QuestionQUESTION: I have had reflux (never feel it) for a minimum of 10 years. Suddenly out of no where I have a empty feeling in the pit of my stomach regardless of eating it is associated with fullness below my rib cage but above my belly button and my ibs seems to be worse with it as well. At times when the fullness is worse I feel burning in my throat but nothing in between (not in chest or anywhere other than the empty feeling in stomach). I have had an endoscopy 1 year ago when all of this started and it showed very mild esophagits and mild gastritis. I have taken double doses of every PPI that exists. My Dr said if it was reflux causing the burning in throat then the meds would have done something and it has done ABSOLUTELY NOTHING. Does reflux present itself with empty hollow stomach feeling? Also, if it is reflux how long typically does reflux begin after eating?
ANSWER: Hi Jill,
Reflux does not present with an "empty hollow stomach feeling." It is, in general, a disorder of a part of your esophagus malfunctioning. Using an analogy, the esophagus is like a hollow tube with doors to help keep the contents in the stomach. The doors are called sphincters. When these sphincters malfunction, they allow the stomach's contents to retrograde. The feeling of "fullness" in your stomach is much more in line of excess gas production. The feeling of an "empty hollow stomach" is more in line with your brain receiving a signal from and translating the information from the stomach saying it's empty.
As you've indicated, your reflux occurs even with the use of PPI. This does not mean that it is not GERD. It just means that your reflux is undergoing a different process which is associated with an essential dyspepsia. This condition causes a pathological increase in chemicals produced in your stomach even during fasting. Please consult with your physician regarding the management with antacids versus PPI. Your physician would be a more reliable source as to which would best fit you.
Another great tool to manage your IBS and reflux is to avoid certain foods. Try avoiding spicy foods, caffeine - coffee/tea/etc, fried foods, heavy diet, carbonated drinks, high acidic foods, alcohol, and junk food for the next month. Then, reevaluate if this helps. Reintroduce a healthy low carb low calorie yogurt. Most yogurts contain beneficial bacteria. Changing your daily meals to 5-6x per day instead of the usual 3 meals. These meals should be small portions. Obtain a referral to a dietician or speak to your physician about a healthy IBS diet plan.
Lastly, stress. I couldn't tell patients enough about "stress." Stress affects your mind and body. During a stressful moment, your brain may release chemicals which may induce an increase secretion of gastric juices. The result may be an irritable bowel attack with symptoms of reflux, abdominal discomfort, etc in certain individuals.
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QUESTION: Thank you so much for the information and response. The feeling in the throat only comes with the empty feeling and the multiple bowel movements. I would agree with the gas because I am not usually a gassy person but since all of this that has completely changed. I don't eat any trigger foods AT ALL. Even water is doing this to me. I have tried every med in the book for reflux. H-2, ppi's, gaviscon you name it. NOTHING. Tested for gastroparesis. Nothing helping or found. My IBS is worse along with this and the meds for reflux make the empty feeling and throat feeling worse which makes sense with the gas because those meds irritate the ibs. It seems like a vicious circle.
How long after you eat something does reflux begin. I am asking because lets say I eat something I shouldn't wouldn't I feel it within an hour or so? Not suddenly 24 hours later with nothing prior to that? Also, when I lay down I feel better not worse and when I wake up after a bowel movement it is worse.
Answerhi jill,
as stated before, there may be an abnormal production of gastric juices. reflux is not a timed process. it is due to a weakened or malfunctioned closure of the esophageal sphinters; thus allowing stomach contents to retrograde. gastric juices normally starts producing as you're ready to eat. the brain starts the process. food will trigger other processes thereafter. the amount of gastric juice secretion depends on the type of food. on average, individuals experience acid reflux 1-3 hours after eating.
if 24 hours thereafter, it is most likely another pathological process of hypersecretion which needs further advisory. please contact your gastroenterologist for a detailed investigation.
