Gastroesophageal Reflux (Part One)
Gastroesophageal reflux disease is the most common disease of the esophagus and involves the return of stomach secretions into the esophagus. This return occurs as a result of the loss of tone of the lower gastroesophageal sphincter, located precisely at the junction of the esophagus with the stomach. This sphincter acts as a functional valve that opens whenever we eat or drink. In the case of the loss of tone of this "valve", it will remain open for a long time and gastric fluids will return back into the esophagus. Such a situation occurs in the case of a hiatal hernia, which is the elevation of gastric mucosa into the esophagus.
A consequence of prolonged and untreated gastroesophageal reflux disease is damage to the mucosa of the esophagus in the form of erosions or ulcers and more rarely with the appearance of cardioesophageal cancer. The most typical presentation of this disease is chest burning and acid reflux into the esophagus.
However, gastroesophageal reflux disease can also present with atypical symptoms. About 20-60% of patients with reflux have throat complaints without having any obvious "chest burning". The most common atypical symptom given by gastroesophageal reflux is the sensation of something stuck in the throat, which we call "pharyngeal globus", a sign that can confuse the doctor and may change the direction of problem tracking, thus forgetting the cause: the stomach. Therefore, a high index of suspicion is necessary.
Laryngoscopy can confirm the diagnosis of laryngopharyngeal reflux and gastroscopy can confirm gastroesophageal reflux and further assess the mucosa of the esophagus for damage or not. During this examination, we have seen redness of the posterior larynx and thickening of the vocal cords. Treatment should be started with gastric acid inhibitors as well as lifestyle changes. If gastroesophageal reflux remains untreated, in addition to damage to the esophageal mucosa, it can lead to chronic laryngitis, voice changes, chronic cough, voice scratching, vocal cord granuloma, and other problems.
Gastroesophageal reflux is defined as the movement of gastric contents into the esophagus without vomiting. Laryngopharyngeal reflux is the movement of gastric contents into the laryngopharyngeal area. Reflux disease will manifest when gastric contents irritate the mucosal surface of the upper aerodigestive tract.
Pathophysiology of Reflux
The primary barrier of gastroesophageal reflux is the lower esophageal sphincter, which is located at the level of the diaphragmatic hiatus and acts as the main security of reflux (Fig. 1a, 1b, 1c). Other structures involved in preventing reflux include the intra-abdominal segment of the esophagus, the gastroesophageal angle, diaphragmatic crura, and the phrenoesophageal ligament.
Gastric motility also plays a role by delaying stomach emptying, predisposing to reflux. The upper esophageal sphincter mainly consists of the cricopharyngeal muscle and the circular muscle fibers of the esophagus immediately distal to it. The upper esophageal sphincter is called the pharyngoesophageal junction and serves as the primary barrier in preventing pharyngolaryngeal reflux.
Differences between gastrointestinal symptoms and throat-related symptoms as a result of reflux.
The pathophysiology of reflux with gastrointestinal symptoms differs from that in patients with throat-related symptoms. Patients with gastrointestinal symptoms have esophageal dysmotility and dysfunction of the lower esophageal sphincter, whereas patients with throat manifestations have dysfunction of the upper esophageal sphincter but good esophageal motility.
Patients with gastrointestinal symptoms feel reflux when lying on their back, while patients with throat manifestations have laryngopharyngeal reflux all the time, even when they are standing up. According to one study, 18% of patients with ENT symptoms have esophagitis
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| FIGURE 1A. The upper aerodigestive tract (cricopharyngeal muscle, the arch of the aorta, diaphragmatic hiatus), the upper esophageal sphincter (cricopharyngeus), the lower esophageal sphincter, and the connection of the esophagus with surrounding structures. |
Burning, the most classic symptom of reflux, is common in patients with gastrointestinal symptoms but is unusual in patients with throat manifestations of reflux. One study reports only a 20-43% incidence of chest burning in patients with otorhinolaryngological symptoms.
Throat symptoms in patients with gastroesophageal reflux.
- Aerophagia
- Burning mouth
- Cervical pain
- Sensation of suffocation
- Chronic cough
- Constant clearing of the throat (voice cracking)
- Dysphagia
- Food sticking in the throat
- Sensation of something stuck in the throat (often)
- Bad breath
- Voice hoarseness (dysphonia)
- Earache
- Pharyngeal tightness
- Sore throat
- Water brash
| Title | Sent by | Date of publication | |
|---|---|---|---|
| • | Hemorroidet (majaselli ) - Diagnoza dhe trajtimi. | Dr. Viktor QERESHNIKU | 02/05/2013 |
| • | Tumoret malinje dhe beninje te stomakut | Dr. Shk. Albana Duni | 13/10/2012 |
| • | Kanceri i pankreasit | Altin CEKODHIMA | 24/11/2013 |
| • | Hemorroidet | Altin CEKODHIMA | 12/02/2012 |
| • | Guret e temthit. | Dr. Rozana Aleksi | 27/08/2012 |
| • | Dhjamosja e thjeshte e melcise | Dr. Shk. Albana Duni | 09/06/2013 |
| • | Melcia e dhjamosur | Altin CEKODHIMA | 25/12/2012 |
| • | Echo-Endoskopi EUS | Altin CEKODHIMA | 24/01/2012 |
| • | Refluksi Gastroezofageal | Altin CEKODHIMA | 24/01/2012 |
Thank you for the information, the article is written with a lot of data
Sent by laureta, më 31 October 2013 në 07:42
Very informative article with lots of data and illustrations
Sent by Flutura Zaimi, më 24 December 2013 në 05:29
I don't know where to turn and I have a child who has these signs
Sent by enkeledahaxho, më 13 January 2014 në 14:36
Matches exactly with the signs that I had, thank you
Sent by ermira, më 17 January 2014 në 16:32
Thank you for the valuable information. But where do the swellings of the lower part of the abdomen come from?
