What Causes Persistent Nausea And Acid Reflux While On Pantoprazole?

Posted on Mon, 15 May 2017

Question: my mother has been nauseous since December 1st. I'm guessing she is not pregnant LOL!! She is 73. She has reflux and is on 40 mg twice a day of pantoprazole sodium indefinitely. She also has been told she has to take ranitidine 150mg twice a day for the rest of life. She should be taking her high blood pressure medicine but has stopped taking it this past week to see if that is what is making her sick.(Lisinopril) Had and EGD Done 2/6/2017 they found small hiatal hernia, localized irreg. margins of the mucosa noted in gastroesrpheg.junction, normal stomach , normal duodenum. She is not one to complain and says she is getting no bonus(Baby) out of the morning all day sickness. She has been taking Ondansetron for nausea but only somewhat is working. Any ideas?

Answered by Dr. Shinas Hussain (2 hours later)

Brief Answer:
Probably acid reflux disease caused by hiatal hernia.

Detailed Answer:
Hello,
Thanks for trusting Healthcaremagic
I have gone through your query and I can understand your concerns.

The symptoms you have mentioned are suggestive of acid reflux disease. The reason for her reflex and related symptoms could be her hiatal hernia.
I have gone through your endoscopy report, as per your report the size of the lesion is relatively small, we can go for non surgical treatment first. If non surgical measures using drugs and life style modifications fails,surgical correction may be needed

You don't need to worry much as it can be managed with timely and proper treatment.

I suggest you to consult a gastroenterologist and get the following things done:-
Since the size of the lesion is small we can go for non surgical measure using drugs.
(1)- Continue her antacid drugs. She can go for PPI(proton pump inhibitors) like omeprazole which is more effective compared to ranitidine.
(2)- Antiemetics like domperidone may be needed to control nausea and vomiting.
(3)- Avoid spicy foods which may worsen symptoms.
(4)- She can use couple of extra pillows under the head end while sleeping to prevent reflex and thus provide symptomatic relief.
(5)- Lose extra weight if she is obese.
(6)- Avoid carbonated beverages.
If symptoms persist despite all these, surgical correction of the defect may be needed.

Hope I have answered your query
Wishing you good health.
Regards
Dr Shinas Hussain

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Above answer was peer-reviewed by : Dr. Remy Koshy