In a previous blog, we introduced you to GERD patient, Elena, our DDC Orlando case study. She continued to endure worsening heartburn and acid reflux for years.  Yet she had barely mentioned her self-diagnosed GERD problem to her doctor.  She tried to shrug it off as indigestion, dyspepsia and just a bad stomach.

Here at DDC Orlando, in Dr. Sanjay Reddy’s words, “Not all GERD is just dyspepsia.”  As we continue Elena’s case study over several more blogs, you will see that not every case of GERD simply signifies indigestion.  Likewise, no case should be self-diagnosed because of a magazine article or a friend’s story.

Case Study:  Patient faces Denial, Takes the First Steps

Case Study in GERD shows a dangerous tendency to self-diagnose.

It is true that most patients with GERD can be successfully treated with medications and lifestyle changes.  However, self-diagnosis of GERD can be medically dangerous because the symptoms of GERD can indicate more serious digestive problems.

In a recent interview, DDC Orlando’s Dr. Sanjay Reddy stated, “Chronic heartburn and acid reflux can mean more than “just” GERD.  Gastro Esophageal Reflux Disease itself can be the body’s way of sending alarm signals to indicate more serious problems.”  This is exactly the reason your primary doctor might refer you to Digestive Disease Consultants of Orlando.  With a careful examination, case history and state-of-the-art testing, we can interpret the alarm signals from your body.  We need to know if your GERD symptoms are just dyspepsia, like most patients.   Or if we should investigate more serious possibilities.

Perhaps, like our case study, Elena, you do not know about all the other possibilities such as Barrett’s Esophagus or the beginnings of esophageal cancer.  In the mind and experience of a patient, the symptoms of those diseases might seem like a straight-forward case of GERD.

At DDC Orlando, when patients exhibit GERD symptoms, doctors work to discern and monitor your risk of a condition that can result in cancer without proper treatment. GERD is not always simply dyspepsia.  In the words of experts, “It is essential for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of GERD to seek an accurate diagnosis, to work with their physician, and to receive the most effective treatment available.”

Case Study:  Elena’s Denial and Excuses for Avoiding Diagnosis

Doctor explains GERD to DDC Orlando Patient

Toughness:  Her parents raised her to be strong.  Years of conditioning to be tough had taught her to grin and bear it.  So she developed a high tolerance for pain when her throat burned or her chest ached.  She avoided the doctor and months stretched into years.  Like many people who deal daily with acid reflux, she blamed it on dyspepsia.

She was in denial that there could be anything more severe than indigestion interrupting her life.  She refused to let GERD take more than a few moments of her time.  This mind-set worked for a while, but as in many case studies, symptoms grew very severe.  Finally, it became obvious to Elena that the over-the-counter antacids did not have the power to treat her illness.

Timidity:  Elena could not be considered an introverted person.  However, she had a deep-seated shyness about discussing bodily functions.  Even admitting her diarrhea embarrassed her.  Additionally, her friends had told her horror stories about the type of testing her condition might require. (Rest assured, DDC Orlando will be addressing that issue in the near future.)

Case Study:  Elena and the Lifestyle Changes—Her Baby-Steps

After a few more attacks like the one at her Birthday dinner, our case study patient’s family became concerned.
Elena’s  husband hugged her as he said, “Three trips to the emergency room in two months?  Hon, something’s wrong.  I took the liberty of making you an appointment.  Keep it or change it, but you can’t go on like this.”

She kept the appointment with her primary care doctor.  Based on her description of her reflux and heartburn symptoms, he diagnosed GERD.  He immediately suggested life-style and dietary changes. (She thought, “Tell me something I don’t know.  I’ve already started changing my life. I know some of my triggers.  I am keeping a food diary.)

He also wrote prescriptions for stronger medications than over-the-counter antacids and booked her for a re-check in six weeks.  She smiled weakly when the doctor gave her several brochures about GERD lifestyle changes.  Our case study dreaded trying to lose her extra 38 pounds of body weight.

Case Study Quiz:  Find the Anti-GERD Lifestyle Changes in Elena’s Story Below!

We challenge you to find the lifestyle changes woven into the following case-study scenario:

Elena drove home slowly and fought sadness because now GERD was a real medical diagnosis.  As she picked up her prescriptions at the pharmacy, she hated the idea of depending on her new pills to control it.  Then she desperately wanted a cigarette, but she had quit two weeks ago because she knew they were a trigger.  They literally hurt her throat and chest.  She smiled grimly.  A good strong cup of coffee would improve her mood, she thought.  But it wasn’t worth the choking hot lava in the throat, the reflux.  Caffeine was another one of the first triggers she discovered.  She had not had a cup in three weeks, since her last trip to the emergency room.

Case Study Scenario:  GERD vs. Family life

Upon her return home, Elena’s 6-year-old daughter Ashleigh met her at the door,

“Mommy, Mommy, Daddy turned your bed into a slide,” she shrilled.

We re-join patient Elena’s story of her diagnosis of GERD.  To enrich your understanding, we suggest you read or review the introduction of her case study in our one of our previous blogs.  Before the dramatic episode on her birthday, which resulted in an emergency room visit, Elena had never seriously discussed her chronic heartburn and reflux with her primary physician.  Her knowledge of the condition came from conversations with friends and a few magazine articles.

Case Study:  The Patient’s Top Three Excuses for Avoiding a Discussion of GERD

Time:  Elena is a busy mom of three with her own part-time real estate job.  Our case study patient, Elena, had a hectic life and a full schedule.  She declared, “I just don’t have time to go see the doctor every time I have a belly ache or heartburn.”

Case Study Patient With GERD finds hope with family support.

Elena could see the head of the bed had been raised on pretty polished wooden blocks.  Our case study patient started to smile.  Her husband, still holding an electric drill from his bed-tilting project, strode into the room and hugged her.

14-year-old Lisa popped her head around the kitchen doorway, “Hi, Mom!  I made Baked Parmesan Chicken Breasts for dinner.  You’ll love them. They’re crispy even without skin!”
Elena’s 9-year-old son, Mike chimed in, “And Dad made me eat the rest of those cookies so you wouldn’t be tempted!”  Elena laughed, hugged, and stopped feeling sad. “Yeah,” added Mike, as if to explain the cookies, “We read all about Gerdie on the Internet.”… And that is how our DDC Orlando GERD case study patient named her condition! 

Please join us at this blog next week for all the answers to the above case study quiz.  You’ll find out more about Elena’s lifestyle changes.  Also, learn why, six weeks after diet, medication and lifestyle changes, she ended up in the emergency room again with GERD symptoms.