Sent by Ervison Domi, më 29 March 2014 në 00:20
I have most of the symptoms that I read above and I thank you for the accurate and focused information that you have provided. I don't know if I am doing the right thing but I have started treating myself with REPRAT 40. Did I do the right thing?
Sent by Liliana Shehu, më 01 Agust 2014 në 08:24
Hello Liliana! Reprat 40 mg is pantoprazole which inhibits gastric acidity. Precisely this preparation is what we recommend after having made the accurate diagnosis of gastroesophageal reflux. If you have this diagnosis, then you certainly have not made a mistake
Sent by Albana Duni, më 14 Agust 2014 në 15:35
Thank you very much for this very clear explanation. My problem is when I drink water and it gets stuck in my throat where I can't even breathe, a very heavy feeling. The doctor has prescribed me pantoprazole 40mg2X-(per day). Greetings
Sent by vahide, më 26 Agust 2014 në 15:47
Regarding Vahid, we can say that the treatment is appropriate as long as Gastroesophageal Reflux has been diagnosed, one of whose signs is also choking. The treatment perhaps needs to be continued for several months. I believe that to diagnose your condition, the doctor did not rely solely on the clinical presentation. In this case, a Gastroscopy and a Contrast Examination of the esophagus are required to confirm the suspected diagnosis or even to rule out other diseases. I wish you a speedy recovery
Sent by Albana Duni, më 27 Agust 2014 në 11:16
Hello!
I have had stomach reflux for about 12 years. Initially, it happened right after I finished a meal, lunch or dinner, especially when I consumed fried foods and vegetables like tomatoes. Now, it occurs after I consume watermelon or when I drink a considerable amount of water after eating. Many of the above symptoms I do not have, almost none except for "water in the mouth". I am a smoker, while the alcoholic drinks I consume are only beers. For a period of time, especially during the ages of 16-22, I couldn't eat breakfast early. My stomach was somewhat upset, but for the past two years, I have been able to eat well in the morning
Sent by Erald, më 02 September 2014 në 09:24
Greetings, I have a problem. My mother is 75 years old and she shows signs of choking and difficulty breathing, and often presents with a cough. Two months ago, we did a stomach examination and it turned out she had atrophic gastritis and a mild hiatal hernia. She received medication that lasted for 1 month, but now, even after the medication ended, she still has signs of choking. Now, we have a problem because she chokes even with water. Please, could you recommend what we could do next since we have a problem where she only passes soups and there are instances where she chokes on those too
Sent by Beta kojani, më 14 September 2014 në 10:45
Hello Beta! The fact that mom has been taking medicine for a month does not fully solve the situation. In such a chronic situation, an extension of the medication for months until the gastric acid production is fully controlled is recommended. The medication should be with pantoprazole 40mg twice a day before food. Mom should also undergo a stomach contrast examination to exclude a possible "achalasia", which is a disease of the esophagus muscles. The diagnosis of "achalasia" is confirmed with esophageal contrast endoscopy.
All the best
Sent by Albana Duni, më 18 September 2014 në 06:46
Hello!!! Congratulations on the explanation, it is very clear. I wanted to know if a surgical intervention is performed for the narrowing of the valve, what is the possibility of the vocal cords returning to normal, and what percentage is the reduction of acidity that burns the larynx and the mucosa???
Sent by Armaldo kllogjeri , më 26 October 2014 në 02:16
Hello Armando! Nissen fundoplication is now considered the standard surgical approach for the treatment of gastroesophageal reflux. This technique consists of wrapping the gastric fundus 360 degrees around the distal esophagus, thus ensuring a tight closure of the sphincter. When comparing the efficacy of antireflux therapy, there is much debate. Some suggest that surgical therapy is superior. The American College of Gastroenterology suggests that surgical therapy is as effective as medication therapy for carefully selected patients with chronic Reflux, when performed by an experienced surgeon. There are some indications for the surgical treatment of reflux:
1- failure of medication
2- need for long-term therapy
3- complications of reflux such as Barrett's esophagus (a precancerous condition) and peptic stricture or narrowing
4- patient preference
5- extraesophageal manifestations such as asthma, voice changes, cough, chest pain
6- paraesophageal hiatal hernia
When surgery is successful, the need for medication ends. Surgery is effective because it reconstructs the valve mechanism at the gastroesophageal junction and physically stops gastric contents from entering the esophageal lumen.
But like any surgical procedure, it also has its complications such as:
1- difficulty swallowing
2- burning or heartburn may return
3- abdominal discomfort that comes from not being able to pass gas.
When you decide between surgical therapy and medication therapy, you need to weigh the cost, risk, and potential complications of surgery against the inconvenience and cost of taking medications. Very important to the success of the procedure is the surgeon's experience.
