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What Are The Treatment Options Available For LAX LES?
Question: What are the treatment options available for LAX LES?
I have been diagnosed with RUT +ve for H Pylori (HP), mild gastritis and LAX XXXXXXX Currently undergoing treatment for HP with triple therapy (Clarithromycin, Metronidazole, Pantoprazole) along with a probiotic. Doctor has prescribed Pantoprazole for about 3 month in decreasing fashion post HP treatment.
Currently (even after starting treatment), the morning chest discomfort and severe anxiety is still present, during which blood pressure also elevates slightly (as observed up to 140/90 but remains 120/80 for whole day). Interestingly, the chest discomfort and anxiety goes away on its own after few hours of normal routine activities like taking breakfast, drinking water, walking etc and so does the blood pressure.
Lifestyle changes already being complied like sleeping after few hours (after dinner) and bed elevated at head side by about 2-3 inches. Cardiac tests (ECG, Echocardiogram, TMT) all are negative. To add with, any dry fruit like cashew, almond, raisin etc if taken, results in loose motion (this is also present since long).
I have been diagnosed with RUT +ve for H Pylori (HP), mild gastritis and LAX XXXXXXX Currently undergoing treatment for HP with triple therapy (Clarithromycin, Metronidazole, Pantoprazole) along with a probiotic. Doctor has prescribed Pantoprazole for about 3 month in decreasing fashion post HP treatment.
Currently (even after starting treatment), the morning chest discomfort and severe anxiety is still present, during which blood pressure also elevates slightly (as observed up to 140/90 but remains 120/80 for whole day). Interestingly, the chest discomfort and anxiety goes away on its own after few hours of normal routine activities like taking breakfast, drinking water, walking etc and so does the blood pressure.
Lifestyle changes already being complied like sleeping after few hours (after dinner) and bed elevated at head side by about 2-3 inches. Cardiac tests (ECG, Echocardiogram, TMT) all are negative. To add with, any dry fruit like cashew, almond, raisin etc if taken, results in loose motion (this is also present since long).
Brief Answer:
Mostly GERD. Surgery if medical treatment fails.
Detailed Answer:
I understood your query. It suggests GERD(GASTO ESOPHAGEAL REFLUX DISEASE).
Following are the treatment options.
Life-style modifications are the cornerstone for anti reflux therapy.
Antacids and alginates are effective in improving heartburn symptoms in patients with mild disease. H2 receptor antagonists, in both regular and high doses, improve and sometimes eliminate the symptoms of heartburn with mild-to-moderate disease. The proton pump inhibitors are the best agents to control esophageal acid exposure.
If antacids and alginates are not effective, you might consider either a drug that acts directly on motility abnormalities or an acid suppressant. Ideally, the promotility agents, such as cisapride, are meant to improve esophageal peristaltic clearance, maintain increased XXXXXXX tone, and improve gastric emptying.
The patient with severe esophagitis (multiple erosions, confluent erosions, ulceration, stricture, Barrett's esophagus) can be expected to require more definitive therapy to obtain remission. Here, the choice should include life-style modifications plus either a proton pump inhibitor or fundoplication. Fundoplication achieves excellent results in 95 percent of carefully selected patients. SURGERY IS ONLY RECOMMENDED TO PATIENTS WITH BOTH A DEFECTIVE LOWER ESOPHAGEAL SPHINCTER AND A CORRELATION BETWEEN ACID REFLUX AND THE ONSET OF SYMPTOMS.
Chest discomfort and anxiety can be associated due to reflux of acid which will be controlled if the reflux disease controlled. Other thing is in morning, take breakfast and avoid fasting. Small frequent meal may help you as symptoms of gastric ulcer are aggravated by empty stomach.
Also avoid spicy food and avoid fruits which increase gastric acidity. Drink 3-4 liters of water a day. Do regular exercise and Yoga.
Hope you are satisfied with my answer.
Dr KUNJAN h SHAH.
Thanks
Mostly GERD. Surgery if medical treatment fails.
Detailed Answer:
I understood your query. It suggests GERD(GASTO ESOPHAGEAL REFLUX DISEASE).
Following are the treatment options.
Life-style modifications are the cornerstone for anti reflux therapy.
