Suggest Treatment For Severe Heartburn And Back Pain

Brief Answer:
Take a proton pump inhibitor with prokinetic drug.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic.
I am a Gastroenterologist and would be answering your query.

Reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.The backwash (reflux) irritates the lining of your esophagus and causes GERD.In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the XXXXXXX is weak or relaxes inappropriately, allowing the stomach's contents to flow up into the esophagus. If not treated, chronic acid reflux can injure the esophagus and, in some people, progress to a precancerous condition known as Barrett’s esophagus.

Usually we manage GERD with a combination of medication and lifestyle changes. If symptoms persist or are severe, innovative endoscopic and surgical procedures can be done that provide long-term symptom relief.
Tests suggested are-
High-resolution esophageal manometry. Using a catheter inserted down your esophagus, muscle contractions in your esophagus are measured when you swallow water.
Endoscopy.

Please request your gastroenterologist to start you on PPI-antacids like Rabeprazole or Esomeprazole.Ranitidine will not help you much. 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

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.
Thanks.

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