Good luck
Sent by Albana Duni, më 27 October 2014 në 14:54
Dr. Albana, thank you very much for the professional explanation you gave to my question!!!!! I am very clear and very grateful for this answer. Success to you too in your work!!!
Sent by Armaldo, më 28 October 2014 në 04:14
Hello Dr. Albana.
I hope you are well.
I too have been bothered for some time (more than 1 year) by a sore throat as a result of your diagnosis of "acid reflux".
I had a probe checkup at your Clinic and after taking a long treatment for about 6 and more months, I see that I have the same signs that appeared here a year ago such as: Presence of acidic liquids or vapors in the mouth, "thickening of the inner mucous of the mouth as a result of the movement of these liquids or vapors, feeling as if I have a "blockage" from time to time in the throat of food, a "sour" or "bitter" taste in the mouth especially after eating.
As we have discussed from time to time after I stopped the medications that fought the Acid in the stomach, I have taken "Gaviscon" at first Gel and then Tablets and mainly I take it at night before I go to sleep.
My question is: Should I return again to taking antacids or perhaps should I do a PH test and then depending on the result you decide what I should do next.
I have carefully read the answers you have given to other patients, and through them, I have also received some answers.
I am waiting for some advice from YOU.
Thank you and have a good day.
With respect,
Kujtim Bumci
Sent by Kujtim Bumci, më 06 November 2014 në 02:53
Hello! I am 26 years old. For many years, I have had the problem of gas and colitis, I have considered it as something normal but it is becoming more and more troubling, I have not yet sought medical advice. My problem has to do with the non-release of gas and their circulation in the intestines, I also always have the feeling of bloating which puts me in great discomfort as I think I could be embarrassed from one moment to the next when I am in a social setting, and now it has also become a psychological issue for me. Please, can you give me some advice on how to proceed and if it is necessary to seek treatment. Thank you. With respect, Jeta
Sent by jeta, më 18 December 2014 në 05:04
This is the first time I've managed to get such accurate information without going to the doctor, and I hope that by following this treatment with pantoprazole, maybe I'll get better because I suffocate a lot when I lie down, I can't breathe when I'm on my back, but also on my sides, somewhat. Thank you very much for these tips and such useful information from you, Dr. Albana Duni. Success and may God give you life and health...!
Sent by majlinda cala, më 22 December 2014 në 05:20
Hello! I am a 26-year-old guy. I wanted to know if gastritis or acid reflux also causes sore throat or red spots on the palate? Since I have been using Nolpaza intermittently for 5 months. After stopping it for a month, I have noticed some red spots on my palate and have a slight sore throat when swallowing.
Please reply to me. I wish you all the best
Sent by andi, më 04 January 2015 në 19:32
Reflux causes sore throat, but I am not sure if the red spots are related to reflux. I recommend an ENT or an infectious disease consultation to assess these elements
Sent by Albana Duni, më 06 January 2015 në 14:37
I am a 45-year-old suffering from acid reflux with throat pain and coughing, and it goes so far as to vomit all the food. Please, what do you recommend? Because I have the problem at night with a very sore throat until I vomit the food
Sent by lulzime zuna, më 26 January 2015 në 15:06
The doctor recommended Ulcezol 20 mg to me, and only after reading this do I understand that I might have this disease because I have these symptoms: cough for almost 3 weeks, feeling of suffocation, itchy voice, burning in the chest, stuck feeling in the throat, voice hoarseness, etc. Please tell me if this is the right medication and what I should do for a more accurate diagnosis. Thank you
Sent by Dritanfiori, më 29 January 2015 në 16:17
Hi, I am 26 years old and from time to time I experience problems such as: for 10 to 20 days I feel normal, but after these days I get a bad feeling in my stomach, not pain, I have a lot of dryness in my mouth and throat during these days, dizziness, I have done all the necessary blood and urine tests and everything is fine, when I tense my body, my chest and both sides of my back near the shoulders hurt, so this happens periodically, and then it goes away, and then it comes back again, for the past 2 days I have been to a doctor who recommended me to take Nolpaza 40mg tablets, he said that I have high acidity in the stomach, but I still feel this sensation and I don't know how to treat it
Sent by Egzoni, më 02 February 2015 në 07:57
Hello, I am 47 years old and have problems with my stomach and throat. I have almost constant bloating, no matter what food I eat. I also have a problem with my throat, it feels like something is stuck in my throat or it sticks, only on the right side of my throat. Sometimes it's very pronounced without throat pain but with slight pain on the surface of the throat when I touch it with my hand. I wanted to mention that sometimes I have pronounced itching and slight ear pain on the right side. I have had these throat symptoms since last January, after a treatment with antibiotics and trebon. The stomach bloating is rarely accompanied by pain, except in cases when I am emotionally distressed. Years ago, I was prescribed cilroton for my stomach by a pathologist, two pills before meals three times a day for two months in a row but I did not see any improvement, on the contrary, the medications made me more bloated. I have not taken any medication for my stomach for a while
Sent by silvana, më 23 February 2015 në 13:28
Hello! I'll start first with stomach bloating, which often might not be a sign of illness but just an excessive presence of gas in the digestive tract. There are two ways that increase the amount of air in the stomach and intestines: one is from eating too quickly, gulping, drinking water from a bottle, and the other way is food digestion that often produces a large amount of gas in the intestines. Many of us are intolerant to certain foods such as dairy (which could be a cause of your bloating), vegetables, and legumes like cabbage, cauliflower, peas, beans, and many other foods that fall under healthy foods. If you were to test with these foods, especially dairy, you could confirm this. As for the problems with the throat and ear, it's very possible that the stomach is the cause. However, medicine cannot rely on "maybes," so I think you should undergo a gastroscopy, which is the only way to confirm if you have stomach issues like gastritis or reflux. You can't be treated for 2 months without knowing the exact problem. Anyway, try a little with dietary regimen:
1- eat little and often
2- avoid coffee, chocolate, citrus fruits, fats
3- don’t lie down immediately after eating
4- keep the head of the bed elevated.
