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GERD cases: Unusual Signs/Symptoms

Posted Oct 20 2009 10:01pm
_A ten year old boy with "photosensitivity" for several years; several doctors(?) suggested treatment with Benadryl and sunblock which failed to give relief. His "condition" was in reality dermatographia thus no sensitizing medications were involved as a causative agent. Twice daily treatment with antisecretory treatment (Prilosec OTC) eradicated his longstanding skin problems in less than a week. His "sinus allergies" also got much better.
-A lady in her mid sixties undergoing chemotherapy for gynecologic cancer developed severe shortness of breathe causing hospitilization. She was discharged after a week in the hospital, in another community, with little improvement in her condition. Shortly after discharge from the hospital my history and exam suggested her GERD had relapsed. This went unrecognized as a reason for her symptoms. The amount and/or harshness of the gastric reflux into the esophagus was causing her lungs to protect themselves. The vagus nerve fibers, by reflex, were stimulated thus making mucus, favoring bronchospasm and causing neurogenic inflammation. At this visit her chart revealed an insurance mandated medication change. Her favored Prevacid was switched to omeprazole. Less than 4 months after this medication alteration her breathing deteriorated to the point of hospitilization. I was suspicious of GERD "relapse" even though her condition did not worsen in the first few weeks of the new treatment with omeprazole. Based on her exam and history I put her back on Prevacid and her difficulty breathing (dyspnea) resolved on day three (72 hours). I knew she was better when she worked in her flower garden for the 1st time in four months.
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