Hi all. I often get acid reflux (the valve on top of my stomach doesn't seal properly). I am currently on 100 mg daily Flecainide and 2.5 bisoprolol. Had an ablation for Paroxysmal AF last September.
Here in New Zealand we have available at supermarket treatments like Gaviscon, Enos, Mylanta, Quickeez to settle the stomach. Are any of these appropriate for us AF sufferers or should we stay well clear? Alternatively any other suggestions?
Thanks Blake
Not familiar with Enos or Quickezz, but have taken both Gaviscon and Mylanta and they are appropriate for us with afib. The only concern would be timing the Mylanta so that it doesn't potentially interfere with any other drugs absorption. Your pharmacist would be the best guide here. If they don't work, then the next thing to try would be a H2 Blocker like Pepsid ( famotidine). And then if that doesn't work, go to the big guns the PPI's. Neither the H2 Blockers or PPI's should present any issues because you have afib. Lifestyle wise, eat smaller less acid producing meals, don't lie down or go to bed for several hours after eating, no tight belts or garments and some find raising the head of the bed helpful.
Jim
Thanks Jim. What's a PPI? I'm not familiar with that one.I often go for a kilometre or two walk after dinner, which I find helps.
Cheers Blake
PPI abreviation for Protein Pump Inhibitor like Nexium, Dexilant, etc. And anyone who tells you to avoid them is someone who has never had debilitating GERD/Reflux that has not been helped by lifestyle, diet or other medications. It's certainly not first line, but if you need them, you need them.
Jim
Thanks Blossom. I'll chat with the Doc, see if I can get something on prescription.
Hi KiwiBlake,
I had this in my 40's when I lived in Melbourne. Fluke solution. Went to hospital and they put a camera down my neck to have a look at this valve and came up with this very diagnosis.
Sorted .... job done. The mere event of putting the camera down the neck initself solved the problem. This problem has cropped up once or twice over the years after eating but not enough to cause me any concern. Forgotten now more than I have remembered.
Prior to hospital I just used to swig Mylanta. BUT, in those days I never had AF. These days (I'm now 78 with a paroxysmal AF diagnosis but highly controlled) if I have any digestive issues I just swig Double Action Gaviscon. No unpleasant side effects.
John
I take Liquid Gaviscon extra strength - works well for me but also learned that swallowing often can help, as can sipping warm water often. I rarely now need to resort to taking anything as I managed to stop the worst affects by changing my diet.
I’ve always avoided taking any PPI’s because of the awful affects long term but I believe there are occasions when the benefits outweigh the risks. I recently had suspected ‘silent’ acid reflux which can get into the lungs and be corrosive so it is very much a risk:benefit assessment for you as an individual.
i used to suffer with reflux when I was heavier and took omeprazole which stopped it completely.Since I lost weight the reflux has stopped, not sure how it was connected.
In the month following my ablation I was prescribed omeprazole as the EP said the nerve which runs behind the heart can get damaged by the cryo freeze. Is it safe to take omeprazole long term, and is it a PPI?I might try the Gaviscon, I don't get the reflux after every meal, and some foods give me gas, which makes the reflux worse. For the last couple of weeks I've been avoiding things like onions, garlic, brocoli, and lactose (dairy) and the gas is definitely less. I need to try and reintroduce one at a time and see if the reflux and gas returns.
I'm with Bob on the PPI issue. Read the book I've recommended- it'll open your eyes as to which foods are causing the bloating (bloating puts pressure on the weakened sphincter), and explain what to do about it. You can definitely deal with this without pharmacology.
Hi KiwiBlake,
Reading others posts in reply to you. Have you considered consulting a Nutritionist (Dietician) - don't know what they trade as in NZ - I did in my very early days with paroxysmal AF. Eventually got on top of the monster with a reformed diet/food plan and eventually git on top of AF due to calming the vagal nerve. So, for the last 12 years I have become progressively AF free to the point I cannot now remember my ladt event ...I guess at least 18 months ago. That said, I still stay on my medication.
