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sleeplessin canada
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Gas and Bloating Caused by CPAP

Postby sleeplessin canada on Tue Feb 03, 2009 9:31 am

I have been using a cpap for over 2 years and still have the problem of getting very painful gas and bloating that only allows me to wear my mask for a few hours a night. I have seen my sleep specialist many times and consulted with the equipmwent distributers and nothing they suggest works. I have had the pressure put up and down tried gax x, elvated mattress, special pillows, chin straps. Does any body have any good advice?

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Re: Gas and Bloating Caused by CPAP

Postby OutaSync on Tue Feb 03, 2009 10:18 am

You need to see a gastrointentinal specialist. You very likely have a weak lower esophageal sphincter. That is the muscle at the bottom of your esophagus. It should close up so the air doesn't get through to your stomach. But if it is weak, it will not close properly. The most damaging thing about that is that stomach acids also will back up through that same opening and will damage your esophagus. Enough damage and you could get Barretts Syndrome. Google it and see how serious this is. Thank goodness that your cpap use alerted you to this problem and may very well have saved your life. Your doctor may give you acid inhibitors to reduce the acid and allow the esophagus to heal. That may help your situation. If not there is a procedure called Nissen fundoplication to tighten that area where the muscle is weak.

Good luck and let us know who it turns out for you.

Bev

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Re: Gas and Bloating Caused by CPAP

Postby tomjax on Tue Feb 03, 2009 1:32 pm

outasynch,
I think you are confusing aerophagia with GERD.

Not the same at all and probably not related.
Your advice is directed to GERD.

The use of antacids and gasX is useless.
It is air, not metabolic gasses.

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Re: Gas and Bloating Caused by CPAP

Postby OutaSync on Tue Feb 03, 2009 1:52 pm

No, sir, I am most certainly not getting the terms confused. I know the difference and they are related. Air goes into the belly (aeorophagia) and acid comes from the belly up (GERD) through the same opening. It is that weak LES that allows both of those conditions, and I'm saying that if you have one, you probably have the other and it's a good idea to get it checked out. You don't have to have any symptoms of GERD to have it. Sometimes the only symptom is aerophagia.

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Mask: Mirage™ SoftGel Nasal CPAP Mask with Headgear
Humidifier: REMstar Heated Humidifier
Additional Comments: 3M MediporeTape, Respironics Premium chinstrap, CMS 60D Oximeter
Diagnosed 9/4/07
Sleep Study Titrated to 19 cm H2O
Rotating between Activa and Softgel
11/2/07 RemStar M Series Auto with AFlex 14-17
10/17/08 BiPAP Auto SV 13/13-23, BPM Auto, AHI avg <1

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Re: Gas and Bloating Caused by CPAP

Postby OldLincoln on Tue Feb 03, 2009 2:02 pm

This linked post might be helpful.
Respironics System One APAP & Humidfier / F&P Forma / DME: SleepQuest
It's going to be okay in the end; if it's not okay, it's not the end.

sleepness in Canada
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Re: Gas and Bloating Caused by CPAP

Postby sleepness in Canada on Tue Feb 03, 2009 2:06 pm

Thanks for bringing the condition to my attention. I have never had any reflux issues and the gas and bloating only occurs when I use the cpap. I did have a barium test for GERDS when I was younger as I have IBS and they thought it was GERDS. I will look into it again better safe then sorry. I do doubt that is the issue as I have read many threads on this forum of people complaining of bloating for extended periods of time and it seems to be VERY common but I appreciate all adivce, thank you. In the meantime if anyone knows how I can use my cpap without getting gas please let me know. Also i can only use my mask 2-3 days before th pain gets too bad

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Re: Gas and Bloating Caused by CPAP

Postby Sllepless in Canada on Tue Feb 03, 2009 2:15 pm

I also had a Esophagogastroduodenoscopy (EGD) done last year and eveything came back fine. Thanks for the concern though

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Re: Gas and Bloating Caused by CPAP

Postby OutaSync on Tue Feb 03, 2009 2:22 pm

Old Lincoln,

That post was spot on. Thank you.

