Dr. Clarke Is GERD TMS?

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Question

Hi,
I was diagnosed with TMS a few years ago for fibromyalgia, bad foot and ankle pain, tendinitis, GERD, etc. and was able to rid myself of most of the symptoms, except for the GERD. A few years back, my first endoscopy showed inflammation in the esophagus and further 24 hr ph test showed acid reflux reaching up to my throat. My most recent endoscopy showed what my doctor believes, based on the pathology results, to be Barrett's esophagus, which terrifies me. I've tried on and off for years to act like this GERD was TMS and ignore my symptoms and continue to eat and drink what I want, but I just continuously will have this raw soreness in my esophagus and throat and burning irritation in my mouth. I do believe my GERD is linked to stress and likely TMS, since when I take Xanax or go on a relaxing vacation the symptoms drastically decrease and sometimes even disappear briefly, but I just can't seem to get rid of them otherwise. Have you successfully treated people who sound just like me with their GERD and related damage? Do you have any advice? Thank you!

 

[davidclarke]

Answer

One of the most challenging situations we physicians face is when a patient simultaneously has symptoms from TMS (which I prefer to call PPD for psychophysiologic disorder) and symptoms from an organ disease (such as GERD with or without Barrett's esophagus). Though some patients may have an interaction between these two conditions (stress may lead to more acid reflux in some people), for the most part these are two separate forms of illness. In this case the appropriate approach is to treat both conditions and not focus too much on trying to guess what proportion of the symptoms comes from one or the other. Complete success in treating PPD may relieve many symptoms elsewhere in the body but still leave a patient with the GERD and certainly will not affect the Barrett's and this appears to be what has happened in your case. I wish I had better news but keep working with your doctors since GERD/Barrett's is a focus of active research, we have good treatments and new treatment ideas are likely in the future.

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