John
Gaviscon is fine but please don't take any of the "azole" drugs (PPIs_) for any length of time. Read up about them as the tend to be self perpetuating and almost impossble to come off once started.
I agree with your concern about PPI's, especially long term. However, for those of us, like myself, who have had debilitating GERD/Reflux/LPR that has been refractory to diet, lifestyle and other medications, it can be the only solution.
Yes, difficult, but not impossible to come off of and the problem is more the underlying problem than than the short term acid rebound which is real and therefore a proper weaning program must be instigated, sort of like when coming off of beta blockers.
Sometimes you have to make a pact with the devil because the other devil is worse 
Jim
Hi Blake
I guess the valve at the top of your stomach may not seal properly as you're sore and swollen there.
I'd cut out all fatty foods, yogurt and vinegar (hidden in baked beans) until you've healed, also raise the head of your bed - I put books under mine. Well chewed almonds can help, as can a banana. Never eat large meals, or you know you will suffer.
After an ablation PPI's are often automatically prescribed here in the UK but it's not good to take them long term. Losing weight if you need too can really help if you have fat around your waist. Also avoid bending for as long as you can, bent down weeding in the garden could set mine off.
Mastic gum capsules bought from a health shop or online are a great healer, but quite expensive. Don't wear anything tight around your body as that can press the stomach and aggravate the condition. Honestly, no joking, I'd buy a kaftan to wear when you're at home. Try the Gaviscon route if what I've suggested takes time to work and you're desperate.
Re gas, try to eat a little slower and for a while avoid cabbage, brussel sprouts, broccoli, cauliflower and cabbage, just have runner beans, carrots and parsnip. Once the inflammation completely dies down, you may be able to eat these vegetables again in moderation.
I've been where you are and can assure you that my tips above work.
Jean
Thanks JeanI've had reflux my whole life. Re weight I have the problem where I have quite an active physical job (farm manager) and I struggle to get enough calories in). It doesn't help when I get too busy in the day to eat and drink properly, skipping lunch, which I think over the last decade has contributed to developing AF. My weight is stable at 69kg, but I have to eat like a horse when I get home. I've recently discovered having a bag of whole almonds in my pocket which I munch on all day, is a great way to get energy and protein in.
I'm going to buy Gaviscon.
Thanks for the feedback. Blake
You will need to change your eating habits for best results 😀. It's totally doable. Can you have a substantial breakfast before you start your day? You could take the Gaviscon after your last coffee or tea and then again at night.
The almonds and grazing is a good idea if you really can’t stop for a break but mix it up a bit - add some dried fruit and other types of nuts. The biggest thing you can do to help yourself is to reduce the amount of food you eat at night and limit or avoid eating carbs and leave at least 3 hours before bedtime. Hope you get there.
Hi Jean. I trust that raising the head of your bed is only a temporary measure? I was listening to my daughter who is a senior NHS nurse giving a lecture to my wife about never lying flat to sleep. Apparently it's very dangerous as it stops some vital system the body has from working properly and can lead to death. My daughter has to insist on all the patients in her charge laying flat to sleep to avoid the problem arising. Difficult as a lot of them have dementia.
My wife is still not laying flat to sleep though!!
All the best.
Roy
I'm not sure what you're saying Roy. Is it not good to sleep flat or better to do that?
When just the head of the bed is raised, that's not lying flat.
Jean
Not good I'm afraid Jean. If I remember I'll ask her what the problem is and make a note of it and let you know.
All the best.
Roy
Hi Jean. She just came home and she said that it is the Lymph system and unless you lay flat your body does not get rid of the Lymph which is a major serious problem for it. Dr Google said this... "If our lymphatic system were not present in our body, we would not be able to drain the excess fluid, so our tissues would swell due to the accumulation of fluids and cells would literally drown, or become stagnant in the accumulated fluid and it would become the breeding grounds for infection."
Do you notice any limb swelling? My wife does as her legs swell up by the morning.
All the best.
Roy
No fortunately I don't get any swelling at all in my body. I do sleep with just one pillow.
