Anyone with experience of taking PPIs for GERD/acid reflux together with AF?

[4optimistic]

Sorry to bing this issue up again but I would really like to hear from anyone who also suffers from GERD/Acid reflux and is taking PPIs. Whilst a link has been suggested between reflux and AF, I can't find much reliable information on the link between PPIs and AF. In my case I take 80mg Pantoprazole and the NHS site on Pantoprazole states it can cause 'irregular heartbeats'.

I have just been diagnosed with Paroxysmal AF and what concerns me is that if the PPIs can cause irregular heartbeat then it would seem logical it may well be a trigger on a far too regular basis for episodes of AF. (Whist at the moment I have regular heartbeats, I do have lots of ectopic beats)

Has anyone had/having experiences of the above and how do they handle it.

Lots of good wishes to everyone.

[4optimistic]

Please note that I am most grateful to those members who replied following my last post on same subject - PPIs and AF - and I have gained such a lot from the replies. No need to reply again, thank you.

Lots of good wishes.

[meadfoot]

I have both af and gerd and struggle greatly. I took ppis for six years and didn't make a connection between the two. Over the years I changed from ppis to ranitidine. It could be coincidence but I had less af after I stopped the ppis.

Recently my gerd has got worse and it had been suggested I go back on ppis which I did in November last. Bingo more af and more ectopics so I stopped them again. That's my experience I can't prove a medical link although I have read of the connection but I won't go near them again and my EP and gastroenterologist aren't pushing me too either. Hope this helps.

[4optimistic in reply to meadfoot]

Yes your reply has helped. Thank you.

[Gwersey in reply to meadfoot]

Hi meadfoot. What medication are you taking for GERD now?

[meadfoot in reply to Gwersey]

I am currently taking ranitidine which works differently to ppis apparently. It is ok and works fairly well. I do take gaviscon on occasion too to quell reflux and bolster my ability to keep things under better control. Apparently according to my motility and ph 24.hour reflux test I have no motility in my Oesophagus whatsoever and severe reflux too so I am in a bit of a mess in that respect.

[Gwersey in reply to meadfoot]

Had to look up 'motility' as I'd not seen the word before. I tried stopping Omeprazole and took ranitidine instead, but had to go back to taking Omeprazole. My stomach was behaving like a washing-machine cycle every day so I stopped the ranitidine.

I'm to have a 24 hour nasal monitor (a tube in my nostril going to my oesophagus) which I'm dreading. I had an endoscopy last year and it made my ectopics so much worse. My gastroenterologist flatly denied any association with endoscopy and ectopics. The belief in their infallibility amazes me sometimes.

[meadfoot in reply to Gwersey]

I totally agree about ectopics, af and endoscopy and my EP agreed. He said it was a price worth paying to get to the bottom of things but easier said than done isn't it. The eosphagus and atria are extremely close so I can easily see how it could impact.

I had the test you mention or one very similar to detect the motility issue I had a nasal tube Inserted for ten minutes and drank water while they monitored it then I had 24 hour ph acid test. I was really concerned it would set off my af and ectopics having the tube in place but it didn't cause any issues much to my relief. Here's hoping the test gives some information and treatment to help you.

Incidentally I don't like ranitidine and have concerns it is contributing to my chest and stomach pains but my heart won't tolerate ppis and I don't know of other meds to help. I am currently undergoing further tests in London where I have gone for a second opinion and they are being thorough.

Good luck with your test.

[Gwersey in reply to meadfoot]

And good luck with yours.

[4optimistic in reply to meadfoot]

Hi Meadfoot. You said you were going through further tests. When you are able would you be able to share the results? If not - no problem - and good luck.

[meadfoot in reply to 4optimistic]

Happy to share when I eventually get the results. My GP has rung consultant for them but not received anything as yet. Very frustrating as I am in a lot of pain.

I was referred by my GP to local pain management clinic and was disgusted at my appointment when a very arrogant doctor told me I should accept the pain not search for a diagnosis and accept I will have chronic pain for life. Suggested CBT. Laughable if it wasn't so disgusting.

So hope things are manageable with you. I will report back as soon as I have test results. Best wishes.

[4optimistic in reply to meadfoot]

Thanks meadfoot. Ironical isnt it - first law of medicine via Hypocretes his good self - 'Do No Harm'. Second law - 'treat the patient not just the disease.'

I suppose thats difficult when GPs only have 8 mns but always nice to have some empathy. Look forward to your next post/results and I do hope its encouraging for you. Best wishes.

