Help w/Dr. visit: Acid Reflux and Sinusitis (LONG)

[Amethyst]

I know! We spent January in Florida, where the humid winter air was helpful in so many ways. My hair doubled in volume, I lost (temporarily) 5 years off my face, and my sinuses felt better. I bet all the 80-year-olds we saw are actually 90 or 100 due to this youth effect Too bad I cannot tolerate the long hot summers, or we would be living near the beach in FL.

I'm not sure if this will help, but where is your location, and what kind of heating system do you have?

For a lot of us, winter has been pretty cold, with temps in the teens and single digits. Winter air is very dry, it's why mining disasters always occurred in winter months. Swampy, muddy areas underground became deserts, and forced air heat makes the air that much drier, drying the sinuses and throat. That in turn makes one more susceptible to viruses, dust and the like. Add some moisture to your air, but not too much, because that will trigger molds.

 

[Lsbcal]

Thanks for your thoughts...In the mid-Atlantic area, ragweed (my Nemesis) can indeed persist into late fall if it is warm, while maple trees (my other nemesis) can pollinate as early as late February in a warm winter. But my 2 episodes occurred outside those extreme times. There are online pollen reports for every zipcode, and the current report is "low/no pollen." I react when the report is "medium" or higher. Also I do not react to every kind of pollen (at least, according to the tests). Just certain species - ragweed, English plantain, maple, ash. Thank goodness, since I love flowers and love to stick my nose right in them to sniff.

My personal experience is to not rely on the on-line pollen counts. I mention my case just as an illustration. In my case I don't always know the source or its location but I might have itchy eyes and a runny nose in January-February. I have a bit of a runny nose all year but January and February are obnoxious and bother my sleep in the late morning hours.

Allergist's tests probably identify major allergic reactions. My guess is that one might have a low level of allergic reaction to some sources (rhinitus, untreatable by allergist shots) that is additive to a seasonable source like tree pollen which might be treatable by shots.

 

[Floridatennisplayer]

Severe acid reflux and/or GERD is not something to be trifled with. Especially if the onset seems sudden and you haven't had any big changes in eating habits. A visit to to your GP will probably result in a prescription for a PPI drug like the generic version of Protonix. If your health plan permits seeing a specialist without referral, you may want to directly consult with a gastroenterologist who will still likely prescribe a PPI but may also be concerned enough with how your symptoms began to consider an endoscopy.

Whatever you do don't ignore the problem; GERD can lead to Barrett's esophagus and potentially (although rarely) to esophageal cancer. My GERD was more of a nuisance and flareups were easily treated with a drink of milk or liquid antacid. But I'm now on a high dose of a PPI and have been diagnosed with Barrett's meaning an endoscopy every few years to catch cancer early should it ever appear. I've known two people to die of esophageal cancer and it's a miserable way to go.

Do this right now. Go see a gastroenterologist. I am in this field. In the interim go to the drugstore and buy otc Prilosec or nexium. The tooth decay and your other symptoms speak of erosion. Don’t waste your time with a family physician.

 

[Yarnstormer]

My daughter has some serious health issues.

To help me remember and avoid repeating myself I provide a printed timeline of her symptoms and any other providers we have seen. You might add what you have tried to the list.
Make clear your concerns about acid reducers.

Since your situation seems severe, I would push for a specialist referral. Because of the history of coughing I’d want to see a pulmonologist for asthma screening as well as a gastroenterologist. They would send you for that anyway if you were being screened for reflux surgery.

If you end up on a medication, try for prescription zantac. I have not experienced any constipation with it and it’s less scary than ppi’s.

My nocturnal reflux was tied in with mild sleep apnea. Gasping for breath causes the reflux.

A prompt care doc taught me that if you can taste your nasal spray you are using it wrong and irritating your throat. Don’t “sniff” after!

 

[Mr._Graybeard]

My nocturnal reflux was tied in with mild sleep apnea. Gasping for breath causes the reflux.

That is interesting. I've been putting off a sleep study till I enroll in Medicare, but this convinces me I should get it done sooner. Thanks for the info.

 

[Yarnstormer]

I took omeprazole for years but developed some vitamin deficiencies and wanted to quit. It took a while before the prescription zantac was enough but most days it is now. I might take a tums during the day as well but it’s calcium so I need that anyway.

My ex died of carcinoid syndrome. There’s not much info about the cause but I read an article possibly linking the two (ppi and the cancer). That was enough for me.

Honestly, I feel better overall but hard to say if that’s why because I’ve made many changes in my life in the last year.

Fwiw - I had a throat infection from the reflux so it was getting pretty bad, but my scope was clear. No damage.

I read an article about ear infections actually being reflux - maybe your sinusitis is related?