It might be somewhat corrected with these rules
Sent by Albana Duni, më 25 February 2015 në 14:21
Dr. Albana is very well-prepared, successful in her work with passion and virtuoso scientific explanation
Sent by naim ramadhi, më 28 May 2015 në 13:51
Hello! Thank you to the great God and long life to the doctors! Without them, our life would have been much shorter. I have been regularly treated with lansoprazole, 30 mg antiacid tablets for 10 years, which has helped me a lot. For a month now, acid reflux has been burning my throat, I need to clear my voice, I feel a scratch in my larynx occasionally, I have a dry cough and this is accompanied by pain in my left ear. From the information I read from this article, I learned many new things that I didn't know, and I am concluding because acid reflux requires a strong diet accompanied by vegetables and fruits, fresh meals, and we need to say "NO" to fried foods and sweets. Most importantly, an alkaline diet must prevail!
Sent by Rita Sadikaj nga Londra, më 28 October 2015 në 18:39
I always have a lump in my throat and I try to swallow it down, and I have a cough and my throat is always dry
Sent by Era , më 16 December 2016 në 04:57
You can stick to the reflux diet and if it's not enough, you should get examined
Replay from Dr. Albana Duni, më 16 December 2016 në 06:56
Hello Doctor! I am a person diagnosed with stomach reflux. I have a continuous, suffocating cough. I have been in this condition for about three months. The medications I have taken for the stomach have not removed the cough. What treatment should I use to eliminate the cough besides the diet that you have described in the article published by you? Thank you
Sent by Donika, më 04 January 2017 në 13:23
Hello! You should continue the treatment for, say, another year, and of course, follow the regimen. However, the chronic situation of reflux has already caused inflammatory or allergic changes in the lungs, which means speaking with an allergist would be advisable so that you can also receive concurrent medication for allergies
Replay from Dr. Albana Duni, më 04 January 2017 në 13:34
Hello Albana!
I want to ask for your help with something. I read the information and comments above, but I want to ask you about something. I don't have any of the symptoms mentioned above, no pain, no itching, no numbness, nothing, only that often when I eat bread, it feels like the food stays in my throat and I have to wash it down with water. It doesn't happen all the time, but it does happen. I wanted an explanation from you, do I have something to worry about or not? Thank you and good luck
Sent by Aleksander STAVRO, më 21 January 2017 në 17:51
What you are complaining about is called dysphagia: difficulty swallowing. Dysphagia can come from several reasons that may be related to the esophagus or to neurological diseases. Initially, the esophagus must be ruled out. Causes from the esophagus are reflux, esophageal spasms, candida (fungus), no offense meant but tumors can also be a cause, however not in your case because dysphagia caused by an esophageal tumor is progressive without interruption, with weight loss, vomiting, etc. Should you take it seriously? It makes sense if this complaint becomes frequent. All the best
Replay from Dr. Shk. Albana Duni, më 22 January 2017 në 13:40
Hello ...thanks for the very valuable information .....I wanted to ask about my son who is 9 months old and has been diagnosed with reflux in the stomach ......I wanted to know if there is any medication that can calm or cure it ....thank you again
Sent by Serenela, më 28 January 2017 në 06:02
Dear, you should speak to the pediatric gastroenterologist about whether the child needs treatment
Replay from Dr. Shk. Albana Duni, më 30 January 2017 në 05:07
Hello,
I also have these symptoms except for the hoarseness of the voice. I want to know where I can go to get checked for reflux, what tests or scans are needed.
Waiting for your reply.
Thank you
Sent by Malvina , më 31 January 2017 në 16:16
In this case, a gastroscopy is performed, which is the examination of the stomach with a camera in a fasting state
Replay from Dr. Shk. Albana Duni, më 03 February 2017 në 07:25
After reading the article, I saw that most of the symptoms have appeared to me as well. To which doctor should I make a visit, the Otorhinolaryngologist or the gastroenterologist?