I think you keep well hydrated too, which helps a lot in the hot weather.
All the best.
Roy
FWIW a side affect of Flecainide is an acid stomach....
That's interesting, I did not know that.
I did not know that either and i think my acid reflux (usually in the night) is recurring only since I’ve been diagnosed with AFIB and taking flecainide 🤔. I’ve had a very successful ablation 12 months ago and cardio told me I could go off the afib drugs. I’m a bit scared to. I’m 68.
Unfortunately doctors are not the ones to suffer the side effects and many doctors prescribe PPIs along with certain medications before any symptoms!
My Lifestyle GP spent half their life developing protocols to get people off PPIs because of the damage. Bob was giving information and expressing an opinion - not giving medical advice - IMHO.
Raise the head of your bed 3" to 6". It works miracles.
bicarb
Wife suffered room bad heartburn for years. Her mum and siblings also suffer. GP refused to prescribe Omeprazole due to risks of long-term use. HOWEVER , as soon as she was diagnosed with PAF and put on Bisoprolol due was automatically put on Omeprazole. She's been on it now 5 years and would not want to come off it.
Hi, I've taken Gaviscon Advance for years with no issues including when taking Flecainide. If you can get the Advance formula it's best for the upper oesophagal spincter type reflux and is recommended by ENT. LPR - the acronym used for this type of reflux can damage the laryngeal tissue. I've had this type of reflux for decades due to abdominal surgery. Here's my advice:
Avoid taking PPIs except for a short time. Why? Because acid is needed to assist with the digestive process. Without it the digestive enzyme Pepsin cannot operate. Our problem is when the oesophagal sphincter become weak and the acid climbs up the digestive tract leading to heart burn from gastro oesophagal reflux (GERD) or at the upper sphincter - laryngopharngeal reflux (LPR). What the Gaviscon can do is neutralise the acidity so it doesn't damage the soft tissues of the oesophagus or larynx, after you've eaten. The Advance formula creates a kind of raft on the stomach contents, protecting your further if you have LPR.
Further advice from acid reflux experts:
1. Raise the head of your bed with two bricks
2. If you can, sleep on your left side. I always start off like that except if I'm having an AF episode
3. SUPER IMPORTANT- finish your evening meal 3 hours before bedtime.
4. In the evening, after your Gaviscon Advance, do not eat or drink. No water. Otherwise the 'raft' will be breached.
I control my acid reflux well this way plus the knowledge gained about the digestive process and how to work WITH it from this book.
Thanks Singwell. I'm going to try the Gaviscon first. For me it's not after every meal, so I don't think a PPI is justified. I've been eliminating certain foods which is helping immensely. My situation is a combination of bloating and acid reflux. I've just gone 3 days without any sign of it. Will have the Gaviscon on hand in case I slip up and eat something I shouldn't.
Good idea. And I highly recommend the book. Bloating is usually due to FODMAPS do you need to know what to do about that.
Yes I've done a bit of reading on FODMAP. I've cut out a couple of things already. Thanks
I’ve done the whole FODMAP thing and it was helpful. However, I caution against doing a DIY version. It’s not a diet for life, the elimination phase, followed by a very methodical reintroduction phase, should be seen as a diagnostic test to establish which foods are causing digestive symptoms. I did this under the supervision of a specialist dietitian, and that’s my advice to anyone thinking of this approach. What you believe or expect you may be sensitive to may well turn out not to be the case, whereas some foods you don’t suspect at well may turn out to be the culprit.
The reason why a diet that eliminates FODMAPs is not a good idea long term is that it omits many foods (plant fibre) that are beneficial for the health of the gut microbiome and there are studies that show that eliminating FODMAPs will deplete the diversity of the gut microbiota. So that’s why the elimination phase is only 3/4 weeks or so.
Someone saying “oh, have you thought about cutting down on FODMAPs?” is not good advice. If you can’t see a registered dietitian on the NHS specifically to help you with this issue, there are freelance dieticians who will be NHS trained who specialise in digestive health. (Please avoid “nutritionists”, it is not a protected title. Anyone can call themselves a “nutritionist.”) You will only need 2-3 sessions so it may be money well spent. Otherwise you’re just floundering about and making it up as you go along.
