Esophageal Reflux

Interesting posts....I have had GERDS for at least 15 years now. For many years, I used to take Prilosec the last thing before I went to bed. Recently, about 2 years ago, I was told by an ENT, to take it first thing in the morning, before you do anything else. This has made a HUGE difference for me. Another tip...right before you go to bed....the LAST thing you do, take either 2 extra strength TUMS, (I take them also because of the Calcium)...or, take some extra strength liquid antacid, and don't drink anything after. The idea behind this is to coat the throat/esophagus, so that IF there is any gerds, it will help protect it. THIS has also made a huge difference. GERDS was affecting my voice big time, and in my line of work, I can't afford that! I hope that helps some of you out there. I have several collegues that have switched to taking Prilosec in the am, and it has worked really well.

As to nasal congestion.....I wrote about this in another post, and several folks got a bit upset. For me, it's been a life saver, as I would not have been able to use CPAP all these years if it were not for this tip from an allergy doctor....this formula was originally devised to wean a person off of Afrin, but in my case, it's necessary I use it every night, 2 sprays in each nostril. It keeps me pretty much free of nasal congestion the next day as well. Here is what I do....for a new bottle of a cortisone nasal spray, such as Nasacourt. I take about 3/4 tsp of Afrin and mix it in the Nasacourt. The new bottle of Nasacourt lasts me at least a month, and I can breathe all night long without any congestion. I have been a mouth breather all my life, and this has been my salvation. Some of you are going to say it's not good to use Afrin....the fact of the matter is that the amount of Afrin I am putting in the Nasacourt is so minimal, it takes me about 9 or more months to go through a normal bottle of Afrin using it that way. I would NOT use straight Afrin every night, you are asking for trouble then, high bp, irritated turbinates etc.

In any case, this has worked for me for at least the last 7-8 years. I have tried turnbinate reduction, allergy shots, all to no avail.

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I was just diagnosed with hiatal(sp) hernia where your stomach actually extends beyond the sphincter that is supposed to close it off. According to the MD this is very common and 20% of the population has this, especially people with GERD.
GERD will definitely interfere with CPAP therapy. The reason it affects sinuses is because the acid actually reaches your sinuses while you sleep!

My MDs suggestions:
1. Slight incline on Bed.
2. In this order try: TUMs at night, if that does not work Pepcid(H2 bocker) plus tums, then if this does not work then Prilosec (proton pump inhibitors) type medicine. He is trying to go from the least "side effects" to the greater side effects ie mineral absorbtion etc.
3. Lose weight.

Kurt

Yes, there is a CURE.

It is called a nissan laparoscopic fundoplication.

It is a fairly easy surgery where they strengthen the valve at the top of the stomach / bottom of the esophagus.

They make 5 very small little holes and poke in a tv camera and some instruments and do their miracles. Hardly any scars and no pain at all.

I had reflux for years and they would go down in there and take biopsies etc. and had me on various pills.

Then one time, the location where they took biopsies hurt for 3 months afterward ( usually no pain ). I got to checking on the internet and found that my stomach doctor could have had me on twice as much medication as I was on and then I discovered there was an operation to fix it.

So I made an appointment at Mayo in Scottsdale Arizona ( fortunately for me I live close ) and they took one look and scheduled me into an operating room in 2 weeks, which is really quick the way they are booked up.

That was in 1999 and I can eat anything since. But I still take prilosec because after a few years I developed a small ulcer at the site of one of the sutures they made. I am the only one that has had that happen though. Very unusual.

They check me every year -- well now they have lengthened it to every 2 years for endoscopic exam and I am basically fine now.

GERD can be life threatening. I had it so bad that I would wake up choking because I had inhaled the acid reflux in m sleep.

Several times Da Boss almost had to call 911 because I couldn't breathe because of the choking.

The lungs do not appreciate the acid ... at all.

I probably had OSA back then too but had not been tested or diagnosed.

But curing the GERD did not cure the OSA.

I'm sure I wouldn't have lived to be a member of the windsucker gang if I hadn't had them fix the GERD.

Get it fixed ... you don't have to live with it ... pills can help but they don't cure it.

Arizona, my daughter had the same procedure (nissan laparoscopic fundoplication) at the young age of twenty. She is now tenty three, and has benefitted from it 200%. It did take her about six months to fully adjust to the changes in her change of "gastric lifestyle". She definitely has no regrets whatsoever, and like you, can eat just about anything she cares to now. I don't believe she is on any sort of maintenance medication either.

Just thought I'd comment, been a while since I've seen that procedure talked about. I never knew about it until my daughters situation, and haven't heard about it since until your post. Small world!

Pipey

Don't know what you mean by " changes in gastric lifestyle " ... the docs didn't say anything about changing what I ate. Before I couldn't eat pizza or any spicy stuff and afterward I can eat anything.

Unfortunately I do as my rotundness can testify.

I certainly recommend the operation to anyone who can't control the GERD 100% with medication. As I understand it, the GERD causes Barrett's esophagus which, in turn, causes esophageal cancer about 80% of the time.

