Update on shooting pain to breast - esophagitis

[HappyDiamonds]

I have gastritis and esophagitis to add to my woes and the shooting pain it appears was possibly my esophagus going in to spasm. It hasn't happened again today but Ive hardly ate anything as even a cup of tea is giving me problems. Have doubled my Lanzoprazole and taken gaviscon advanced after any food. Very bloated, uncomfortable, heartburn, belching and feeling miserable.

Spoke to a different Rheumy today who suggested I stopped my Leflunomide for a week and if Im well to restart it every other day for a while and when Im happy to go back to one a day. Due to taper Pred on Monday but he left it to me to decide if I felt well enough as another week at present dose won't make any difference. Still continuing with 2 weekly Actemra. Lef. can cause GI disturbances but its normally diarrhea. If I get this again when I resume the Lef. they want me to try something else 😧 probably mycophenolate and Im not keen to do it.

I have had this before several times and I had an idea yesterday that it was acid related.

Thanks to all who responded to my post, just thought I would update in case it helps anyone else in the future.

[PMRpro Ambassador]

Glad you have a sensible verdict. Not the lansoprazole causing problems is it?

[HappyDiamonds in reply to PMRpro]

Ive been on Lanzoprazole for 2.5 years now 15mg one that dissolve in mouth. Take it every morning when I get up and put the kettle on, by the time I've got back to bed with my tea im already belching (sorry). Never understood why it would do that but soon stops. Years ago when I was being investigated with scans and endoscopies I was prescribed esomeprazole. Im assuming once I get off Pred and stay on Lef I won't need a PPI🤞always preferred Zantac if I needed anything tbh but its discontinued now. Consultant always said that was only any good for a bloke following a curry and a pint! Yesterday morning I had a latte and a Pastel de Nata in Waitrose and the spasms started soon after although I already had problems before that.

[PMRpro Ambassador in reply to HappyDiamonds]

Yes - Zantac/ranitidine is gone, but famotidine/Pepcid is the same sort of drug.

[SnazzyD in reply to HappyDiamonds]

The ‘azole’s made my stomach worse and gave me bloating. The Zantac types (Famotidine) were much better.

[HappyDiamonds in reply to SnazzyD]

I totally agree with you. I have a problem with the muscles on the lower half of my oesophagus so swallowing tablets is difficult. Until recently I could take my Pred using dissolvable tablets but they are not available below 5mg so altogether I now have to try and swallow 10 tablets a day. I strongly suspect this episode is due to tablets stuck on the way down (as it was years ago) rather than the Leflunomide. If it wasn't for that I would avoid PPIs like the plague and stick with my greek yoghurt.

[Polymialgia]

I have suffered with this intermittently and have always put it down to yet another side effect of the prednisone, I haven’t taken a ppi since I started taking prednisone with yogurt some 5 years ago, I also often have difficulty swallowing, nothing showed on camera and the hospital just our it down to inflammation