Also want to add, FODMAP elimination is to address fermentation in the colon. It’s not recommended to treat acid reflux which is in the upper digestive tract, so whether it has any impact on this I don’t know. I suggest you see a professor instead of asking for advice from random strangers on the internet.
I’m
On the same meds as you
I know this sounds mad but I
Find a glass of tonic water helps a day
Avoiding white flour products also helps
I've been tested for gluten intolerance and I'm fine in that respect. However I read that you should cut down on carbs particularly wheat as we get older. So I have cut down on white flour such as white bread.
I take Famotidine 20 mg twice a day . It is an over the counter stomach acid blocker. I started with once a day but after about 5 years I needed more. It is not recommended for long term use so if you try it, check with your doctor. My docs know I have been taking it a long time and are okay with it . I also take a B12 vitamin daily because lowering your stomach acid can lower your B12 levels. Bottom line, I feel like famotidine helps prevent my afib. I noticed afib often started for me after eating or with indigestion . I think the famotidine really helped break that pattern. It is different than a PPI.
Yes for me bloating and indigestion is a contributing factor. If bloated I feel the reflux more particularly when sitting down. I also feel the pressure on my diaphragm, and feel the pressure on my heart, which can increase my risk of flipping into AF. Standing and/or walking gives me immediate relief.
Hi KB … I’ve been on Lanzoprazole (low dosage) for years.
You might find my response higher up the thread helpful. Medics are not in agreement on PPIs. My ENT won't use them except in acute situations. Blajes description is not acute
For reflux, my dr scripted me 20mg rabeprazole sodium, however, you seem to have a pretty heavy problem with a seal leaking. I'm from Australia.
Agree you need to research PPIs. They were designed originally for post surgery but now doctors push you into them as it’s an easy fix. This investigation was comprehensive and the findings worth considering safetyandquality.gov.au/sit...
One of the big differences between this forum and BHF forum is there is a lot more discussion and thankfully far less in the way of posts disappearing and people being banned on all sorts of issues and you CAN mention the C word and it’s affects.
I have AFib and I am also in remission from GCA. I was prescrib Lansoprazole, eventually increasing to twice a day but it did not help and I even came to suspect it was actually making things worse. Anyway, during a period when my GP was trying to find if any of my drugs were causing the terrible itching l was experiencing, I was taken off the Lansoprazole and advised to take Gaviscon 4 times a day,; after meals and last thing at night. My stomach improved immediately and I have stayed on the Gaviscon.
I used to find that Rennies (calcium carbonate, magnesium carbonate - also with alginic acid in their dual action product) provided relief.
But cutting out gluten got rid of the heartburn/reflux, and I don't need to take anything now.
I find sucking a Rennies before I go to bed, very helpful too.
After years on ranitidine, was moved on to omeprazole, couldn't tolerate it, changed to lansaprazole and have been on that ever since, lost count of how many years. Reflux control was OK during the day but it would all start again at night. Doctor prescribed me Gaviscon Advance (other forms of Gaviscon too weak, not effective), and have been on regimen of lansaprazole before breakfast and Gaviscon Advance on going to bed for several years. It works for me, I eat most things but try to avoid or minimise fatty foods. Can't say I have established link between diet, reflux and my paroxysmal AF , but open minded.
I often had acid reflux and a lot if indigestion during the night until I stopped drinking alcohol. Cured overnight.
I have the same, and I take a PPI inhibitor and have done so for years now. If I had my time again, I would try hard to find an alternative but none of the others worked for me. For years I tried Gaviscon and similar - no use whatsoever for me. Rennies were my go-to relief (calcium and magnesium carbonate). If your reflux is causing problems something needs to be done to prevent erosion and worse. In the end, I succumbed to omeprazole (prescribed), then lansoprazole and more recently, esomeprazole.
