QuestionJohn
Hi, I need your help, My mom is 82 years old and has
major Acid Reflux. According to the Doctor she is seeing
its the result of Hiatal Hernia. She is taking Nexium 40 MG, THREE times a day and Ranitidine 300 MG at night. Her doctor states with all this medication he doubts she is getting acid reflux. The problem that my mom is having, according to her is she feels acid in her throat, and
feels acid, a burning sensation when she has bowel movements.
Is there anything else that this could be, can you help us out -
thanks
Ken
AnswerHi Ken,
Hiatal hernia becomes more common as people age and their muscle elasticity weakens. There is a strong correlation between hiatal hernia and GERD (gastroesophageal reflux disease). Hiatal hernia increases the risk of GERD. However, GERD, in itself, does not increase the risk of having hiatal hernia.
The acid reflux is most likely the reason your mother is having this strange acid feeling in her throat. Medications, like nexium and ranitidine, are "preventive." Meaning they only try to minimize the problem. It does not fix the problem, per se. Although it is invasive for an 82yo, I do recommend going through an EGD, which is a procedure in which a gastroenterologist inserts a fiberoptic camera into her mouth and down her esophagus to observe the lining of her upper digestive tract. The physician will ultimately have a visual idea of the extensiveness of the disease. If she already had one, was it recent? If it was years ago, your physician will make make his/her best judgment as to the necessity of another one.
Your mom will need to change your diet to decrease the amount of acid. She needs to avoid
1. caffeinated products - coffee, tea, sodas
2. carbonated products - soda, spritzers, alcoholic beverages, etc
3. acidic products - spicy foods, citrus (i.e. orange, lemon, lime, etc), tomatoes, chilies, etc
She must change her routine diet from 3 whole big meals to 5-6 meals. The 3 meals are portion down with a low sodium, low fat, low carbohydrate, but high protein and approximately 1800 calorie diet.
As far as her feeling of a "burning sensation" when she has a bowel movement. From my own professional experience, it is not due to acid running down her bottom. I recommend that she speaks to a gastroenterologist for either a quick anoscopy to see if she has anal fissures, external hemorrhoids, etc. A colonoscopy is definitely recommended. However, your gastroenterologist would make the best judgment based on her age, mobility, physical health, and strength to handle a colonoscopy.
Regards,
John T, MD
