GERD / When PPIs Don’t Work - Kevin Ghassemi, MD | UCLA Digestive Diseases
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- Опубликовано: 11 июл 2024
- UCLA Digestive Diseases
Continuing Medical Education
GI Issues for the Primary Care Physician
February 22, 2014
Kevin Ghassemi, MD
Associate Director of Clinical Programs
UCLA Center for Esophageal Disorders
Assistant Clinical Professor of Medicine
Division of Digestive Diseases
David Geffen School of Medicine at UCLA
Learn more at gastro.ucla.edu 
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Personally, I think that any patient that has GERD symptoms should have stomach Ph level testing and an endoscopy before being given a PPI. Just my thoughts.
Robdrums Studios couldn’t agree more! It should be the first step!
then they woundnt make profit would they
How to check stomach ph ? What is the test name?
Insurance companies don't want to pay for those tests.
I’m learning more from the comments. 🤔
Dr. Kevin Ghassemi is an outstanding doctor.
I struggle with GERD, but at night all hells seems to break loose. It literally forces me to stay awake and remain sitting up all night. It’s so miserable
Do you have dificulty breathing and do you burp often?
I’ve had Severe GERD since birth (it never went away) and YES it’s always worse at night especially when laying down. Try laying on your left side it promotes digestion and prevents acid from coming up better than if you were laying on your right side
Not certain about the points made but ,if anyone else is searching for how long does gerd flare up last? try Larlazboon Predictable Domination (should be on google have a look ) ? Ive heard some super things about it and my mate got great results with it.
@@lexjordan691 how are you noe
Jennifer Lawrence not much better :( still looking for possible solutions s
I have a 35 year history with gerd. I cant believe how backwards this is. There is supposed to be no live bacteria and thus no fermentation in the stomach. The bacteria live because of too much fermentable food (sugar, starches, even veg fiber) and too little acid. First eliminate fermentable foods for a while. The relief will be amazing. Yes, a very low carb diet and lay off raw veg at least for a while. Then increase acid by taking apple cider vinegar. For me, low carb cuts out 80% of it and ACV takes care of the rest. I can eat salad and veg with no problem. I had horrific reflux 30 years ago. Went away when I first started low carb 23 years ago to control my newly diagnosed type 2 diabetes. Over the years if I slip up on the low carb it comes back then goes away when I get back on track.
sorry to hear that, have you had endosopy to find the cause?
So are you saying that probiotics are causing the problem and people should avoid things like yogurt, kefir etc.? I believe acv has live bacteria as well
I did this and more and it didn't work . ACV made it so much worse and low carb has messed me up blood sugar wise . I wouldnt recommend anyone do that crap.
i was on ppi for 2 years and i got SIBO and terrible bloating also I had severe symptoms; chest pain and burning and i couldnt work. Eventually i gave myself a 380 Nissen and I got better. No more discomfort or reflux. All good.
How do you feel now
@@la5389 zero reflux
@@Itsabdullahkhan007 the surgery help you thats good
I want to get surgery hope is approved for me I have regurgitation everyday
What is 380 nissen?
I was drinking morning coffee without milk then heartburn started so I ate a tums but I thought it messed up my stomach and belching started. I've discovered sip some water after a sip of coffee to reduce acid in the esophagus. It's helpful.
What abt H. Pylori? SIBO/dysbiosis/neuromuscular weakness?
I think the problem is fixating on acid and not reflux. There are other damaging secretions in the stomach that will come up, as the doctor says. Also, this constant claim about not going to bed after eating ignores places like Italy and especially Spain, where the traditional dining time is around 10:00 p.m.
Interesting, yes, as well as a siesta after the midday meal
So, Dr. Ghassemi, what causes the increased abdominal pressure? (DDx: bacterial dysbiosis / overgrowth, producing excess H2 gas; poor diaphragmatic tone, which would reduce hiatal pressure or herniation; obesity, which can produce a mass effect; overactivity of T6-T9 vertebrae, which innervates the stomach; etc., etc., etc.)
Every time i gain weight i cant breathe driving, belching and the worst was neck ache with nausea (mostly like morning sickness) then throwing up bile. Not going to gain weight or eating tomatoe soup again!
How long can we take PPIs and what about the long term side effects? I do ok with PPIs but worry about long term.
Kidneys, poor mineral absorption, failure to kill off intestinal bugs, eg C.difficile, and these have been known to come up and cause lung, sinus and ear problems. I’ve only experienced the first two on my list
I took this stuff for years in the past and then I got put back on it because of symptoms. And it gave me all types of joint pains muscle and body aches.
@@412JFury Ouch!! I have had all sorts of joint and body aches for years. I wonder if it is the PPIs.
My throat was completely fine until I took one pill of Omeprazole which is a proton pump inhibitor and ever since I have had difficulty swallowing. Has anyone else had this happen to them? It’s been about 3 months and it’s improved moderately but there is still problems. Also my tongue and the roof of my mouth feel weird as well.
Bro me too
Just with one omeprazole
How are you feeling right now?
@@highvibes5531 Well I wrote that comment almost 2 years ago and a lot has happened since then. I now have a disease called eosinophilic esophagitis (EoE) and I still struggle to swallow certain foods to this day. It’s not as bad as when it first happened, but this disease is chronic so it’s unfortunately not going to go away. I’m still convinced that the Omeprazole had something to do with it, because my throat was fine before that. This is why I hate pharmaceutical drugs.
This stiff feeling in the soft palette and throat can also be felt with hiatal hernia, like a lump in the throat. As the stomach pokes up into the chest cavity, the oesophagus has to go somewhere, and you get a feeling of upthrust, or I suppose it might bend slightly. With me it pushes up and makes swallowing more uncomfortable.
