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 Post subject: Severe reflux??
PostPosted: Sat Mar 15, 2008 1:31 pm 
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Q: 29 yo female with sudden onset severe reflux with belching 6 months ago. GI workup esophageal ulcer, excessive stomach acid on pH monitoring, barostat test shows opposite action (stomach contracts and pushes food up esophagus. Negative celiac workup. Treated with PPI, 10 days antibiotics for bacterial overgrowth. digestive enzymes. No response. Recent CDSA shows mild yeast overgrowth only. She burps every minute for 6 months. Ideas? I am giving first acupuncture treatment today and starting Nystatin and fluconazole.

Daniel Blodgett MD


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 5:50 pm 
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A1: I would definitely start with IgG food allergy test, I use Immuno labs and have gotten great results. with the exception of one patient all of my patients with GERD, have had dramatic help with elimination diet. All meds are usually stopped by 2 - 3 months of the process and are able to be free from GERD. I also supplement with a good digestive enzyme with meals and probiotics once daily.
Curtis Takemoto-Gentile, MD


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 5:59 pm 
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A2: I would not trust the celiac workup if it is blood or saliva. Test for all food intolerances through Enterolab (972) 686-6869, they use stool. If you go with theory that there is excessive stagnation of the stomach contents leading to over acidity, then using HCL is the way to go. First you must settle down the ulcerations with things like licorice and zinc carnosine(zinlori 75(metagenics))while using a PPI for 30-90 days. Then stop the PPI and use some Orange Peel Extract(Heartburn Free from 800.783.2286 or http://www.enzy.com while you introduce the HCL and staying off all intolerant foods that came up on the test results. This procedure works for my patients 80% of the time. also make sure the problem does not stem from an H.Pyloi infection. Be careful using enzymes, if they are not the cause of the stagnation then they will promote the ulcerations.

Robert Seamon DC DACBN


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:00 pm 
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A3; Try treating with NAET for stomach acid, enzymes, yeast. Sounds like an allergy to me.

Joyce Benjamin RN,PA-C NAET Practitioner


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:01 pm 
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A4: Constant belching is very very unlikely to be from physical disease. There simply is no disease process that can make that much gas, except possibly candida of the GI tract PLUS A SUGAR INTAKE. This person is most likely an AEROPHAGIAC. Watch her in your office for less than an hour, and be sure that she is not allowed to close her lips during that time (You can't swallow air unless you close your lips). If the belching stops during this time, you made the diagnosis.
GORDON JOSEPHS, MDH
SCOTTSDALE, ARIZONA


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:02 pm 
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A5; Does she have any mercury amalgam dental fillings? Remove them as early as possible. Mercury from the amalgam bleeches out and enters the stomach damaging the mucosa, especially at the duodenum. The duodenum develops an inflammation in the presence of stomach acid.
Inflammation leads to duodenal spasm, causing the retrograde propulsion of gastric material up into the oesophagus. Also exclude any external source of heavy metals damaging the stomach mucosa.
Oesophageal ulcer is secondary to the reflux gastric acid.
S K Tan, MD


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:04 pm 
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A6; That's a great start. Sounds like the opportunistic fungal overgrowth is main culprit. I'd also consider having her use DGL (Licorice Extract Wafers) from Douglas Labs as a lozenge several times a day. This bathes the esophageal surface with DGL and may help heal the irritated epithelium. I also use aloe concentrate to soothe the surface and support epithelial repair and recovery. My preference is Oasis Aloe Gold -- not too expensive and plenty of sweet spot polysaccharides. Perhaps a tablespoon every couple of hours while awake.

Ralph A. Miranda, MD, FACAM


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:05 pm 
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A7; Dear Dr. Blodgett,
Interesting challenge. I hope this patient has had an abdominal ultrasound to rule out pancreatitis or abdominal growth. I suspect that something is pressing on the stomach from below and stimulating secretions of HCL. The fact that peristalitic action is reversed suggests that the stimulous is mechanical, rather than digestive in nature. When it comes to digestive enzymes, I would look at pancreatic enzyme blends preferentially. After you do the cleanse, I presume probiotics will follow. If the US finds nothing, look for constipation as the source of pressure. I hope this helps.
Dr. Macart


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:07 pm 
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A8: Juice of 1/4 purple cabbage qid, VSL#3<http://www.vsl3.com> 2 packets each day. If you can't test stomach acid production, empirically start betaine HCL 10gr/meal. Get off grains/sugar. Her symptoms are due to yeast overgrowth. Question is why "sudden onset"? Post partum, antibiotic tx, stress overload, hypothyroid? Something happened to compromise her immune system.

Roby Mitchell M.D.(Dr Fitt)


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:08 pm 
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A9; Hello Daniel,
Have this patient chew DGL tablets every 15 or 20 minutes.....it may not totally solve the problem....but it is likely to help a lot. Below is one link.....there are many others........Ross Pelton
http://ezinearticles.com/?Get-Heartburn,-Indigestion-and-Ulcer-Relief-Using-DGL&id=133828


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:10 pm 
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A10; I have had over a 90% success rate with any form of GERD or hyperacidity with Manuka honey produced by the Synergy Co.- amazing product-people with years of symptoms and treatments after one or two doses all symptoms gone

Yours in health and wellness

Bruce H Berman, MD
675 W Indiantown Rd
Suite 100
Jupiter FL, 33458


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:11 pm 
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A11: I would suggest experimenting with Apple Cider Vinegar. One spoonful added to a glass of warm water. Drink once or twice per day. Hold/pinch nostrils shut if vinegar smell is bothersome while drinking. Remember "likes dissolves likes". Vinegar should neutralize pH..... Of course, probiotics and activated charcoal may help too.

Michael Frank, D.C.


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:12 pm 
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A12; Bitters before meals will help most cases of reflux. I prefer a blend that is not too cold, so as not to injure the digestion: tinctures of mixed angelica, dandelion herb and root, orange peel, artichoke leaf and peppermint. If you add gentian, warm it up with some ginger. A swig of angostura bitters will also work to cue the body to make bile. It will also help prevent H. pylori from colonizing any reflux-erosions. A salad of bitter herbs- radicchio, dandelion greens, etc. will also stimulate the reaction. But the bitterness must be tasted and shouldn't be covered with sugar.

Swedish bitters and Fernet Branca will also work, but tend to be too cold, so need ginger.

Karen S. Vaughan, L.Ac., MSTOM
Registered Herbalist (AHG)


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:14 pm 
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A13; 1,000 mg of orange peel extract has been shown to be very effective. LEF makes a good one called Natural EsophaGuard. I've heard good things about it...Keep me posted if you end up trying it...

Niloo


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 Post subject: Severe reflux??
PostPosted: Tue Mar 25, 2008 6:15 pm 
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A14: Did anyone check for Zollinger-Ellison syndrome? I've found it in a guy who'd been to GI several times (though it took me a couple visits to put the pieces together). Get a gastrin level: in Z-E it will be sky high (close to 1000 or more). This is one circumstance I'd use meds (though surgery is supposed to help by cutting the nerve that controls it): PPI and H2 blocker at high doses.
The incidence is 1 in 1,000,000, but that means there's 300 other people out there with it.

Dr. Malcolm Sickels, MD
210 Little Lake Drive, Suite 10
Ann Arbor, MI 48103
http://drsickels.com


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