Sent by Renardo kushtaj, më 07 February 2017 në 09:17
At the beginning of the ENT (Ear, Nose, Throat), if the problem isn't there, they send you to the gastroenterologist
Replay from Dr. Shk. Albana Duni, më 07 February 2017 në 10:07
Hello! I don't know where to start. I have been suffering from an irritation in my throat on the left side below the tonsil for almost 3 years. I should mention that a few years ago, I started having gastritis. I took medication and got over it, then it happened again somewhere else and I got over it well, but I always have reflux. I have food coming back up as soon as I finish eating, immediately I feel the urge to burp. I also underwent a three-month treatment for my stomach because an ENT doctor recommended it. I went to the ENT doctor because I thought it was due to my tonsils. One ENT doctor advised me to get my tonsils removed because I have streptococcus and the ASO was 311. I have lower limb pain as a consequence of rheumatism. But, will removing my tonsils solve this issue? Will I get rid of this discomfort if I remove them? I always want to clear my throat because it feels like I'm going to choke. Every time before I speak, I want to clear my throat; it feels like I have secretions I want to get rid of, but meanwhile, I only bring up normal sputum. I have taken many antibiotics for my tonsils and have also developed fungus. I don't know what to do and I don't know what solution to take. Sometimes, I have bloating, a lot of gas, and occasionally suffer from bowel movements. I also tested positive for parasites and have been treated twice, but it continues to test positive. Three months ago, I was pregnant but the pregnancy was terminated. Now I don't know what to do, I don't know where to start. I am very upset and tired. Sorry for going on so long, but could you please give me your opinion?
Sent by Era, më 05 April 2017 në 08:27
The things you're mentioning are not as serious problems for you to be so worried about. Reflux issues are becoming very frequent due to our lifestyle which has now changed. ESR (Erythrocyte Sedimentation Rate) up to 400 isn't a problem and I don't know if you should remove your tonsils or not. Even the swellings are acceptable because they are a process of our eating, what we eat and how we eat it (meaning when we eat quickly). A lifestyle with physical activity would help in these situations. Fill your day with useful things and stop worrying about complaints. All the best
Replay from Dr. Shk. Albana Duni, më 06 April 2017 në 02:21
Hello esteemed Doctor Albana, I would kindly ask for your help with a prescription for the treatment of duodenal gastritis, as I have been examined and the doctor said that I have duodenal gastritis. I have had stomach problems and my food comes back up; I have belching, and when I cannot belch, I have strong chest burning which goes away after I stand up and belch. Please, I beg you to help me with a prescription. RESPECT FOR YOU
Sent by besnik mehaj, më 02 March 2018 në 11:53
Hello! In fact, duodenal gastritis does not exist as a term. What your duodenum might have is food intolerance, which could be to milk, wheat, yeast, caffeine, etc., since there are many, and that's why food intolerance tests are done. So, I find it difficult to help you. At the pharmacy, you can get some over-the-counter medication like simethicone and probiotics
Replay from Dr. Shk. Albana Duni, më 02 March 2018 në 14:22
I have been having problems with my esophagus for almost 10 years, I have had several esophageal tests, most say that I have problems with reflux, but there are also those who tell me that they notice that it is damaged, it closes well but I continue to suffer from regurgitation which often causes me severe sternum pain, often making me doubt my heart, I don't have pain or burning in the esophagus, I take great care with food but still suffer from the air that comes back up. Thank you for your understanding
Sent by Halit zenuni, më 15 March 2018 në 11:59
Hello! Air in the digestive tract is not a disease. The way we eat and drink results in different levels of air in the intestine. Different people react differently, even with cardiac complaints. I would recommend a website: wwwaltincekodhima.com, where you can read about gases in the digestive tract. All the best
Replay from Dr. Shk. Albana Duni, më 15 March 2018 në 14:17
I received your email regarding your answer but the email doesn't have anything written in it. However it may be, thank you
Sent by Halit zenuni, më 15 March 2018 në 15:15
I recommended you to read on wwwaltincekodhima.com the topic about gases in the digestive tract
Replay from Dr. Shk. Albana Duni, më 15 March 2018 në 16:48
Hello dear. I wanted to ask a question about my mother. She is 67 years old and has a big problem with osteoporosis, but the other problem is that she also has problems swallowing food and even liquids. A doctor told her that the esophagus has narrowed because she has been bedridden for three years. I wanted to ask what this could be since she is currently very weak and we cannot take her to the doctor in this condition. Thank you for your understanding!
