# GERD or something else?



## Serenity (Feb 6, 2002)

What is the difference between acid reflux, GERD, functional dyspepsia, non-ulcer dyspepsia, functional heartburn, indigestion, and functional nausea? Would they all be treated the same way?


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## christine (Jun 4, 1999)

Hmmm, let me see if I can answer this. Acid reflux and GERD are one in the same. They are caused by the lower esophageal sphincter (LES) being loose and not clamping shut properly. The stomach contents (which are acid) then "reflux" back up into the esophagus and cause irritation. It can also cause belching, nausea, heartburn, chest pain, etc.Functional dyspepsia and non-ulcer dyspepsia are also the same. Basically it means that you have "indigestion" with no know cause (i.e., not caused by an ulcer or GERD). You can have ALL the symptoms of GERD (nausea, belching, etc) but when the go down and "scope" you they cannot find a loose LES or ANYTHING wrong, but, in fact, for some unknown reason you are experiencing discomfort.As far as functional heartburn, functional nausea, and functional indigestion, I haven't really heard those terms but the "functional" leads me to below that they are symptoms with unknown etiology. Would they all be treated the same? Maybe, maybe not. What works for some may not work for others. Acid reducers may help with a lot of the symptoms for many people, but not help others. Medications that speed up emptying of the stomach may also be of some use for some. I think it is an individual thing. The important thing is to get an examination and find or rule out "bad" things which cause it.Christine


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## Serenity (Feb 6, 2002)

Christine, thanks for your explanation. It helps tremendously.I posted my question because I often wonder if I really have GERD. My main symptom is nausea, especially when lying down and upon waking in the morning. After having an upper endoscopy and biopsies for IBD and Celiac disease come back negative, my GI told me I have "acid reflux" and prescribed Losec (omeprazole)(20mg).At first, the Losec made my nausea worse. Then it got a little better, but was still pretty bad. So I was given Motilium (domperidone) to take in addition to the Losec. It really helped a lot. Unfortunately, my prolactin levels went way too high, so I had to stop taking it. Of course, the nausea came back, so I was told to take 40mg of Losec. That seemed to work, but right now I'm back down to 20mg. My GI wants me try to wean myself off the Losec. My problem is, the nausea is getting bad again.I' really not sure what to do. Although I had an upper endoscopy done, I never had the 24-hour pH monitoring test done. My understanding is pH test is the only one that will definitively diagnose GERD. Is this true? It seems my GI's approach is more symptomatic: antacids reduce the symptoms, therefore, excess acid is the problem. I feel the problem is more likely one of motility since the Motilium helped me the most.When I saw my family doctor (my GI is on maternity leave at the moment), she suggested switching to another antacid. I'm just not comfortable taking prescription antacids all the time, considering we don't really know a whole lot about their safety. (BTW, I've been taking Losec for 2 years now.)Does anyone have any thoughts on any of the above or any suggestions? I would really appreciate any input any of you might have. Thanks.


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## christine (Jun 4, 1999)

I would agree that it sounds like motility is your issue. I'm not sure if the pH test is the definitive. I had an upper endoscopy and my GI doc saw what he needed to see--a loose sphincter muscle and a mildly red, inflamed esophagus. If thsi was not seen on your exam, then most like you do not have reflux. But maybe it is a mild case. Sounds more like food is hanging around in your stomach too long. When I talk to my GI about that symptom, he tends to believe that I also have a motility problem. We have never tested for it though and since I am keeping it under control with Prilosec I will not pursue it further. I do not want to take motility drugs. But if it gets to the point that I cannot function, I will certainly go in that direction.


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## Serenity (Feb 6, 2002)

There were no signs of imflammation when I had my endoscopy done, but I do have a small hernia. Do hernias contribute to GERD? My understanding is they can prevent the LES from closing properly. I did have an upper GI (barium swallow) and small bowel follow through done. Would that show GERD, or would it just show the hernia? I really don't want to have the pH monitoring done as I have a really strong gag reflex and had a horrible time with the upper endoscopy.


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## TroubledHeart (Apr 8, 2002)

Ask your doctor about Prevacid...I have the same symptoms...When I lie down or in the mornings the nausea is very bad...and during the day it was very very uncomfortable...and if I panicked at all it felt as if I was going to choke or not be able to breathe...The Prevacid helped so much!...Although lately the Gerd symptoms have resurfaced slightly, I believe this is due to the fact that I am under an enormous amount of stress...So some days I take 2 pills instead of one to offset it...I can't miss a day of Prevacid or I get so sick I feel like I am going to throw up!...I havent had any side effects from it. I use it along w/Paxil to keep all my symptoms under control...Every major illness I have seems to be linked to my stress Level it seems...Are symptoms are very similar...I get the gagging feeling too...I dont have the burning sensation, thankfully...You may want to change your diet too. This has helped me alot...Water is so important...Describe your diet so we might be able to give suggestions...


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## Serenity (Feb 6, 2002)

TroubledHeart, thanks for the suggestion about the Prevacid. I was reading some of the older posts on this forum and I noticed you mentioned:


> quote: it only took two changes in medicine in a 3 week period to find that Prevacid work for me


Just wondering what else you tried.I think I have probably eliminated everything from my diet that could be a problem: fried food, greasy food, citrus fruit, tomatoes, onion, garlic, spicy food, caffeine, chocolate, carbonated drinks, alcohol, and dairy products. I don't smoke either. Unfortunately, I do have to take iron supplements which bother my stomach. I also take Elavil, which is an anticholinergic and can contribute to heartburn, but it's a very low dose (25mg), so I don't think so.As for other lifestyle changes, I probably should exercise more. I haven't elevated the head of our bed yet either, which I've heard may help. Not sure my fiancee would appreciate having to sleep on a slope. Besides, I haven't quite figured out the logistics of how to do it. Our bed is on wheels (castors?) on a hardwood floor. I can just picture the bed rolling off the bricks or whatever in the middle of the night!


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## sue660 (Dec 8, 2001)

Something happened to me the other night whilst asleep. I am not sure whether this was a GERD symptom or not...I woke up choking and couldn't breathe. I had this hot stuff in my throat and I thought I was going to throw up (but I didn't). Was this some kind of gastric reflux? It has never happened to me before, but I do suffer from heartburn from time to time.Can someone shed some light on what this could have been?Sooz


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## OppOnn (Jun 30, 2002)

Serenity. When I used to have heartburn, Islept on more pillows, and raised my head atleast 6", sometimes more. That helped.And my husband just sleeps lower than me onhis side of the bed! Sometimes, I also foundit better to sleep on my left side, don't knowwhy exactly.I hope this is useful. O


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