Urgent endoscopy required if worsening symptoms of GERD are present despite PPI therapy

Dear Ask The Doctor: Ive had gerd for 9 months now and has been getting steadily worse, my doctor is useless. ive been on lansoprazole, changed to omeprazole, now ive been on nexium last 2 days. my doctor is finally sending me for an endoscopy, but i dont know how long i have to wait on the list to be seen. i have a constant burning tight pain in my chest, burning lump in my throat, and it never goes away. ive been in tears last couple days, its been so bad. food, and even water makes the nausea and acid worse. ive been treated for heliobacter infection in my stomach. but my symptoms are getting worse. ive currently on a liquid diet, and i cant keep food down. ive lost weight, and most days i have no energy to do anything. is there anything that will help relieve the pressure and burning in my chest and throat? Lisa

Dear Lisa: The severity of the symptoms you describe with increasing burning tight pain in your chest, nausea, vomiting and weight loss suggest that a simple diagnosis of gastro-oesophageal reflux disease is inadequate. If your symptoms are progressing even on treatment with multiple proton pump inhibitors, then you require urgent investigation with endoscopy and barium swallow. Endoscopy allows visualization of the gastro-intestinal tract through a camera lens and biopsy of any lesion to identify benign or malignant cells, and a barium swallow identifies any blockages or narrowings of the oesophagus under x-ray guidance. You will also require a repeat Helicobacter pylori test to check that this is completely eradicated post triple therapy. Treatment options are limited without a specific diagnosis, therefore I would advise these investigations are completed urgently.