 

[pacergal]

Reading your post of symptoms was like looking at my own history! Frequent sinus infections, post nasal drip, stomach upset/acid, severe choking occasionally when eating, etc.
It has taken a while to root out what resolved them, and testing to rule out certain diagnosis.
Did have Upper GI and barium swallow, then EGD with dilation. Testing showed very small hiatal hernia, no reflux, but small schatski's ring. (thus the dilation). Allergies to pollens, also.
I have stopped flonase and take daily antihistamine. At least once weekly, I mix 2 tablespoons Braggs live culture apple cider vinegar, one tablespoon natural honey and hot water to drink. I eat live culture yogurt. If I notice stomach upset/acid,(which happens far less frequently now) I do take OTC omeprazole daily for a few days to stop the acid production (I rarely need to do the 10 day regime). I will never take omeprazole on an ongoing daily basis, but it certainly helps as needed.
I have no idea if the sinus stuff is related to the stomach/acid stuff, but since I have started the changes above, my symptoms have decreased dramatically.
Not sure this info helps you or not, but definitely need to give your doctor a full report as Meadbh recommends, and request/follow up on tests.
Best of luck in your quest to better health.

 

[Amethyst]

My primary care Dr. said the same thing. She said to aim for the nasal turbinates (had to look up where they reside within my nose!) since that is where the nasal irritation mostly takes place.

M

A prompt care doc taught me that if you can taste your nasal spray you are using it wrong and irritating your throat. Don’t “sniff” after!

 

[Dreamer]

As a former physician, I appreciate your wish to be an organized historian. I recommend you write down your responses to the following points (many can be yes or no). If you have a patient portal available, you can copy and paste your summary into it.

1. Describe the symptoms of your Principal Complaint in detail. Looking through your OP, I couldn’t find sufficient detail. Your doctor needs to know:
- what is the sensation? Pain? Burning? Acid in your mouth? Nausea? Vomiting?
- how bad is it on a scale of 1-10?
- what are you doing when it happens? Lying down? Does it wake you up? Does it ever happen when you are standing?
- how long does it last?
- what, if anything, makes it better?
- what makes it worse?
- is it accompanied by other symptoms, e.g. shortness of breath, choking, coughing?

2. Once the Principal Complaint has been described in detail, outline any relevant recent and past history:
- diet including alcohol
- weight changes
- smoking history
- medications
- self medication if any
- past abdominal or chest surgery
- respiratory infections including sinusitis
- any cardiac problems
- thyroid issues
- anxiety

This should make it easier for you and your doctor to focus on a plan of investigation and subsequent treatment. Best of luck!

This is very helpful. I can see that I have not been very good at describing what is wrong with me in the past, when I have gone for doctor's visits. This gives me a better idea of what to keep track of when I have an ailment. Thank you.

 

[Winemaker]

I have been taking omeprazole for almost 10 years. Somehow, a nerve, probably my vegus nerve, gets irritated by gastric juices, and gives me heart/chest pain. As long as I am medicated, I'm fine, if I forget, well, I get full blown symptoms of a heart attack.

 

[Finance Dave]

I can't respond to the sinus issue....but I "suddenly" got reflux in my early 30s and have been on medicine since. But there is a trick/fact I've learned.

Reflux, left untreated, can cause severe burning of the esophagus, which then REALLY hurts bad. If you then use medication to make that burning subside. After it subsides, you still have reflux...but think you don't because the severe burning has healed. It often will then come back.

For me, I take Omeprazole OTC 40mg once a day. I have found I can go a few days without it, but if I try to simply stay off it for a month, the pain returns. I've also found that when I lose weight (say 15-20 pounds), it's less severe and I get it less frequently when I don't take the pills.

There are not many long-term studies of what these acid inhibitors (like Omeprazole) do to your other organs, so I recommend you either take the lowest dosage you can or take it when you know you'll be eating something that will bother you.

 

[Focus]

I found the first portion of this book very useful, although later it's padded with unexceptional recipes:

The Acid Watcher Diet

Dr. Jonathan Aviv's findings align closely with my own experience. If the book had been available a couple of decades ago, it would have spared me years of trial and error as I figured out my reflux triggers.

He points out that the so-called "silent reflux" has often been misdiagnosed. That was my experience when I had a particularly bad bout. (I had trouble swallowing and breathing in deeply, but no regurgitation. Several doctors could not figure it out, and one misdiagnosed it as COPD.)

By the way, he explains why taking apple cider vinegar is not good.

 

[EveryLady]

Perhaps emphasize the severity and seemingly sudden onset of the symptoms to your gastroenterologist. And insist on an endoscopy prior to starting PPIs, which could only mask an underlying condition.

You mention periodic nausea, which was one of my symptoms. Faint at first but then over the months it would reappear gradually becoming worse.

Turns out that I had complications from an unknown ulcer - that wasn't diagnosed until I ended up in the ER months later with severe pain. All told ... I had several diagnoses along the way. GERD ... IBS ...gastroparesis with testing for celiac disease, gluten sensitivity more.

The gastroenterologist was mortified for ... his words at the GERD diagnosis were that he really should do the endoscopy but he KNEW what it was.

Fortunately, the grade B erosions to the esophagus healed once the ulcer was controlled.

Without drugs or lifestyle changes. And no more reflux.

No one wants to "over use" health care but months of delay (and three gastroenterologists) showed me how complicated some diagnoses can be.

That first endoscopy would have saved a lot in the end (including a last-minute cancellation of an overseas trip).

 

[Focus]

My endoscopy was a very unpleasant experience. If my esophagus needs to be checked again, I'll try to find a doctor who will do the narrow tube through the nose (no general anesthesia) procedure.