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Mask: Mirage™ SoftGel Nasal CPAP Mask with Headgear
Humidifier: REMstar Heated Humidifier
Additional Comments: 3M MediporeTape, Respironics Premium chinstrap, CMS 60D Oximeter
Diagnosed 9/4/07
Sleep Study Titrated to 19 cm H2O
Rotating between Activa and Softgel
11/2/07 RemStar M Series Auto with AFlex 14-17
10/17/08 BiPAP Auto SV 13/13-23, BPM Auto, AHI avg <1

Sleep Doctor MD
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Re: Gas and Bloating Caused by CPAP

Postby Sleep Doctor MD on Tue Feb 03, 2009 2:41 pm

If Old Lincoln is right then the 80% of cpap users that experience bloating have GERD. If the problem is so common the specialists would be aware of this issue. Sleepless in Canada these people are hypochondriacs please do not listen. GERD is Gastric and if you Google it there are a list of symptoms. If you are not medical doctors please do not scare people. Please do your research before you give bad advice. Bloating and gas is VERY COMMMON please do not spook new users. This site is for information sharing not scare tactics

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Re: Gas and Bloating Caused by CPAP

Postby tomjax on Tue Feb 03, 2009 9:32 pm

I should have clarified gerd vs aerophagie.
They can be totally unrelated or coincidental.
One interesting thing that happens to MANY people who start XPAP have severe GERD.
In many cases the gerd goes away with PAP.

This was my case as well as others.
Another related situation is the use of PPi for gerd.
This is very helpful but it has drawbacks. Rebound occurs with PPI and it is very difficult to get off.
I would like to know of any data on those are on PPI before strting PAP vs those using other drugs for GERD.
I strongly suspect those NOT on PPI will have the GERD go away with pap, but those ON PPI cannot because of the rebound condition.
Rebound is not widely known by those who use and prescribe tht miracle purple pill.\
I do my homework, btw.

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Re: Gas and Bloating Caused by CPAP

Postby track on Tue Feb 03, 2009 10:03 pm

these people are hypochondriacs.....


Lot of truth in that. If you stay around here long enough you will discover that sleep apnea is the root cause of about every illness known to man. :)

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Re: Gas and Bloating Caused by CPAP

Postby Wulfman on Tue Feb 03, 2009 10:04 pm

Sleep Doctor MD wrote:If Old Lincoln is right then the 80% of cpap users that experience bloating have GERD. If the problem is so common the specialists would be aware of this issue. Sleepless in Canada these people are hypochondriacs please do not listen. GERD is Gastric and if you Google it there are a list of symptoms. If you are not medical doctors please do not scare people. Please do your research before you give bad advice. Bloating and gas is VERY COMMMON please do not spook new users. This site is for information sharing not scare tactics


What "specialists"? When would they be aware of it? Many of the XPAP users don't realize they have these conditions (aerophagia in particular) until after they start this therapy. Then, there's also "silent" GERD. That one's really interesting to see on some of the detailed reports from the machines.

Do yourself a favor and do a search on this forum for "GERD" and then another on "aerophagia". You'll find many of those words in many, many posts and threads going back to the beginning of the forum's existence. (I see 116 pages of posts for GERD, going back to Sept. 2004).

It's not that bloating and gas is not common, it's because the XPAP users are searching for solutions to how to deal with aerophagia and GERD that they look to the forums for help from others who have dealt with it. And, from reading many of the posts over the years, it's obvious that their medical and sleep doctors are clueless. If you're really an MD, you sound "clueless", too.