[Auriculaire]

PPIs prevent absorption of magnesium from food and supplements and can lead to magnesium deficiency. This would explain irregular heartbeats . In my opinion ( non medical) they are one of Pharma 's inventions we would be better off without. There are lots of alternative ways of dealing with GERD . Our stomachs are acid for a reason - to digest our food properly and kill off pathogens.

[Gwersey in reply to Auriculaire]

What alternative ways would you suggest? I would be happy to try anything.as an alternative to PPIs.

[Auriculaire in reply to Gwersey]

The only times I have suffered myself from reflux have been after disturbances to my microbiome and I found taking probiotics helpful. After my first attack of diverticulitis the combination of the antibiotics and then the colonoscopy prep made it quite bad and I had never had problems before. I remember doing a search for alternative methods of dealing with it but as it was four years ago can't remember them all. I do remember stuff about people who had actually taken some sort of hydrochloric acid capsules for the problem and it had cured it!

[barbly1]

When I first experienced two fast heart runs about a year and a half ago, as well as some pain in my chest at night, I didn't know it was afib, but was worried that something was wrong with my heart. Went to a cardiologist who did a stress test, and all was so well that he believed that I was having acid reflux, so prescribed omeprazole, which seemed to immediately correct the situation. Six months later, I ended up in an ambulance going to the ER as my heart was beating more than 220 beats per minute, while I had double pneumonia. (Walk in clinic had said it was just a cold five days earlier). That was the first of two episodes of 220+ heartbeat, separated by a month. Lots of PVCs as well, Flecainide and Metoprolol could not stabilize my heartbeat. I had an ablation at Texas Cardiac Arrhythmia in September, which has totally corrected my afib, but not the PVCs, so I continue on the Flecainide, Eliquis (anti-coagulant) and MagOx 400, in addition to the omeprazole. Since I don't have a magnesium deficiency, feel fantastic with the Flecainide, and don't really have any digestion issues that a few papaya enzymes can't fix when periodically needed, I hate to rock the boat. Though Dr. Natale told me after surgery that he could do a separate ablation for the PVCs, for now, since things are stable with my current regime, I will wait. I have thought about getting off of the omeprazole since it has been associated with many negative conditions, but understand that you can't go cold turkey, and it can really cause your stomach to start pumping out acid and make you feel horrible. For now it works for me, so I am not going to make medication changes.

[Madscientist16]

Hi 4optimistic, We have chatted before. I had my AF diagnosis while on PPI's for gastritis. My EP did not believe there was a connection until I mentioned that one of the long term side affects of PPI usage was low magnesium absorption due to low stomach acid. Magnesium deficiency is know to cause arrhythmias. Because my magnesium blood work was normal during my diagnosis, he insisted that this was not the cause of the AF. I am not so sure I agree. After doing further research, serum or blood magnesium test results do not necessary represent the intercellular magnesium amount in the body, so I could have still been deficient. Although I have not had another episode of AF since my diagnosis, I experienced a lot of ectopics daily that taking magnesium supplementation did not help, but I was still on PPI's. I have since weaned off PPI's and have had a huge decrease in ectopics. I will never know if magnesium deficiency caused my AF, but being off PPI's (and now better able to absorb magnesium from my diet), my heart is much calmer.

[4optimistic in reply to Madscientist16]

So pleased for you. I have a long way to go to reduce my 80mg of pantoprazole a day - but trying! I have a few added complications as I am a laryngectomee which means reflux can effect the tissue in my throat which hold/support the 'speaking valve'. Some people call it a voice box. I also have COPD so I am between a rock and a hard place. This site certainly gives me the enthusiasm and inspiration to keep battling on.

I'm really pleased your strategy has worked and I will be following your example. Best wishes. And best wishes to all those who have replied.

[Madscientist16 in reply to 4optimistic]

Sorry to hear about your complications. Get through them first, then battle on. We are rooting for you!

[EngMac]

Look up Dr. Sarah Myhill and GERD or Dr. John Bergman and GERD. They both tell you what is the typical cause and the solution is not PPI's. These make the condition worse. Your stomach does not have too much acid but instead does not have enough. A table spoon or two of organic apple cider vinegar, when it occurs, will likely stop it.

[4optimistic in reply to EngMac]

Thanks for that. Will do.

[Supernerogirl]

I have acid reflux and I’m on Omeprazole 40 mg a day and I take Nebivolol if helps I have a Hyatus hernia diagnosed 3 weeks ago but suffered with the acid reflux for a while now .