Hello doctor,I have reflux esophagitis as determined by endoscopy last month. They found grade M tear in GE junction and also mucosal atrophy reported. H-pylori was found in rapid urease test. I am on Clarithromycin, Amoxicillin and Esomeprazole medication for 14 days and I have three days of course left. I do not seem to be healing well and reflux is getting worse than before and I need to be able to control the inflammation as I am scared it will get worse. I am 40 years old otherwise fit male. Any suggestions?
Hi. I have gone through your query in detail. Usually, reflux esophagitis is reported based on the Los Angeles classification, which does not have a grade called M, but going through the report it is mentioned minimal changes of reflux esophagitis with the lax sphincter. Your treatment for H. Pylori is appropriate based on the rapid urease test result. Usually, when a person has H. Pylori infection, the acid production is suppressed by the infection (chronic gastritis, mucosal atrophy is a sign of that). Once it starts getting cleared from the mucous membrane, it is quite common to find the reflux symptoms, especially heartburn worsening, because that acid production is improving due to clearance of infection from the mucosa, hence even though you may be on acid-suppressing agents you might have heartburn. It is a temporary phenomenon and would improve over the next couple of weeks. Kindly continue with the treatment and you may add 10 ml of Gaviscon syrup (if you are abroad you can get Gaviscon tablets too) to be taken three times after major meals for a week.