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.