Deciding on getting another upper endoscopy or not

[Curly03]

Im basically wanting opinions on weather or not I should get another upper endoscopy or not. In November 2010 I was suffering from stomach problems for years and I finally got a GI doctor and he did an upper endoscopy on me. The night before I was throwing up acid the entire night constantly and felt very nasous. I was real nervous about the endoscopy but I knew I needed to get it done. When they put me to sleep It really freaked me out how I felt so I had a panic attack as I was falling asleep it made my heart rate go up but they finally got it under control. When I woke up I was extremely tired from the meds. I pretty much felt like a zombie all day and slept the whole day. After that I had severe chest pain everytime I ate It hurt. They said my stomach produced to much acid which I knew from throwing up acid all night and they dignosed me with gasteritis and acid reflux which is what multiple doctors have been telling me but the acid reducers never helped. My GI then did a HIDA scan on my gallbladder and the test results showed my gallbladder didnt function correctly and thats what was making me so sick. I had my gallbladder removed Feb 2011. I have been doing a lot better since then but I still will randomly have stomach symptoms. Sometimes I will feel nasous, get gas pains, belching, or have diarreah but thats probably from the surgery. The symptoms arent everyday and they usually dont last long when I do get them. I finally decided to go back to my GI doctor last month. He wants to do another upper endoscopy to try to figure out why Im still getting those symptoms randomly. I really dont want to get it done or think its going to do much good just looking at my stomach. Im also nervous about getting it done again because I hated it last time and dont want to have to do it again if I really dont  need to. My regular doctor gave me some better acid reducer pills Protonix I feel like it works better then the Prilosec I was taking. Lately I have been feeling ok as long as I eat I feel fine. Except these past few weeks I feel like I got nasual drainage stuck in the back of my throat espically after I eat or drink something. Its very annoying and makes it hard to swallow at times because it feels like something is in my throat. So Im wanting advice from anyone who has ever had an endoscopy if you think it would do me any good to get another endoscopy or not? Im suppose to get it done this Wedneday so I have until tomorrow to decide.

[Christopher R Watters, MD]

With all due respect to your gastroenterologist, distal gastritis does not come from too much acid. It is consistent with bile reflux gastritis or other reasons for the mucosal barrier to not work such as non-steroidal use. When all is said and done, the presumptive trial of sucralfate would have been appropriate. Somehow, endoscopic evaluations are considered to be part of a physical examination by most gastroenterologists. No coincidence that the most common site is in a physician owned endoscopy center.
As for liquid versus pill, the liquid should be used if there is inflammation in the esophagus, otherwise the pill form is preferred due to ease of taking and storage.

[Curly03]

Yeah thats how it was explained to me. I have taken Carafate before i had my gallbladder surgery it made me worse but I dont know if Sucralfate is the same but it sounds similar to how they work. Im hoping now that im on better acid reducers too and I got my gallbladder removed it wont bother me to much. They prescribed me both liquid or the pills they said its up to me on what I decide. Im going to get it in the pills. Maybe it wont burn as bad and will be easier to take, The Carafate I use to take a few years ago was in the liquid. The nurse told me if i wanted it in liquid all I had to do was put the pills in water.

[Paulalex]

Good to hear that all went well for your test. You will find that the sucralfate
will help. Were you prescribed the pills or liquid? The way it was explained to me many years ago is the  sucralfate coats the inflamed areas from further damage. You may feel a burning sensation as the sucralfate finds these areas and coats them. The burnning goes away as you get used to the sucralfate.
Take care.

[Curly03]

Well I just wanted to do an update I did go ahead and get the Endoscopy done this morning. It went really well had no problems this time. They said my stomach and throat looked ok but the bottom of my stomach was a little inflamed and I still was producing to much acid. So they told me to take my Protonix twice a day and they prescribed me sucralfate 4 times a day for a month. Then I have to go in for a follow up next month. Im just happy it went ok and that Im not in pain like I was last time I had it done a few years ago. Hopefully these meds will help me get completely back to normal.

[Curly03]

Yeah I know its not that horrible I was just so sick the last time all that night throwing up acid and have a panic attack right as I got put to sleep because I hated the way the meds made me feel. After the EGD I slepted all day and had chest pain for a few days. Hopefully since Im a lot better then I use to be it wont be that bad and I wont get the chest pain or a panic attack. I kept my appointment didnt want to but maybe now they will figure out if theirs anything else causing me to get random stomach symptoms.

[Paulalex]

Sounds like you need the help upper endoscopes are usually a piece of cake
no prep other then fasting beforehand. Insertion of an IV sedation a deep sleep and wake up when its over.Stay calm it will be over before you realize.

[Curly03]

Thanks for your reply. Im still very undesicive on if another endoscopy would help me any. Im pretty sure it wont but I dont want to be stuck with these random symptoms forever so if I cancel I dont think they would do anything else for me. I just wish my doctor would do a different test or try the sucralfate like your recommending. He thinks the acid reducers should be working thats why he wants to look inside my stomach again to try to figure out whats causing my symptoms since I have my gallbladder removed. My regular doctor thinks acid reducers are the answer too but if its not solving all my problems then I think they need to try something else. My GI doctor said he also wants to to the EGD to see what he needs to do about my meds so maybe he will give me something else depending on if he see's anything wrong with my stomach. I left a voicemail for my Gaterologist nurse to try to get advice so hopefully she will call me back before its to late to cancel if I really need to.

[Christopher R Watters, MD]

I can't say that an upper endoscopy would be inappropriate but I think the yield would be low. If you were my patient, I would have you undergo a trial of sucralfate for what may well be alkaline reflux gastritis. This is a fairly common co-traveller with gallbladder dyskinesia and would not be helped by acid reducers. As an aside, you don't get gastritis from too much acid. You get it from a breakdown in the protective barrier. Patients with Zollinger -Ellison syndrome who make industrial amount of acid suffer only from duodenal ulceration, not gastitis.