You'll likely read horror stories from some who hate these types of drugs, but two years ago I saw our leading prof from Leicester Medical School, and he thinks they are saving a massive amount of lower oesophageal and other problems and cause very few problems themselves (the main argument against their long-term use being that in a very small number of people they can reduce calcium and magnesium absorption from the gut).
Steve
It’s incredible how many people want to treat a problem by not treating the problem, or rather embarking on cutting out fashionably faddy food groups and taking exotic-sounding supplements — and somehow that’s addressing the “root cause”.
I suffered badly after AF diagnosis which is due to meds. Now on lansoprazole taken 30 mins before breakfast. This has helped but occasionally I need a gaviscon during the day. I have found white flour doesn’t help so trying to cut this out. I can eat sour dough bread without any problems. Everyone s digestion is different so it’s trial and error.
It’s interesting regarding flour and sourdough given the similarity of the two. I imagine it to be how, where and how quickly these carbohydrates become released in the GI tract.
I recall a study from many years ago which I’d love to find again. It showed a really major difference between traditionally stone ground and modern milled flours. I think, today, even “stone ground” flour isn’t what it was and is far finer.
Steve
Sourdough is fermented. The lactic acid bacteria break down the fructans (oligosaccharides) which is often associated with IBS as many people have lost the gut bacteria to break it down (“western” low fibre diet and exposure to antibiotics over one’s lifetime). So that’s thought to be the reason why some people find sourdough easier to digest. Fructans are fermented in the colon hence the gas and bloating some people experience after eating bread and why so many people self-(mis)diagnose themselves with “wheat” or “gluten” reactions. It’s almost always the fructans component. Sourdough bread can be a better option in that respect. However, it’s expensive and finding a bakery that sells genuine sourdough bread isn’t always easy. (Supermarket versions are known as sour-faux as they’re usually not the real thing,) Some people make their own but I don’t think it’s easy to get right and takes a lot of trial and error. I’m not much of a bread person myself so I will make a buckwheat or oat loaf based on a soda bread recipe.
That was mostly new to me and very helpful indeed. Thank you! The trial I referred to was something that has never left my mind is the many years since I read it and left me forever suspicious of fine flours. I'm not even sure that wholemeal isn't overly fine, these days, and I can't find much online about it.
Steve
It’s certainly interesting. My nephew’s friend is very reactive to wheat fructans to the extent of being sensitive to different varieties of bread flour. I would like to give sourdough a try but it would be a bit like keeping a pet and I doubt I could eat the quantity of bread I’d end up with anyway. I’ll stick with kefir making, that’s much easier, though still a bit pet-like having to decide what to do with the grains if you’re away from home for more than a couple of nights.
Best thing I ever did was to cut down on all bread products. Take it you have a hiatus hernia.
I do an exercise every morning that a friend found online written by a doctor and suck the odd tablet or have very occasional Gaviscon and the odd tablet of Omeprazole but though I have a hiatus hernia and my oesophagus has been slightly damaged, I have hardly ever been aware of the acid reflux - guess that’s ‘cos it only gets as far as half way up my oesophagus!
gaviscon and mylanta are quite short acting and might bind good minerals (like magnesium)and decrease their absorption.PPI like omeprazole are potent but they completely block the acid production and it is now known that while taking them longer time they may deplete the body of magnesium and multiple vitamins.Lower magnesium is the last thing you want to have with a fib
Zantac and Pepcid are the best and safest and can be taken regularly or as needed ,help the symptoms and do not deplete the body since some small amount of acid production remains
Jerryczech
Hi KiwiBlake - had acid reflux quite bad years ago. I stayed away from PPIs due to the downside of these meds. I took a different approach: my naturopath said the issue was not enough stomach acid when I needed it and stomach sphincter not closing enough allowing acid to enter oesophagus causing burning and pain. Short story, I took a bitter like Gentiana Root tincture 30 - 60 minutes before I ate to bring on digestive juices, ate smaller portions and propped up a pillow at night and gave my oesophagus time to heal. I did use Gavescon during acute phases to deal with the dropping pain (which radiated into my neck, back, arms, etc. mimicking heart attack symptoms). Losing weight was also helpful. No longer have acid reflux. Hope this helps.