Sent by Flora, më 21 April 2018 në 16:54
Despite the great desire to help you, it's difficult because I can't know. There could be many problems, but not reflux since it doesn't prevent feeding. You must anyway take them to the hospital where they can undergo examinations. Swallowing disorders could be neurological, could originate from the esophagus such as: achalasia, esophageal spasm, esophageal tumor, or even damage to the esophageal mucosa from treating osteoporosis with bisphosphonates. So, they must undergo examinations until the cause is found
Replay from Dr. Shk. Albana Duni, më 22 April 2018 në 06:00
Hello. I have been taking antacid medication for more than 10 years. Omeprazole. Pantoprazole. Lansoprazole. I had an endoscopy and it showed that I had Helicobacter pylori. I also treated it with pantoprazole along with antibiotics and still have concerns. Now I am taking Degastrol 15mg once a day. Please, is there any problem that I have been using these medications all these years? I don't know what to do. If I don't take them after eating, I have unbearable, terrible burning. Thanks
Sent by Edi , më 24 April 2018 në 01:34
Hello! It happens that the treatment of reflux lasts a very long time, when this is necessary. Also look at the reflux diet
Replay from Dr. Shk. Albana Duni, më 24 April 2018 në 05:45
Hello doctor, I have been struggling with the same problem for a year now, I have a burning sensation in my throat and ear pain. I have visited the doctor several times and they said it's due to reflux. I have taken some medications and followed a diet, it seemed to calm down a bit but now the same pain in the throat and ears is back, and also nasal secretions, often with blood and sometimes in the saliva. Please can you offer me a solution on how I can improve, thank you
Sent by alket muzhaqi, më 04 May 2018 në 05:43
Hello! It is not known if you have confirmed reflux. If so, you need to be treated for a long time and have a regular dietary regimen, especially avoiding tobacco and alcohol
Replay from Dr. Shk. Albana Duni, më 04 May 2018 në 07:15
Good evening Dr. Albana, sorry to bother you, my mom is 49 years old, a while ago she was diagnosed with Hiatal Hernia, the only medication she has taken is pantoprazole 40mg, but after a few days, the symptoms come back. In the visits she has had, they mentioned that surgical intervention could be an option. Please, could you tell me how we should proceed??? I am waiting for your reply, all the best
Sent by Arilda Lloti, më 27 May 2018 në 17:05
Hiatal hernia is operated on when it is a large hernia, otherwise it is managed with long-term medications, possibly for life, and with a dietary regimen. Pantoprazole is an advised medication
Replay from Dr. Shk. Albana Duni, më 28 May 2018 në 02:43
Doctor, please help me, I have had a stomach problem for a long time because I am not someone who eats a lot and many things cause me problems. If I eat sweets at night, I get heartburn and cannot sleep. My stomach has not been well for two months. I used to drink omeprazole and it would calm it down. I drank Zantac and it created a lump that wouldn't go away, unbearable like a choking sensation. I took Nexium 40mg for a week and it made things worse. I am also taking blood pressure medication and it has troubled my stomach. I vomited several times but still have a lump feeling like I'm choking in my stomach. At night, I also take Librium because I have a state of anxiety and fear, but what troubles me the most is my stomach. Please help me, doctor
Sent by Ela, më 11 June 2018 në 07:38
Dear Ela! The stomach needs to be examined with a gastroscope. If it turns out that the stomach is not sick, then it results that anxiety is problematic and is the cause of your stomach concerns. So, if we don't treat the anxiety, we can't eliminate the stomach discomfort either. The current stressful life often leads people into situations of anxiety. It's not a shame or prejudice for you to turn to a psychiatrist, who treats anxiety issues. Of course, after we have seen with a gastroscope that your stomach has no Problems. All the best
Replay from Dr. Shk. Albana Duni, më 11 June 2018 në 14:39
Dear Ela! The stomach needs to be examined with a gastroscopy. If it turns out that the stomach is not sick, then it results that anxiety is problematic and is the cause of your stomach concerns. So, if we do not treat the anxiety, we cannot alleviate the stomach discomfort. The current busy life often leads people into situations of anxiety. It is neither shameful nor prejudiced for you to seek a psychiatrist who treats anxiety issues. Of course, after we have seen through the gastroscopy that your stomach has no problems. All the best
Replay from Dr. Shk. Albana Duni, më 11 June 2018 në 14:39
Hello Dr.
10 days ago I underwent an examination with a probe.
The conclusion of the examination is noted as: Gastroesophageal reflux, sliding hiatal hernia, and erosive gastritis pending histological examination. As for the stomach, it is written: erythematous mucosa. Fundus in the form of petechiae. Gastric secretions with a frothy content. I have been taking Nexium 40 mg twice a day for about a month, in the morning before food and in the evening after food, as well as Gaviscon twice a day 1 hour after meals. I feel no improvement. Burning in the chest and larynx. Pain in the stomach, chest, and larynx and insomnia. I have difficulty eating. I have all the signs you describe in your article. When I manage to sleep, my tongue feels abrasive upon waking, and my mouth is very dry. My throat is always blocked, and I can't catch my breath. Please, what do you suggest regarding treatment and foods I can eat? Thank you and congratulations on the article and such comprehensive and detailed responses
Sent by Ina, më 12 June 2018 në 18:06
The diagnosis has been confirmed and the complaints precisely match with reflux. First of all, it must be said that tobacco, alcohol, excessive caffeine (in coffee, tea, energy drinks), fast food, negatively affect and be careful if necessary. The second is the quality of the medication, it's not for me to say but here the quality leaves something to be desired. One solution is to get the medication from abroad with Pantoprazole 40 mg 2x 1, which should continue for a long time, for example 6 months.
Best regards
Replay from Dr. Shk. Albana Duni, më 14 June 2018 në 11:45
The diagnosis has been confirmed and the complaints are specifically related to reflux. Firstly, it should be mentioned that smoking, alcohol, excessive caffeine (in coffee, tea, energy drinks), fast food, negatively affect and be careful if necessary. Secondly, it's about the quality of the medication, it's not for me to say but here the quality leaves much to be desired. One solution is to get the medication from outside the country, Pantoprazole 40 mg 2x 1, which should continue for a long time, for example 6 months.
Best wishes
Replay from Dr. Shk. Albana Duni, më 14 June 2018 në 11:45
Doctor, I would like to know where I can come to have a consultation/visit with you.