Antacids and alginates are effective in improving heartburn symptoms in patients with mild disease. H2 receptor antagonists, in both regular and high doses, improve and sometimes eliminate the symptoms of heartburn with mild-to-moderate disease. The proton pump inhibitors are the best agents to control esophageal acid exposure.
If antacids and alginates are not effective, you might consider either a drug that acts directly on motility abnormalities or an acid suppressant. Ideally, the promotility agents, such as cisapride, are meant to improve esophageal peristaltic clearance, maintain increased XXXXXXX tone, and improve gastric emptying.
The patient with severe esophagitis (multiple erosions, confluent erosions, ulceration, stricture, Barrett's esophagus) can be expected to require more definitive therapy to obtain remission. Here, the choice should include life-style modifications plus either a proton pump inhibitor or fundoplication. Fundoplication achieves excellent results in 95 percent of carefully selected patients. SURGERY IS ONLY RECOMMENDED TO PATIENTS WITH BOTH A DEFECTIVE LOWER ESOPHAGEAL SPHINCTER AND A CORRELATION BETWEEN ACID REFLUX AND THE ONSET OF SYMPTOMS.
Chest discomfort and anxiety can be associated due to reflux of acid which will be controlled if the reflux disease controlled. Other thing is in morning, take breakfast and avoid fasting. Small frequent meal may help you as symptoms of gastric ulcer are aggravated by empty stomach.
Also avoid spicy food and avoid fruits which increase gastric acidity. Drink 3-4 liters of water a day. Do regular exercise and Yoga.
Hope you are satisfied with my answer.
Dr KUNJAN h SHAH.
Thanks
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi, thanks for response.
That means I have to wait till completion of the treatment course prescribed and then again follow up with gastroenterologist for my conditions (perhaps with fresh tests to monitor the conditions after treatment therapy), and if medicines (extreme case) fail to improve symptoms, then surgical options might be needed!
And lifestyle changes play vital role in this.
Am I right?
Also please let me know whether the triple therapy (Clarithromycin, Metronidazole, Pantoprazole) would only eradicate the H Pylori or it would assist in getting the acid reflux (and LAX LES) under control over time.
Is it true that post eradication of H Pylori, GERD symptoms would automatically eliminate gradually.
That means I have to wait till completion of the treatment course prescribed and then again follow up with gastroenterologist for my conditions (perhaps with fresh tests to monitor the conditions after treatment therapy), and if medicines (extreme case) fail to improve symptoms, then surgical options might be needed!
And lifestyle changes play vital role in this.
Am I right?
Also please let me know whether the triple therapy (Clarithromycin, Metronidazole, Pantoprazole) would only eradicate the H Pylori or it would assist in getting the acid reflux (and LAX LES) under control over time.
Is it true that post eradication of H Pylori, GERD symptoms would automatically eliminate gradually.
Brief Answer:
Yes, you are right. Triple therapy eradicates infection only.
Detailed Answer:
Welcome again.
Yes you are right.
Wait for completion of course and then do follow up with your doctor and yes life style play very important role to cure this.
Triple therapy helps to eradicate infection only. If your symptom are due to H. pylori only, then it will be resolved otherwise not. H.pylori increases acid secretion leading to all these symptoms.
So after treatment, there will be decrease in your symptom but you have to continue medication to suppress the acid secretion. If everything fails, then surgery is the last resort.
Hope you are satisfied with my answer. Please keep updating your condition.
Wish you a good health.
DR KUNJAN H SHAH
THANKS
TAKE CARE
Yes, you are right. Triple therapy eradicates infection only.
Detailed Answer:
Welcome again.
Yes you are right.
Wait for completion of course and then do follow up with your doctor and yes life style play very important role to cure this.
Triple therapy helps to eradicate infection only. If your symptom are due to H. pylori only, then it will be resolved otherwise not. H.pylori increases acid secretion leading to all these symptoms.
So after treatment, there will be decrease in your symptom but you have to continue medication to suppress the acid secretion. If everything fails, then surgery is the last resort.
Hope you are satisfied with my answer. Please keep updating your condition.
Wish you a good health.
DR KUNJAN H SHAH
THANKS
TAKE CARE
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Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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