Acid Reflux Medicines (continued)

Since surgery I suffer from acid reflux. I've never had this before so I'm educating myself on the fly, so to speak. It appears this may be a chronic problem for me now. It does not appear to be going away at all. I never thought it was a big problem, just annoying. But with some research I've found that chronic acid refluc can damage your esophogus. So keeping it under control to prevent that kind of damage is important. However, it appears to be a balancing act between the long term affects of acid reflux vs. the long term side affects of the medicines used to treat it. 

That said,  I've used WebMD to look up the different acid reflux meds and found some interesting and concerning information.

The PPI drugs, such as the one I take once a day and was considering for twice a day, Prilocec OTC have issues with calcium absorbtion that cause a higher risk of bone fractures. Over 50% higher for vertabral fractures. I cut and pasted from WebMD below.

·         The present study, by researchers at Seoul National University Hospital in South Korea, is an analysis of 11 previously published studies in which researchers examined the possible link between fracture risk and PPIs. Overall, the risk of fracture increases by 29% with the use of PPIs. Hip fracture risk rises by 31%, vertebral fractures by 54%. ·         The researchers explain that the increased risk of fracture likely occurs in part because PPIs interfere with the body’s ability to absorb calcium, leading to weaker bones that are more prone to break. ·         Fractures are not the only risk factors associated with PPIs. PPIs may raise the risk of GI infections, while taking them for more than a year may lead to low serum magnesium levels, which can cause muscle spasms, irregular heartbeat, and convulsions, according to the FDA, which issued a warning to that effect in March of this year.

· The researchers also report that they were unable to find a significant association between fracture risk and histamine H2-receptor antagonists, another class of acid-suppressing drugs, marketed under brand names such as Axid, Pepcid, Tagamet, and Zantac.

Having read this study, I think I will try the H2-receptor first along with some diet/food modifications.
I am over 50 years old and bone density and strength are a real concern.

Anybody else use Pepcid, Zantac etc successfully?
Any suggestions for food/diet modifications to reduce acid reflux?

And does this acid reflux thing ever go away with time?

Thanks,
donna

Hi Donna,
I replied to your last post about this.

Yes, it is true about PPI and bone fractures.  I take a lot of calcium citrate and always had because my doctor warned me about this when I started them 7 years ago.  For me, PPI's and H2 blockers together work best for for me.  The benefit outweights the risks for me.  I am miserable without my meds.  Chronic GERD can lead to Barrett's espophogus (which is precancerous) so you have to find what works for you.
I hope you find that the H2 blocker works well for you...you may have to try a couple to find the best one.

The big foods for me to avoid are
caffine
chocolate
wine
citrus
(do a search, there are more)

I also sleep at an angle to avoid the acid from coming up into esophogus.  They make special wedges and pillows just for GERD.  Also, not eating 2-3 hours before bed.

Some doctors say that if the surgery caused your reflux that it could go away after time when your body adjusts.  I know mine won't.  It was there before surgery.

Good luck!!!

maylox was one of the only things that worked for me its nasty but it works fast and every time all the daily medications would work for awhile then stop

Hmmmm great info.

But why does the surgery cause GERD?

donna

Initially, the stomach does NOT recognize that it is so much smaller and produces enough acid for our previous big stomachs. Plus, the sleeve is a hot pocket of pressure due to the swelling and drastic reduction in size.

Many people are able to wean off their PPI after 3-6 months. I choose to stay on it because it keeps me from being hungry.  Some people never suffer with reflux post-sleeve. I never had reflux before VSG either, and didn't experience it after either. I simply started having false hunger after  a meal and after research and discussing the issue with other vsg'ers that were further out,  found that reflux can cause false hunger. I started Prilosec 20mg once daily and never had physical hunger again.

The long term risk of bone issues with PPI use can be warded off with proper calcium supplementation and having bone scans performed to monitor bone density. Blood calcium levels are NOT good markers for calcium levels for bone health.

Make sure you are taking your PPI on an empty stomach 1 hour before a meal, or 2-3 hours after a meal. It can take several days for the PPI to kick in maximum efficacy, and for you to get relief. If you are on a certain brand of a PPI and are not getting relief after 7-14 days, you might need to have your surgeon double the dose (day and night) or switch to a different brand all together. Some add an H2 blocker such as Zantac or Pepcid to help get it under control. Tums and Rolaids contain calcium carbonate and can actually cause rebound reflux so I was advised to avoid those completely.

Someone please correct me if I'm wrong.....

I was told that the esophageal sphincter has a hard time adjusting to the new way of eating and stays open or relaxed more allowing the acid to come back up.  Also, your stomach is producing a lot of acid for a small abount of food.  The theory is that the body adjust to this after a while and it gets better.  This is from the surgeon's nurse, so take it for whatever you want.

My GERD is a million times worse after surgery to the point I'm miserable most of the time.  I went to a GI doctor and he is going to do an upper endoscopy on me next week.  I just hope to find the right combo of drugs to help me get some relief.