What to Do When Symptoms Persist Despite Treatment

When you're dealing with post-COVID conditions, it can be difficult to know what to do when your symptoms persist despite treatment. It's important to have a good medical history and to understand the nature of your symptoms. Heartburn is characterized by a burning sensation in the chest that lasts a short time, while regurgitation is described as a backflow of gastric contents into the mouth or chest. Your doctor may start you on a standard dose of proton pump inhibitors (PPIs) once a day, and if you don't respond, they may increase the dose to twice a day for a defined period of time.

Gastroscopy is an important screening tool for excluding any underlying organ lesions in the upper gastrointestinal tract and allowing esophageal biopsies to be performed. People with post-COVID conditions may also experience muscle weakness, problems thinking and judging, and symptoms of post-traumatic stress disorder (PTSD). It's important to seek the care of a healthcare provider to develop a personal medical treatment plan that can help improve your symptoms and quality of life. It's increasingly evident that some people who have recovered from COVID-19 will experience symptoms that persist well beyond testing negative for the virus.

Magnetic resonance imaging can show myocarditis in some of these people, indicating that the heart muscle may remain inflamed several months later. Despite the high efficacy of PPIs, up to 30% of patients continue to have symptoms similar to those of gastroesophageal reflux disease (GERD). Healthcare providers may misunderstand people with these unexplained symptoms, which can cause them to take a long time to receive a diagnosis and receive appropriate care or treatment. After excluding any serious underlying etiology, it is not uncommon for patients to continue to have symptoms similar to those of GERD.

Patients with hypothyroidism who continue to have symptoms with levothyroxine monotherapy may consult their doctor about the possibility of trying a combination therapy or a pill that contains both T3 and T4.The PPI test involves measuring the symptomatic response to a 1- to 2-week cycle of a high-dose PPI in patients with GERD symptoms. GERD is often overdiagnosed; atypical symptoms that are common and even less responsive to PPIs include chest pain without any abnormalities in the cardiac evaluation; unexplained chronic cough that has been evaluated by a respiratory physician; or sore throat symptoms that persist despite a normal evaluation of the ear, nose, and throat. In these situations, ambulatory monitoring of esophageal reflux is useful in determining if symptoms are actually due to GERD.