Thank you
Sent by Mira, më 15 June 2018 në 07:57
Contact at this number
Replay from Dr. Shk. Albana Duni, më 15 June 2018 në 15:07
Hello doctor. From the information I read from this article, it helped me a lot. My mother has almost the same symptoms as mentioned above, and the doctors have told her that her left throat valve has been paralyzed, and they have prescribed her Etason 0.5mg. Is this the correct treatment because I am a bit doubtful since, based on some information I read, this type of medication is related to the eye and not the esophagus part. Please, I kindly ask you to reply because I am worried. Regards
Sent by Klajd Pashkaj, më 26 June 2018 në 05:56
Hello! From what I understand, your mother's issues are neurological, and the medications we prescribe in gastroenterology would not help. Etason has many effects and not only on the eye. Therefore, you have no reason to doubt the treatment you have been given. Especially since you are not a doctor and no matter how much you read, you do not have the necessary expertise to raise even the slightest doubt, meaning your mother should be treated as the competent doctors have said. In this case, I cannot help you. All the best
Replay from Dr. Shk. Albana Duni, më 27 June 2018 në 07:38
Hello doctor, I have been experiencing throat pain for a few months when I touch it with my hands, difficulty swallowing and holding water in my mouth, and what bothers me more is it often feels like something is stuck in my throat, along with nausea and a bitter taste in my mouth. What do you recommend? Regards..
Sent by Antoneta, më 29 October 2018 në 10:58
Hello! Difficulty in swallowing can indicate problems with the ENT (Ear, Nose, and Throat) area but also with the stomach. First, have an Otorhinolaryngological consultation to rule out throat problems. If nothing comes up, then a gastroscopy should be done. All the best
Replay from Dr. Shk. Albana Duni, më 29 October 2018 në 14:46
Doctor, is it possible to have a contact number?
Sent by saranda, më 21 November 2018 në 23:12
La Vita endoscopic clinic can be easily found on Google
0696015018
Replay from Dr. Shk. Albana Duni, më 27 January 2019 në 11:12
Hello, doctor. I am a 30-year-old girl and I have stomach problems. I use omeprazole. My problem is that when I eat food, it remains in the esophagus somehow, and my esophagus tightens. Please help me with any advice or what to use in this case
Sent by Lenda, më 13 January 2019 në 20:19
Hello! Advice before examination is not valid, otherwise I might make a mistake by delaying your diagnosis. So, your diagnosis is more important than advice. Your complaint might come from reflux, from Achalasia, from esophagitis, etc. Therefore, gastroscopy and contrast fluoroscopy would help you with the diagnosis
Replay from Dr. Shk. Albana Duni, më 27 January 2019 në 11:06
Doctor, you are very kind for providing answers and calming people down. I have been having stomach problems for a long time, but 5 months ago I was experiencing pain, vomiting, acidity, and was diagnosed with H. pylori bacteria. I took antibiotics and omeprazole for 14 days, which was a difficult treatment for me. After 6 weeks, I took the test and it came out negative, but it's been 6 months since the treatment of the bacteria and I am not 100% well. I still experience burning sensations and acidity from time to time, and omeprazole doesn't help. How long will it take for my stomach to recover from the bacteria? It's causing me a lot of stress and anxiety, and I am not in a good financial situation to undergo an endoscopy. Could you help me with some medication...?
Sent by Ana, më 16 January 2019 në 09:18
For the first time, you have been treated without relying on examinations or undergoing a gastroscopy, and this is not correct because under the symptoms of Helicobacter, any possible situation in your stomach could be hidden. You can do the gastroscopy at QSUT or at Specialties Polyclinic No. 3 if you are insured to do it for free
Replay from Dr. Shk. Albana Duni, më 27 January 2019 në 11:02
Hello Dr. Albana Duni. I have been diagnosed at your clinic with gastroesophageal reflux. I have been treated with pantoprazole 40 and foreak gel for a relatively long time of 6 months. Then for another 5 months, I used Esomeprazole Magnesium. I continue to have severe throat pain, a lot of secretion cough, difficulty breathing, chest pain, and occasionally ear pain. What do you suggest I do next?
Sent by Stiven Molla, më 27 January 2019 në 10:11
It happens that treatment may continue for years until a complete improvement of the reflux. Of course, the quality of the medication matters, but also the diet for refluxes that you should have received from us.
You are welcome
Replay from Dr. Shk. Albana Duni, më 27 January 2019 në 10:57
Hello doctor, I have a problem. When I eat food, it comes back up to my throat. I am very worried
Sent by Krenare, më 28 January 2019 në 13:08
Proud Greetings! You need to contact a gastro-hepatologist where you live because you might need to be examined. All the best
Replay from Dr. Shk. Albana Duni, më 29 January 2019 në 05:18
Hello doctor, I have been having a problem with my throat for almost a month, it feels like I have something in it and every time I swallow it seems like something is stuck, but I don't have this problem when I eat or drink. The problem is worse when I lie down and the pain is greatest when I lie on my back. Could it be reflux?
