CPAP and GERD

I'm still trying to figure out the effects of CPAP on GERD. I see some references that say the pressure improves it by not letting the acids flow up and others that seem to say it makes GERD worse. Can anyone offer any insight. I've long had GERD and take meds prior to going to bed but any other thoughts would be appreciated. As I haven't been able to keep a mask on for even an hour most nights, I have no clue what effect it will have on my GERD when i do so would like to hear other's experiences.
cheers,
gregg )

I don't have GERD, but have read some of the information about the relation between GERD and OSA that you've probably come across.

I think some people probably do see improvement in their acid reflux symptoms once they begin using CPAP and are no longer having strong compressions of the chest and abdomen possibly forcing acid up out of the stomach while they struggle to breathe all night.

On the other hand, some people have probably had so much damage done already by acid reflux episodes happening before they ever began CPAP, that the esophageal sphincter muscle has been weakened to the point that CPAP pressure might force some air into the stomach (aerophagia.) If a lot of daytime belching resulted from aerophagia, I guess acid could be forced up again.

For most, I'd think that CPAP treatment would be beneficial in that it would stop the struggling abdomen movements associated with apneas.

Hi, I think we're mixing apples and oranges a bit here - GERD is one thing, aerophagia another, and the two are not necessarily experienced together at all, or if they are, it is likely quite coincidental, rather than anything. The LES (sphincter) is certainly related to a lot of GERD problems, if not most, but aerophagia is gas related, which is a different issue entirely (though our systems sometimes can't tell the difference from the way they go on at us ). "Strong compressions of the chest and abdomen" may be related to aerophagia, but not to GERD, which is a matter of too much acid, sometimes causing ulcers, especially if the H. pylori bacteria is busy, sometimes damaging the esophagus (and LES along the way), and occasionally showing up as gastritis (my version), with surprisingly little reflux until late at night or early a.m. If someone with GERD were to wolf down a ton of e.g. white bread, pasta, etc. right before bed, they're more likely to bring on aerophagia, due to gas production manifested by belching, but still not have acid reflux. It's all very confusing though, especially as treatment for both can be almost the same!

I do have GERD. I have no knowledge of what others may have for results. But I just wanted offer my personal experience.
I've had Gerd for more than 25 years which is the result of a hiatal hernia. (I know there are surgery options, but i choose to opt out of that)
Prilosec is my friend and I have always had to avoid lying down after meals. I sleep with my head elevated and also slightly tilt my bed to assist in this.
I started CPAP in May this year, about 6 months ago and so far I have seen no difference for the better or worse in my condition.
I still wake at time having a nasty mouthful of reflux. (sorry to be so graphic. ) Anyhow, CPAP does not seem to make any difference for me.

-Dennis

Denisia, what are you eating and drinking, especially before bed? Prilosec may help keep you from awareness of an acid problem when you're awake, but if you continue to e.g. drink coffee, eat acidic foods and/or certain spices, your body will react when you're prone, and eventually even when you're not. Meds are to help prevent symptoms, but you also have to do your part (and you may be, of course, I wouldn't know ).

ofarchesandants wrote:I'm still trying to figure out the effects of CPAP on GERD. I see some references that say the pressure improves it by not letting the acids flow up and others that seem to say it makes GERD worse. Can anyone offer any insight. I've long had GERD and take meds prior to going to bed but any other thoughts would be appreciated. As I haven't been able to keep a mask on for even an hour most nights, I have no clue what effect it will have on my GERD when i do so would like to hear other's experiences.
cheers,
gregg )

Hi Gregg,

I don't know for certain if cpap causes GERD but I do know that from my own experience that my GERD has never been this bad. I get bad chest pain that radiates to my back and have to sit up very straight just to get any sleep at all when I have a bad GERD attack that lasts 6-7 hrs every time and always comes on just before bed or occasionally an hours or so after going to bed. I cannot use the cpap machine as it seems to make me worse. I went several days without an attack then just had another 6 + hrs episode the night before last. This is with not eating anything gas related at all. I do not have reflux, just the chest pain radiating to upper back every 60 seconds or so for hours. This is with prescribed protein pump inhibitor and other med for emptying stomach faster and Gaviscon inbetween. I know it is not a heart attack (women's symptoms may be different then men's) or I would have been dead several times over.

I still attempt to use my mask every night but if GERD starts or stays I take it off and wear it all the nights I don't have GERD. So far, within the last month I have not worn it all night or at all for several nights because pain was too bad.


If you can stand wearing your mask when you have GERD I would say wear it. I want to wear it all the time but some nights I just can't...at least until this GERD thing is cleared up.



I have read that cpap therapy helps some people who have GERD. I'm just not one of them. Maybe you will be. Hopefully.

Anne

Your body may in fact be protesting (backlashing) all those antacids by trying to produce even more acid to make up for what's being suppressed. You do need a little for proper digestion. See if you can skip the Gaviscon for instance on 1-2 nights and if you have the same reaction. I also have had similar problems though (pain, no reflux except in early a.m.), and endoscopy showed chronic gastritis. I now eat very carefully (have figured out all my 'triggers' over the years) and only need a Tums at times, except for rare instances when I haven't read labels very carefully (you wouldn't believe what's in some food!) and then take 1-2 swigs of Diovol.

Puppy,

Have you had an endoscopy of the upper GI tract recently? If not, I highly recommend having one.

In my case I am convinced GERD was caused by undiagnosed/untreated osa. CPAP, Prevacid for three months, and elevating the head of the bed cured GERD.

Good luck,

I was on prescription tablets for Gerd, after the initial and one refill I decided to try without and seem to be getting on
ok, but I try not to overeat or eat too quickly. I raised the bed head 6 ins, a bit excessive maybe as
4 might be better. Sometimes there is no sign of it until I lie down, but a tums seems to work ok, now.
I have a certain amount of damage caused by acid reflux.

many people mention proper diet and elevating the head off the bed, both excellent suggestions. There is another though and it is what did me in. It is making sure there is nothing too tight around your waist. I visited the ER many years ago for what i later found out was caused by wearing tight elastic waist band workout clothes. I was only by accident that i realized what was happening after symptoms resolved when not wearing those pants and restarted when i was.

For the most partr except for mild flair ups, an occassional tums and or zantac was all i needed. this year it started getting bad and i was searching for the reason. Then one day while sitting down and feeling pressure on my gut, i had an epiphany. I had been wearing an overstuffed fanny pack at work for several months for up to 12 hours at a stretch and it was literally squeezing/pushing the acid into my throat. I should have known. I apparently did some damage as while the symptoms have improved since i stopped wearing it, i am definitely not my pre fanny pack self.

as soon as i get the cpap a bit more dialed in and find a gastroenterologist, endoscopy is in my future.
gregg )

It may just be me, but since starting CPAP a year ago, I have seen a gradual improvement from needing to use Prilosec and/or Pepcid AC on a regular basis and still having problems, to not using anything at all and having very little heartburn at all. YMMV

People can have acid backing up into their throat / mouth because they're struggling to breath, and the pressure created by their diaphragm on their stomach breaches the lower esopahgal sphincter.

People can have an LES weakness for other reasons.

People can have gas produced in their stomach as a chemical by product of what they eat and how their food is digested.

People can have air pumped into their stomach by their cpap machine - air is another kind of gas - and that causes pain until it is forced out from either side of the alimentary tract. It feels like digestion produced gas, but it is not the same. The air gets pumped in when they swallow and their LES is breached - this may have nothing to do with what they eat and how it is digested.

And that point about pressure on your stomach from the outside is also very important.

O.