never suffered from heart burn, but have all the symptoms you had. I say the same thing. If your off the meds, how do you know if it's acid isn't silently destroying your insides. If you don't feel the symptoms, maybe they're not there. Eat right and continue doing what you did, to get you to where you are. 90 percent better

13

Exactly this, yes. So what have your doctors said? Have you shared this concern with them?

14

Yes, I've had an endoscopy in April. Was about the same as yours. I too have a hernia. I'm tired of taking the meds. I TRY and eat right. Sometimes I am not as disciplined as I should be. The dr.s tell me it isn't that bad. I can't believe everything they say. If they cured everyone we wouldn't be on this forum. So they pacify our issue, when the issue isn't going to go away if you have a hernia, unless you eat right or have surgery.