Ask a doctor on the topic of Internal medicine

Reflux, gallbladder-liver weakness

September 23, 2012 | 40,00 EUR | answered by Dr. med. Kathrin Hamann

Since February of this year, I have been experiencing swallowing difficulties, which are sometimes painful. An examination by the ENT doctor revealed a mild inflammation of the vocal cords and diagnosed reflux. I was prescribed PPI medication. I have tried to take the medication multiple times (Omeprazole, Pantozol, etc., later also Pepcid) and I experience severe stomach pain shortly after taking them. In May, a stone was found in the bile duct (I have had no gallbladder for 4 years) and it was crushed. The endoscopy did not show any abnormalities. Since then, I have continued to have swallowing difficulties and tried to alleviate them with Pepcid. However, I still experience stomach pain shortly after taking it, and the swallowing difficulties do not really improve. I have never smoked, do not drink, and eat a mostly healthy diet. Could it be that I am not producing enough bile to digest food? What would you advise me? I am also very open to alternative medicine.

Thank you.

I live in Canada. Nearly 5 years ago, I had ovarian cancer and underwent surgery and chemotherapy. My concern is whether there could be something else underlying these symptoms.

Dr. med. Kathrin Hamann

A good morning and good evening to Canada.

It is quite possible that you may have too little bile for digestion, as the reservoir (the gallbladder) is missing. However, this does not explain the reflux, nor does it explain why you react to proton pump inhibitors (Omeprazole, Pantoprazole) with stomach pain.
From my perspective, there are a few more tests that are needed:
- Is there a Helicobacter pylori infection present?
- Has a mucosal sample been taken and examined for Gastritis Type A (autoimmune) - in that case, proton pump inhibitors would be less suitable and antacids such as Maaloxan or Ranitidine would be better suited to alleviate your symptoms.
- Was reflux confirmed during the gastroscopy, or is the irritation of the larynx and vocal cords indicative of another condition (lung or viral infection).

In my opinion, further tests (including lung endoscopy) are advisable, as only once the correct cause has been identified can it be treated effectively.

Do you have any questions about this? I am happy to help.

All the best and a speedy recovery!

Kind regards,

Dr. K. Hamann