Hoarse voice, chronic cough, pneumonia and GERD
Erik from Houston sent us this question: “About 18 months ago I began waking in the morning wheezing and coughing. That progressed from occasionally to daily and worsened. I had an EGD and colonoscopy last summer and was told I have Barrett’s esophagus. I was prescribed Omeprazole 40mg daily. I now sleep at an incline, I have no alcohol, tomatoes, fried food, spicy food, I eat smaller portions of food and have nothing but water after 4pm, yet I am currently suffering with pneumonitis, hoarse voice and chronic cough in spite of my lifestyle changes. There has to be a better option. Can you offer me any recommendations for the short term, until the COVID emergency is over?”
You are doing all the right things to help control acid reflux. Unfortunately, you suffer from stage 4 GERD and lifestyle changes are no longer enough to control acid reflux. The presence of Barrett’s esophagus indicates severe acid reflux. Laparoscopic hiatal hernia repair and Nissen fundoplication is the best solution for severe acid reflux and stage 4 GERD. A properly performed Nissen fundoplication
Due to Corona virus pandemic, all elective surgeries have been put on hold in Houston. Obviously, if the risk of aspiration pneumonia is high, one may consider your situation to be more urgent than elective. I recommend you continue avoiding heartburn trigger foods, avoid overeating, as well as eating late at night. Sleeping at an incline helps alleviate nighttime symptoms. If you are a smoker, I recommend you stop smoking. Losing weight also helps decrease GERD symptom severity.
You may double your Omeprazole dose for now. Consider getting in touch with your acid reflux specialist to review your symptoms and response to medical therapy and potentially plan for hiatal hernia repair and Nissen fundoplication.