Very interesting video. My problem started with a cough that persisted for 3 months. I eventually shook it but came back three months later. Four weeks into that, I started to get the lump in throat sensation which would not go away. My doctor put it down to reflux and gave me a PPI. I really went downhill after that. Started to get bloating, belching, and heartburn. After four weeks on the PPI I was referred for an endoscope and esophagitis was found. Another 3 weeks of PPIs and in my follow up visit I was admitted to hospital for more tests. I had a ct scan and while no cause for the reflux was found, there was scarring in my lungs which they are putting down to reflux. I just been discharged with a 4 month prescription for more PPIs - 40mg twice daily. I have a followup visit in 6 weeks.
My quality of life has gone down the toilet, I feel miserable most of the time. I'm often sensing what I can only describe as a mist of acid coming up and irritating often up as far as the back of my throat. Going to try an alkaline diet to see if it helps. The magnetic ring device looks promising but I think I'm still a way off the point where surgery would be considered - my doctor has not even mentioned the s word yet.
How are you feeling now? Has your condition improved?
@@advenco344 Following consultation with with my doctor I came off the PPIs. I weaned off them over three weeks. The first week after my last PPI was really bad with acid rebound, even with h2 blockers (pepcid) and gaviscon, but am feeling much better now than I felt when taking the PPIs. I still have a long road ahead, my oesophagus still needs to heal and I'm still taking h2 blockers, which I want to wean off over the next few weeks, but the feeling of despair and misery has lifted. I've see a lot of material that suggests stomach low acid causes reflux so given my experience with PPIs it may be the case for me.
MrUnderwurlde that's good to hear. I've also had a bad experience with PPIs which gave me swallowing difficulties.
Stop taking PPI garbage. It'll make your digestive issue worse. Go to a Naturopathic Doctor.
@@MrUnderwurlde How are you currently? Im in the same situation you were in and really thinking about what to do with PPIs
Been on PPi's for 8 days and had the endoscopy. Dr. recommends taking Protonix for 3 months. Never had any problems with heartburn but told I have GERD. PPI's don't seem to help and I have severe upper back pain between shoulder blades. Protonix doesn't seem to be helping me and I want to know if I can stop taking it. From what the doctor described @14:48 could it be possible that I am hypersensitive and need something else or nothing at all? I should mention that I was on antibiotics up until 2 days before the endoscopy due to an infection and took one Protonix pill before quitting for 2 weeks due to the endoscopy. More problems seem to happen after the endo. Like something stuck in throat, coughing, more belching, more gas, weird electrical shock feeling in my head and this horrible back pain in upper back. I would rather quit taking this med but want to make sure not making a mistake.
Anyone got no appetite as well
Isn't reflux due to low acid in the stomach? This doctor is talking about reducing acid even more with medication!! Strange !!
low stomach acid isnt the only cause of gerd
The hyper-acid theory tends to be pushed by alternative medical people.
Max, you are correct!
I thought the same thing. Acid refluxed because it’s too much, but they say intake apple cider vinegar 🤷🏼♀️i am confused
That’s the nonsense spread by alternative medicine. I had a Heidelberg test which showed I am producing excess acid.
BMI index, weight loss may help you.
I have a hiatal hernia and bad gerd I want get surgery who should I talk to.
iron grip 455 ive been suffering like hell in my stomach for many years. .i hate food but have to eat..get hypoglyceimic a little if don't eat..it got WORSE after endoscopy. .no help..
Don't have a Funoplication and don't take PPIs, as the PPIs lower acid which actually required for correct digestion and valve / shpincter function. I had a Funoplication done and it was the worst thing to do. I took PPIs for years before, and I didn't get told what damage they would cause and the problems they disguised.
John Taylor i am Suffering from GERD and Stomach Disorders can Fundoplication Surgery can Heal my Problems.How is your life after Fundoplication Surgery Please Share Your Testimonals and Problems facing by you after surgery. Brother i am waiting for your Reply.
I took apple cider vinegar and my symptoms improved
iron grip 455 i
Will gerd sympton worsen after vaccine ?
We just don't know. 0 Long term safety data for the V.
With all of the negative side effects and death from the V, I think it's smart to wait 5+ years like we do with typical vaccines to see the true safety of the medical procedure.
yes your immune system is severely compromised after
Who feels like they can't catch their breath sometimes?
I feel like that 24/7..since my gerd started i couldnt take normal deep breath for exactly one year now..it chokes me to death and no medicine has worked for me yet..
@@aldoaldi2613 Its either haiatal hernia, or it can be anxiety because of what your going through, thats what I found out, Both are reversible. Dont worry yourself, it makes things worse, I had the same thing. When I calmed myself, I was able to eat because I had trouble swallowing when I felt I had trouble breathing.
@@mtucc07 same i think i have trouble swallowing when i couldnt breathe due to my anxiety. im just so scared because im 17 and its too young for me to have these symptoms. it bugs me everytime coz i cant sleep normally like i would before i have this disease. i always sleep in a sitting position and everyday i have an excessive burping and chest pain. PPIs don’t work effectively for me and i’m very anxious about it
@@eroljamessamonte629 @Belcher I know it sucks, Dont worry too much though, there is a cure, you just have to keep looking until you find something that works for you. Stop eating at 5;00 PM and eat lots of greens and dont fill yourself up eat hand fulls not plate fulls, that will help tremendously, ok?
@@eroljamessamonte629 how are your symptoms now?
Are these Stomach Conditions affected adversely by taking d Vaccine? Anyone with and reactions ?
thats my thaughts too… 😢 my body seems weird after the vax
@@sheilac3043 yes, because after you get one your immune system is completely compromised
No point
Do surgery
He is a good doctor. But most doctor bad doctor syamdrom bds