I Have Been Having This Esophageal/upper Stomach Pain In And
Acid peptic disorder with constipation.
Detailed Answer:
Hello,
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Have gone through your details and i appreciate your concerns.
You are having acid peptic disorder with constipation.
Please go through every line and try to understand that basic cause of your problem is reflux of acid from stomach to esophagus.Stomach is lined by a natural layer of mucosa membrane which is resistant to acid however mucosa in esophagus is easily destroyed by acid which regurgitates back from stomach.This cause severe irritation of esophagus leading to inflammation which causes pain behind breastbone etc.
Have a more detailed look,
The esophagus is a muscular tube that is located in the chest and serves to transfer food from the mouth to the stomach. The lower esophageal sphincter (LES) is a valve that is located at the junction of the stomach with the esophagus. Its function is to prevent acid and other contents of the stomach from coming back into the esophagus. GERD is a condition in which excessive acid-containing fluid refluxes (flows) back into the esophagus, in part because the lower esophageal sphincter is weak.
Now management consists of two step-
1)Control acid production-Just by taking ppi.
2)Prevent reflux of acid formed back to esophagus-by taking prokinetic drug.
Please request your gastroenterologist to start you on PPI-antacids like Rabeprazole or Esomeprazole.
Esomeprazole can be used in the dosage as high as 80 mg twice daily.Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms. Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back.Prokineic should be added in your regimen.
An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.
All these drugs should be given by your gastroenterologist to provide you with relief in your problem.
To prevent the esophageal damage from developing into late stage Barett ask your gastroenterologist to follow aggressive treatment pattern initially. As your symptoms will improve drugs can be tappered off gradually.
Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, grapes and apples
Fiber.
Fatty foods and carbonated drinks.
Try Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Take a high-quality probiotic.
Take external enzyme supplements.
Exercising, to help keep food moving through your system.
Using spices that may help to prevent contipation. These include turmeric, coriander, peppermint, fennel, sage, chamomile and ginger.
Hope i answered your query in details and hope you understood my explaination.
In case you have more doubts feel free to ask doubt on speciality query under gastroenterology.
Thanks.