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Patient of The Week

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Magda was a new patient who was referred by one of my ENT colleagues for “refractory reflux”. She’d been on the proton pump inhibitor Nexium at a dose of twice daily for over a year, and was still complaining of symptoms. She’d cut out caffeine, alcohol, chocolate and late-night eating when the symptoms first began, and was a pretty healthy eater at baseline: oatmeal or fruit for breakfast; a salad for lunch, and chicken or fish with rice or quinoa plus veggies for dinner. At 5’8” she weighed 126 pounds, and was an avid exerciser. Magda was 29, didn’t take any other medications besides Nexium, and had no other medical problems. Hmmm. Why would a lean, active, healthy 29-year-old woman with good eating habits suddenly start having acid reflux? The symptoms had developed seemingly out of the blue, on the heels of a bad viral upper respiratory tract infection 14…