Sent by Enxhi, më 08 April 2019 në 18:36
Hello Enxhi! It might be reflux but it cannot be treated through guessing. Perhaps it would be best to start with the anti-reflux diet that you can find right here at mjeket.al
Replay from Dr. Shk. Albana Duni, më 15 April 2019 në 15:27
Hello Enxhi! It could be reflux, but it can't be treated with guesswork. Maybe it would be good to start first with the anti-reflux diet that you can find right here at mjeket.al
Replay from Dr. Shk. Albana Duni, më 15 April 2019 në 15:27
Hello Dr, I am 42 years old and for a year I have had a problem with my throat as if something is stuck in it, secretion. I have had 5 visits to ENT doctors but have not been successful in curing the dryness of the throat. In the throat, I have also done a gastroscopy with Dr. Skender Telaku who said it's because of the acid and I have used pantoprazole, sometimes 20 mg, sometimes 40 mg, but this obstruction does not go away
Sent by ibrahim Hoti, më 20 April 2020 në 15:52
Hello! From what you tell me, I think you are on the right track. Your complaint is related to reflux. But it will take time to disappear. You need to continue with the medication combined with a dietary regimen. No smoking, no alcohol, no spicy food, no chocolate, no fatty food products. These are the main ones
Replay from Dr. Shk. Albana Duni, më 21 April 2020 në 03:24
Hello, in February I started experiencing some abdominal pain in the colon area and around the spine. I did an abdominal ultrasound and it came out fine, but the pains continued. I did blood tests and the lymphocytes were above the maximum value, while the neutrophils were low. I had a gastro-hepatological consultation and the doctor asked me to do 2 stool tests for parasites and Helicobacter pylori (the latter was negative). The test results showed that I had the parasite Giardia lamblia, so I continued with a treatment of Ornisid (3 pills in 1 day and another 3 pills after 3 weeks). 2 weeks after completing the second treatment, I did the test again and it showed that I still had the bacteria, so the doctor prescribed a third course of treatment. Now, 3 and a half weeks after the treatment, I still have pain in the abdominal area, sometimes even in the stomach. I've noticed that I've lost my appetite over the last 10 days, feel fatigued, and sometimes dizzy. When I did the stool analysis, I also did a blood test where again the lymphocytes were high and the neutrophils were low. Is this a result of the parasite I've had, or should I do further examinations? Thank you
Sent by Sara, më 03 June 2020 në 13:30
Hello! I would recommend that you be followed by an infectious disease doctor
Replay from Dr. Shk. Albana Duni, më 12 June 2020 në 06:06
Hello, 8 months ago I had an examination and was diagnosed with gastritis and reflux, with a slightly red stomach. I took the medicine pantoprazole 40, once a day, and the syrup gastrotuss for 1 month. Later, I only had the concern of reflux, just burning in the esophagus and throat, I took again a medicine omeprazole 20, once a day for almost 4 months and with some interruption. The moment I stop the medication, the condition in the esophagus returns but in a milder form. Now I'm only drinking the syrup but the moment I drink the syrup I feel a bit of heaviness in the stomach, should I continue the medication with omeprazole again? I emphasize that I have never vomited but I only have discomfort in the esophagus, thank you!
Sent by Nertila, më 11 June 2020 në 15:58
Hello! I can tell you that there are cases when reflux requires a longer treatment. Even in your case, this alternative is given to you to continue for several months with Omeprazole. Of course, an anti-reflux regimen as well
Replay from Dr. Shk. Albana Duni, më 12 June 2020 në 06:05
Hello Doctor, I have almost the same symptoms as those described above. There are moments when I feel a thick liquid forming in my throat and I want to expel it, I also feel as if the right side of my throat is numb, and the right shoulder area hurts as well, it feels like muscle pain or as if the flesh is torn. I haven't done any particular examination but the local doctor recommended me pantoprazole 20 mg. I've been in this condition for almost 5 months! Should I follow any specific diet, or undergo some examination, thank you
Sent by Arlind Mukaj, më 13 June 2020 në 15:59
Long-term use of medication is not advised since drugs can regulate on one hand but also can cause damage. Initially, you should check your lifestyle. For this, refer to the anti-reflux diet. Secondly, instead of Pantoprazole use something lighter like Gaviscon. And most importantly, gastroscopy confirms or rules out stomach diseases
Replay from Dr. Shk. Albana Duni, më 14 June 2020 në 08:05
I have been suffering from reflux for 2 months. Initially, it started with chest pain and then stomach cramps. Now, it has moved to my throat, feeling like something is stuck there. However, when I eat bread, it feels slightly better, but then the burning sensation in my throat and redness start again. I visited an ENT doctor who told me it's due to stress and anxiety causing acid to move up to my throat. I have had tests done and they came back fine, but I am extremely worried that I might have something serious. Lately, I have been feeling nauseous. The doctor prescribed me Ultop 20mg, 25 drops three times a day, along with vitamin B6 and some sedatives because I have trouble sleeping. Initially, when I started taking them, it seemed to alleviate the symptoms a bit, but now, after stopping the therapy for a while and starting again, I am only using Ultop but it's not having the same effect. Please, I need advice
Sent by Armendi, më 14 June 2020 në 05:52
Hello! The main advice is to pay attention to your lifestyle and diet. Tobacco, caffeine, fats, spicy foods, being overweight, eating large quantities, and lying down after eating are not recommended. A visit to a gastroenterologist and undergoing a gastroscopy makes sense in your case. The treatment should be prescribed by a gastroenterologist
Replay from Dr. Shk. Albana Duni, më 14 June 2020 në 08:11