Need objective opinions- severe heartburn (LONG)

MKDee

Hello all- long time lurker, first time poster here, and I am in need of some objective opinions. I am currently 15 weeks pregnant.  For several years pre-pregnancy, I took Protonix, a category B drug, for severe acid reflux disease.  My primary care physician prescribed this for me, and I do not currently have a GI doctor.   When I became pregnant and told my OB about the Protonix, he said he wasn't comfortable with me staying on it, and asked that I switch to Zantac or Pepcid (also cat .

 After three months, it is just not working.  I have heartburn every single day, even with the maximum dose of Pepcid and more Tums than I care to admit.  I wake up every night in awful pain, and I can pretty much only eat bread and low-fat dairy.  Everything else causes horrendous pain.  I've even vomited a small amount of blood a few times. 

 So, at my last OB appointment on Wednesday, I bring this up to my doctor, and he didn't even let me explain how bad my symptoms were before telling me I should stick to Tums, Zantac, Pepcid.  When I pushed the issue, he told me that if I can get him a recommendation from a GI doctor AND a written letter about the medication from our hospital's genetics and medication center, he will consider it, but since he has never had a patient on it before, he's really uncomfortable with it.

I am starting down the path he recommended (already called a GI), but here are my questions for the group 

a) I have some Protonix left from before my pregnancy.  Would you take them for a few days to get some relief, knowing that it is a cat B drug AND knowing that the doc's aversion to it is only because he has never prescribed it?

b) Would you consider switching doctors?  I feel like this OB (one of seven in the practice) doesn't listen very well and is not willing to take any extra steps (i.e. doing a bit of his OWN research, consulting with another doctor) to help a patient.  Am I overreacting?

kant08

I would agree with your OB.  It is your responsibility if you have this long hx of seeing a GI specialist.  I work in Dermatology and will get calls once in awhile from practioners regarding acne meds during pregnancy.  Acne is more cut and dry with very few safe drugs.  With all the advances made in meds for GERD I wouldn't be comfortable without expert advisory on protonix. either.  Good luck and I would stick with the Tums, Pepcid, and Zantac for now. 

JimsBride08

I wouldn't take it if the OB specifically told you not to-however, I WOULD be getting another doctor (even if it's your PCP) to talk to ASAP.  You could be destroying your esophagus.  Is it just Protonix your OB isn't ok with or all PPI's?

MKDee

It's not just Protonix- my OB is not comfortable with anything stronger than Pepcid/Zantac.  And, Nexium and Prilosec are both Category C, so Protonix really is the safest of the bunch.

My PCP is no help- I called at the beginning of my pregnancy with a question about a different medication (I also have high blood pressure pre-pregnancy), and he refused to help because I was pregnant- said I needed to defer to my OB.  I have a call into a GI doc.  I just feel very stuck.  Thanks for your help!

Temp865949250007475

My DH suffers from really bad heartburn too and all I can say is that I would seriously consider seeing a GI dr.  I wouldn't take anything wtihout talking to someone with experience in the drug that you want to take.  That said, it does seem like your dr hasn't given your issue 100% attention - I might consider keep talking to him about it until he actually listens to you.  Almost badgering, until he understands teh severity.  Is it possible that you just didn't present your symptoms strongly enough? (just asking)
 

MKDee

Thanks MarissaS- I have been debating about whether or not to call the OB back on Monday (they are closed today) to see if I can get him to listen a bit better (or even get another doctor in the practice to take my call).  I felt very rushed in my appointment on Wednesday, and even my DH, who came with me, said the doctor was really trying to rush us out of there and was not interested in hearing about how bad my symptoms were. So, it is entirely possible that he thinks I'm being a wimpy pregnant woman and does not realize how bad things are.  Either way, I'm going to need a GI doc's input, and I know that.  I'm hoping the GI doc's office is open today and I get a call back soon!