[19F] Experiencing persistent GERD symptoms

Patient Description

A 19-year-old female has been experiencing persistent symptoms suggestive of gastroesophageal reflux disease (GERD), including constant acid reflux, severe nausea, and burps with an unpleasant taste, for several months. These symptoms have been significant enough to disrupt her sleep. She also reports a peculiar taste of perfume in her mouth and has not found relief with water intake. Episodes of heartburn are frequent, particularly at night, and can last for a few hours. Additionally, the patient has noted unintentional weight loss. There is no difficulty swallowing, no presence of black or bloody stools, and no history of vomiting, as she reports an inability to vomit. The patient has no known drug allergies, no pre-existing conditions, and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, the most likely diagnosis is:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. Your symptoms of constant acid reflux, nausea, burping, and the taste of perfume in your mouth are common symptoms of GERD.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Peptic Ulcer Disease: These are sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain. However, a burning sensation in the gut, nausea, and unintentional weight loss are also common symptoms.

    • Treatment usually involves medications to decrease stomach acid. If an H. pylori infection is present, antibiotics will also be needed.

What you can do

You should consult with a healthcare provider for a formal diagnosis and treatment plan. In the meantime, here are some things you can do to help manage your symptoms:

  1. Avoid foods and drinks that trigger heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Eat smaller meals. Avoid overeating by eating smaller meals.
  3. Don't lie down after a meal. Wait at least three hours after eating before lying down or going to bed.
  4. Elevate the head of your bed. If you regularly experience heartburn while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches.

What you should look out for

Seek immediate medical attention if you:

  • Experience severe chest pain or pressure, especially if it's accompanied by pain in the arm, jaw, or neck, as well as sweating, dizziness, and nausea. These could be symptoms of a heart attack.
  • Have difficulty swallowing.
  • Have persistent nausea or vomiting.
  • See blood in your vomit or stool. This may appear red or black and tarry.

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes that can help manage GERD symptoms include avoiding trigger foods and drinks, eating smaller meals, not lying down immediately after eating, and elevating the head of the bed to prevent nighttime symptoms.


Why might someone with GERD experience a peculiar taste in their mouth?

A peculiar taste in the mouth, such as a taste of perfume, can occur in GERD due to acid reflux reaching the mouth and affecting taste buds, or due to the presence of bile or other digestive fluids.


What are the potential complications of untreated GERD?

Potential complications of untreated GERD include esophagitis (inflammation of the esophagus), esophageal strictures, Barrett's esophagus (a precancerous condition), and an increased risk of esophageal cancer.


How can unintentional weight loss be related to GERD?

Unintentional weight loss in GERD can occur due to reduced appetite from persistent nausea, discomfort during eating, or avoidance of food to prevent symptoms. It may also indicate a more serious underlying condition that requires medical evaluation.


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