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Re: Gas and Bloating Caused by CPAP

Postby OldLincoln on Tue Feb 03, 2009 10:58 pm

Sleep Doctor MD wrote:If Old Lincoln is right then the 80% of cpap users that experience bloating have GERD. If the problem is so common the specialists would be aware of this issue. Sleepless in Canada these people are hypochondriacs please do not listen. GERD is Gastric and if you Google it there are a list of symptoms. If you are not medical doctors please do not scare people. Please do your research before you give bad advice. Bloating and gas is VERY COMMMON please do not spook new users. This site is for information sharing not scare tactics
Funny you should post re this subject. I don't know (or care) if you are a licensed medical doctor, but it's odd how you can make such statements if so.

Nothing in my post states that 100% of those suffering painful bloating have a history of GERD. I state that the painful bloating from CPAP is gastric insufflation, NOT aerophagia. If you are a medical doctor you should know the difference. If you are a doctor then you know the dangers of gastric insufflation as it is very well documented. If you care to dispute this please bring it on because I have the studies to back it up.

You state that "Bloating and gas is VERY COMMMON". Well, if it weren't we probably would not be discussing it so much. At issue is the cause of the Bloating and gas. Of course if you are referring to digestive gassing then you are not paying attention. The CPAP users here repeatedly state they have the bloating when using CPAP and don't when they aren't using it (including me). That makes a pretty solid case for a correlation between CPAP and bloating. Agree, doctor?

Does a person complaining about debilitating pain make them a hypochondriac? That's pretty severe isn't it for not having examined them? Based on your statements, if you are a "Sleep Doctor, MD", why? Surely all sleep deprivation must also be hypochondria and for you to prescribe treatment would be fraudulent and in violation of your code of ethics.

However, if you look a little closer and reconsider the possibility that the bloating is from CPAP use and it is very painful, then you must also recognize it is not swallowing air as in chewing gum, but air being "pushed into the stomach" which is the classic definition of gastric insufflation.

To get there, it must push through the LES. Those with a history of GERD often have a compromised LES which results in a lower threshold. That does not mean everybody who has a history of GERD will have gastric insufflation, just as not everybody who has gastric insufflation has a history of GERD. A specific study in England clearly demonstrated a very wide spread in LES threshold in 30 subjects ranging from 4cc (as I recall it) to over 30cc as they stopped there. That's why I suggest the discovery of the individual threshold.

As for research, I have done it and will stack mine against yours any day! As for scaring people, if they have this experience they should be scared. To me, personally, your presumptive attitude is like Congress tossing a couple more trillion into the bailout and saying don't worry about it. As for what this site is for, I agree it is for sharing information and the information I have shared is very well informed - is yours?

Now "doctor", I have a serious question for you. With medical practice so heavily reliant on studies and statistics, why is the standard machine issue a low end CPAP with the accompanying 50% compliance rate, when the Auto Tritating CPAP machines have a consistent 70% or greater compliance? Is it not in your patients best interest to prescribe the APAP machine unless they require a Bi-Level? Would you prescribe an antibiotic with a 50% success rate when one is available with a 70% success rate?

I look forward to continuing this conversation with you doctor and hope you do some research and reply, perhaps by first clearing up you status in the medical community.
Respironics System One APAP & Humidfier / F&P Forma / DME: SleepQuest
It's going to be okay in the end; if it's not okay, it's not the end.

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Re: Gas and Bloating Caused by CPAP

Postby KSMike on Tue Feb 03, 2009 11:08 pm

Not really related anymore, but since Nissen fundoplication was mentioned, I'll throw in a data point. My wife had it done 14 years ago and it was totally, immediately, and lastingly effective at eliminating indigestion.

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Sleepless in Canada
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Re: Gas and Bloating Caused by CPAP

Postby Sleepless in Canada on Wed Feb 04, 2009 8:13 am

Wow looks like things got a little heated. I just want to know how to cure my gas and bloating. From what i am reading if I use CPAP I will get gastric insufflation and if I do not use CPAP I wont get it. That makes my decsion easy i will look into an oral device I have been told my sleep apena is mild so it seems logical. Old Lincon if you have any insight on what i should do let me know it sounds like you know more then this "doctor". Thanks

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