Apnea, Gerd, PPIs and Heart Arrhythmias

I have GERD, Barrett's Esophagus and atrial fibrillation. I've been taking relatively large doses of omeprazole for years, per doctor's orders, to control the Barrett's and presumably reduce the chance of developing esophageal cancer.

However, I am more and more concerned about this long term PPI use causing magnesium deficiency and exacerbating my heart rhythm problems. Also, in the news recently, a study suggesting PPIs can increase chance of heart attack.

I'm wondering is if anyone has experience related to this constellation of problems in general, and specifically, if anyone has been able to get off PPIs and/or switch to something like H2 blockers (Zantac, Tagamet, etc) because cpap has made their GERD easier to control.

I've been using cpap for almost a month. Got used to it quickly, and sleep has definitely improved. I can't say I've seen an improvement in heart symptoms (palpitations), though. I was diagnosed with only moderate apnea. Sleep doc wanted me to try cpap mainly because of the atrial fibrillation diagnosis. I have not had an episode of a-fib since starting cpap, only garden variety palpitations (PVCs, etc). However, a month isn't long enough to reach any conclusions. I've only had 3 documented a-fib episodes since October 2013.

A fair number of people raise the head of their bed on 5-6" blocks to help with GERD, and others just take a small or half a TUMS before bed which seems to do the trick. As well, you can certainly take magnesium to counter the effects of the meds which I think would help with your problems.

If you are not having any GERD symptoms you might try the OTC Omeprazole. I avoided all that drama by having the Nissen Surgery back in 2002.

I was on CPAP for about 8 months when I noticed I hadn't had any night time reflux. Before CPAP I would wake up gagging at least once or twice a month with bile in the back of my throat. Not a pleasant ordeal. After talking with my PCP I changed from Prilosec (which I had been on for years) to Zantac and I still have no reflux, after 3 months, just a couple of indigestion episodes after eating tomato sauce that I knew would cause it.
I also no longer feel the PVC's when I lay down at night.

philajohn wrote:I have GERD, Barrett's Esophagus and atrial fibrillation. I've been taking relatively large doses of omeprazole for years, per doctor's orders, to control the Barrett's and presumably reduce the chance of developing esophageal cancer.

However, I am more and more concerned about this long term PPI use causing magnesium deficiency and exacerbating my heart rhythm problems. Also, in the news recently, a study suggesting PPIs can increase chance of heart attack.

I'm wondering is if anyone has experience related to this constellation of problems in general, and specifically, if anyone has been able to get off PPIs and/or switch to something like H2 blockers (Zantac, Tagamet, etc) because cpap has made their GERD easier to control.

I've been using cpap for almost a month. Got used to it quickly, and sleep has definitely improved. I can't say I've seen an improvement in heart symptoms (palpitations), though. I was diagnosed with only moderate apnea. Sleep doc wanted me to try cpap mainly because of the atrial fibrillation diagnosis. I have not had an episode of a-fib since starting cpap, only garden variety palpitations (PVCs, etc). However, a month isn't long enough to reach any conclusions. I've only had 3 documented a-fib episodes since October 2013.

First, I am happy to hear that the cpap has helped you with the A-fib!! That's scary stuff (my late Dad died from that). and the cpap is going well. YAY!!! I'm glad you mentioned about the omeprazole and magnesium. That could explain the RLS becoming such a problem - the gastroenterologist doubled my dose last Fall, but never mentioned issues with magnesium. I just started supplementing with magnesium and zinc for the RLS, which is still a problem after 7 days. My doc switched me from Zantac quite a while ago to omeprazole because of fewer long term side effects. I believe the bone density thing was one of his chief concerns, but I think there were others. I'm not sure what study that you are referring to, but in many cases, you have to balance the damage done by GERD vs. the potential (and often small risk) of other side effects. In my case, the omeprazole is less risk than the blood pressure medication I would otherwise have to take and it actually addresses the cause directly.

I can't tell you how to eliminate the GERD. My GERD worsened for a week or so from cpap, but has since improved. I originally got it from steroids for an eye problem. So far, losing weight (over 30 pounds) has not eliminated it, but I live in hope that more weight loss will.

Janknitz wrote:http://chriskresser.com/pills-or-paleo- ... -and-gerd/

Great article, and I encourage people to try it. I've been low carb for 3 years - essentially pretty close to the Paleo diet since last Summer. It made no difference in the GERD or diabetes. So do try it, but don't be too disappointed if you are one of the folks it doesn't work for. My cholesterol is right about 200 without meds, so that was a benefit.

SewTired wrote: First, I am happy to hear that the cpap has helped you with the A-fib!!...

I guess my post was a little unclear. It's too soon to tell if cpap has helped with a-fib. Thanks, though.

I had a lot of GERD, and Aerophagia. I got rid of most of both by using a Bi Level machine. Have you tried to max out the Flex on your machine? Let me say this differently: I wish I had gotten a Bi Level machine long before I did. It has made much of my treatment much better, far more comfortable. Insurance companies, I have Medicare, require that one to fail xPAP before one can get a Bi Level machine. Medicare says that one can not get a Bi Level machine for comfort. Also, I have heard it said that many people have far more comfortable experiences with Resmed Bi machines. I have a Resmed machine, S9 VPAP, and I still have it in mind to get a PR machine. My reason being that PR machines feel like they are built like tanks, very solid.

My Pharmacist told me that if I take Prilosec, I should take something like Cal Mag Citrate to make sure I get those things. I also am big on the idea of making sure one has enough Vitamin D. I guess a multiple Vitamin Multi Mineral is a good idea.

There is a theory that A Fib can be sometimes effectively be treated by making sure one has enough minerals. Can't hurt.

I am very sure that by keeping a close watch on your condition, and working closely with your Cardiologist can make a huge difference to having a fun life. I guess you know all that already. But it takes work to do all that, and I wish you the best.