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Gastroenterology (Expert Forum)

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Off Meds and Symptomatic

Answered by

Kevin Pho, MD - Internal Medicine

Kevin, M.D. Boston - MA

This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

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MedHelp Member's Question

Off Meds and Symptomatic

by tessa0825, Sep 03, 2003 12:00AM

Tags: meds, symptomatic, barrett's, esophagus, Work, Barrett's Esophagus

I have been off of all my reflux meds since last Fri. awaiting my 3 day work-up next week....The first two days wernt so bad and these last few have gotten alot worse..The normal reflux symptoms, heartburn and spasms, I can deal with but yesterday morning I started vommiting alot and I cant get it to stop....I can feel ok one minute and in the next minute I have to find a bathroom...I am allowed to take OTC things like mylanta except I have never been able to tolerate them, for some reason they have always made me vomit as does pepto bismol....I can tolerate mylanta if it is mixed with lidocaine and bentyl for spasms but I dont think he wants me using the lidocaine or bentyl right now...It is worse in the mornings and I am not eating anything and havent for three days..Just water and ensure and vanilla pudding....This morning I had to drive 100 miles for work and got so sick to my stomach. Coming home wasnt an option at 100 miles away..Only way to get here was to drive it....I stopped at a place along the highway and bought some alka-seltzer and it has always helped me the most of all OTCs but Im not supposed to take it because of its aspirin content...So, any advise on what I can do to get the vomitting to stop?. if I can make it through the next two days then I will be off from work and able to deal with it until my appt..I do not want this to make me have to miss work, so I only need to get through these few days.....Thank-you for any suggestions.......

Doctor's Answer

by Kevin Pho, MD

, Sep 06, 2003 12:00AM

There are a variety of medications that can control vomiting until you can get your tests.  Most of them are prescription and you may want to discuss them with your physician.

Common ones include either phenergan or compazine.  They are pills, but there are suppositories available if you cannot have any oral intake.

Reglan and benzodiazepines such as ativan are also alternatives.

I think that the medications that most effect the pH studies are anti-acid medications (i.e. PPIs or H2 blockers), but confirm this with your gastroenterologist.  Taking antiemetic medications should not affect the EGD and dilatation.

Good luck with the tests.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,

Kevin, M.D.

Member Comments (7)

by GI.PA, Sep 03, 2003 12:00AM

Hum..this is a very good and timely question. Call and ask them about anti-nausea suppositories (phenergan). I cant recall (and I am at home without reference material) if they interfere with the 24 pH probe (which is the preparation you are describing...no RX reflux meds) or the motility study (perhaps??).

Call and explain the situation, that this is just not livable. Beg them to say it is ok to take meds the next two days just to get by with the understanding that it *may* (but probably wont) interfer with their testing next week.

If they are doing this to rule in or out reflux, I think you symptoms provide conclusive evidence you indeed deal with an acid related condition, because wham..you are off of the for and day or two and are miserable.

Just my two cents...call you doc!

GI.PA

Erin

by tessa0825, Sep 04, 2003 12:00AM

Thanks for your reply, It is in preparation for EGD with biopsies and dilation followed by manometry in a few hrs followed by ph phrobe insertion...The instructions for manometry and ph probe insertion both have me off meds right now....I was referred to a lg training hosp by my local GI for progressing dysplasia with barretts esophagus.....This is all 1st day procedures followed by more non-invasive tests the next day....I really dont want to take anything that might mess up the results but this is not a good thing to be vomitting 15 times a day for the next few days....I will call and ask them about phenergan, thats one I hadnt thought of....Alka-seltzer seems to work a little and Im wondering if the aspirin content of it could possible be any worse than the damage of all the vomitting? Anyway I have used it again thsi morning...I was warned this would be a rough week and I just want to get through work....Im to stubborn to miss work ...But hey, Im at work right now so thats good news......Thanks, Tessa

by nadia, Sep 04, 2003 12:00AM

I like Alka Seltzer for my stomach problems too, but I take Alka Seltzer that is made specifically for Heartburn relief. It does not contain any aspirin. Just a suggestion, hope it helps.

by tessa0825, Sep 04, 2003 12:00AM

To: Nadia

Thanks for this suggestion, I didnt realize alka-seltzer even made heartburn med. with no aspirin.....Im better right now, I ended up at my PCPs this afternoon..They have a family practice on one side and an urgent care center on the other side..I had a spasm that would not stop..Ive had them many times but NEVER like this...My pcp gave me an IV saying I was dehydrated and he also gave me several meds through the IV...The spasm stopped and I havent vomitted since..They also put me back on my nexium at a lower dose of 40mg daily instead of my normal 100mg daily....Again, thanks for this info, I will keep some around from now on...Tessa

by tessa0825, Sep 04, 2003 12:00AM

To: Dr Kevin

If you have read down this far..Has this action now ruined a good result for manometry and PH?

by GI.PA, Sep 05, 2003 12:00AM

No, you should be fine.  Your case is pretty typical for someone who has been on good acid suppression and then it is held.  It can come back with a vengence.

A dose or two of Aspirin (in your alkaseltzer) wont make a difference.

They most likely said no Aspirin for a week before to get your blood clotting back to normal (aspirin thins the blood).  I would let them know about the dose you took on accident and I can bet they'll say oh well...

GI.PA

by tessa0825, Sep 05, 2003 12:00AM

To: GI PA

Thanks again for this info. However, I;m not really worried about taking the alka-seltzer I took the other day..Im more worried about how being back on the nexium might effect the results and also about whatever effects the drugs were my PCP put in the IV might have on the test results...I didnt ask what they were and didnt care at the time...This is a long trip for me and a pretty extensive work-up to #1 rule out EC with my progressing dysplasia, #2 to see if Im a candidate for collis gastroplasty/fundoplication, and #3 to rule in or out a systemic disease such as sclerosis.....I want good test results but surely they know these type things happen when they take you off meds...My pcp knows about my work-up and he seemed ok with starting the nexium back up....Thank-you for all your advise, I appreciate it....Tessa

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