I think many stomach doctors don't tell their patients about the operation because:

a: they make a ton of money doing the edoscopic exams every year

and

b: they aren't qualified to do the operation -- so they can't make any money from it.

Thank you, Arizona. I wondered why they do nto want to do the surgery, especially if it's that simple. I have a friend who lived with GERD for years. She found a different doc--I guess it was one who was qualified to do the surgery. She had the surgery, and she feels much better. She also lost TONS of weight. She's so much happier. She told me that the doc she saw for years ( mine) should never have let hers go that long.

I'll have to find out who she eventually saw and look into this surgery for myself.

Sorry, didn't mean "gastric lifestyle" in a negative manner. She did have a period of readjustment after the surgery, but within a few months things were back to normal andwere absolutely better than before the surgery.

When I suffered from GERD, I relied on an OTC product called Gaviscon recommended by my Gastroenterologist. Its principal advantage is that it also works when you are horizontal - ie you can take it before going to bed and it keeps working. I found that for me, it worked better than other antacids. If you try it, use the liquid rather than the tablets.
Good luck - Dan

Just a note here - Barrett's Esophagus is NOT 'caused' by GERD, but GERD is a symptom of it. It is something you 'have' or you don't. The incidence of Barrett's esophagus progressing to adenocarcinoma is estimated to be 0.5 per 100 patient-years (i.e., one in 200 patients developing carcinoma per year).

A few things I wanted to comment on here but will probably forget because there were so many posts. I suffer from GERD also. There is a difference between just getting some reflux (sometimes called heartburn), which most people get from time to time and having the full GERD (Gastroesophageal Reflux Disease) condition. Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus (someone did point this out).

Medication will not cure this condition. Sometimes there is some damage from the acid backing up, this can be corrected with medications so that may be what someone saw on advertisements as the part that can be cured by medication. I'm on 40 mg (basically a double normal dose) of generic prilosec (OMEPRAZOLE) a day. I take it at night and from what my doctor said it should work for 24 hours so didn't matter when. (NOT saying if a different time works for you not to do it.) My biggest problem was the acid burning my throat when I went to bed so he probably told me to take it at night cause possibly it works more when you first take it (? my guess only). What is does is basically prevent the forming of acid. Symptoms at night are very common because that lower esophageal sphincter muscle does not work - so you lay down and there is nothing to stop the acid from laeking into your throat.

From what my doctor said and what I've found on the internet, surgery does not have the greatest success rate. (Again, not arguing that it worked for some people. Actually glad to hear it since I've considered it myself.) Unfortunately, the stats I found are not great. And seems they don't want to take the chance if you respond well to the meds. I eat whatever I want. I still have some congestion, but not too much. I'd love to not take the meds and if surgery options improve, I would consider. But they say some people actually can get worse, may need a second operation, and may still need meds afterward.

This is all my personal experience and research. Please don't take anything I say for gospel - just sharing my experience. You can do the research yourself like I did. If you're on this forum, you're obviously web-savy.

Ed

P.S. If you're on generic meds and have an insurance company like me that stopped covering Prilosec and even the generic one, pm me if you're looking for a low cost provider. It saved me half of what the drug stores wanted for the generic version and at a double dose every day - it adds up. Again, you can find your own on the internet, which is how I did it, but I've used this one and not had any issues.

Kered seems to make my point on reflux.
Those using the ppi will eventually have to increase the dosage due to the rebound effect.
Seems nobody is interested in this and ignores it, but they cannot avoid it.

PPIs cause reflux or at least make it worse!!

I went from Tums to Tagamet to Prilosec over the last couple years, and had some scary moments waking up unable to breathe from stomach content in airway.
Since I got my CPAP I have not used anything but the occasional papaya enzyme tablet. A mazing. I go with Goofyut's explanation. Stopped my GERD in its tracks, hooray.
Barbara

Hi! I had the surgery this past February. I am very happy that I don't have to take medicine anymore and don't have food come up BUT I now have a problem with excessive gas since the surgery. It's very embarrassing especially being a single female in the dating world. Does anyone have a solution for the flatulation problem????? I don't even want to go on a date at night when it's the worst. Does anyone else have this problem????? Please help!!!!!!!!!!!

I had horrible acid reflux for at least a year, it woke me up almost nightly, and it was very painful (this was several years ago, before I started using my CPAP). My friend suffers from allergies and takes Claritin, and I was waking up every morning having to hack up who knows what for a half hour, so I gave it a try. Immediately after starting to take Claritin D regularly, my acid reflux disappeared. I felt awake and fabulous every day. Then for whatever reason my blood pressure took a jump, and my doctor said no more Claritin D. I now take Singulair instead, but I was feeling foggy in the morning again, and that's how I ended up with my CPAP. I still take the Singulair, I think it really helps, and I feel much more awake now with my CPAP.

Chris, Unfortunately, I've read that gas is one of the common problems after having the surgery.