Steven
I have AF and acid reflux and I take Lanzaprazole , which can only be obtained with a prescription. Hope this helps.
Hi, I've had acid reflux foryears and always been prescribed Lanzoprazol
Hi KiwiBlake
I had reflux first diagnosed in 2020. I was on prilosec. Then I started taking Goli gummies two in the morning and two before a meal I knew would be acidic, like pasta. I did this for about 1 1/2 years and now I’m not on anything. The Goli gummie is made with apple cider vinegar and changes the ph balance of your stomach. My son was diagnosed with H. Bacteria in 2019. He lost 30lbs because he was nauseous all the time. He was put on a PPI and ATB for a few weeks. Then did the Goli gummies. Same way as me. He is also not on anything now. I am a nurse and believe in the science behind using these. It can’t hurt if you try. Over the counter everywhere Target, CVS, Giant Eagle, Walmart etc. Also on line. I’ve recommended this to others with success. Hope this can help you. No side effects. No interference with other meds. It’s like $17 a bottle and can be $14 if you buy in bulk from website. I use to buy bulk like 6 bottles at a time. Once open they get sticky so I store open bottle upside down. Easier to get out. Good luck!
Tina
You might investigate having a fundiplication to solve the problem of reflux permanently with no need for any meds/supplements at all.
Hello there ~ I also have acid reflux - Gord and have tried several gastro-resistant tablets. However, the medication taken now seems the most effective which is Pantoprazole and was fairly new on the market when it was prescribed for me by my doctor. I emphasise for me, being mindful that it might not suit everyone of course. I hope this helps though.
HI, I take quarter teaspoon of baking soda in water , works quickly for me.
Have you an Hiatus Hernia as someone suggested above.
I got some meat stuck and had to have an emergency scope which dislodged the meat but showed I have an Hiatus heria, and was told I would need omeprazole for life, as the hernia can cause barrett's oesophagus which can cause cancer.
My afib is not altered by anything I use for my GERD.Bisoprolol is used to reduce your HR and has no impact on AFib.
My gerd is managed best by pantoprazole or rabeprazole (or the more expensive dexlansoprozole.
There are a few over the counter fast activating solutions but they are more expensive than prescriptions.
My advice is talk to your GP about gerd solution for you.
And ask for a referral to get a Gastroscopy (as I have done).
lanzaprasole if you can get it.
Hi all. Thanks to everyone who has replied. I wasn't expecting such a big response. Lots of really good advice, some differences in opinion, great to see all sides. Response has even such that I can't reply to everyone individually. Really appreciate it however and has given me plenty to think about. Thanks Blake
You’re being well looked after. One issue with PPI drugs, as I found, is that on stopping them, the reflux bounces back rather fiercely, so when the twelve months are up, arm yourself with lots of Rennies!
Steve
Hello
Been reading all these posts
Does Goli Gummies interact with warfarin ?
I am on Warfarin for life
I have had GERD for years
I am in permanent AF, I have just had an AV node ablation and I have a pacemaker
I do take cider vinegar and know the benefits
I do take PPI
I don’t want to but have to
I understand about acid in the stomach and the negative effects of PPI
I also have a hiatus hernia
Hi
KIWIBLOKE!
I took all sorts including RAGWOOD or something before AF and Stroke.
I had my gall bladder out! It had disintegrated!!!!! Trouble since age 4.
Chalk stuff and Dinnefords! Years ago.
Do keep to a LOW FAT Diet. Coffee with milk like Capucchino better and never have it later than 2pm.
Without gall bladder great!!!!!
Have a mouth to stomach scope. Have a scan. My 'balls' were blood balls.
It waa not until I said "my grandfather had his out" that they were bothering about going ahead with surgery - now out through tummy button.
I have just 2 Stainless Steel clips. They show on Xrays and MRIs.
All the best. I ask for special GA to stop reflux and no more vomiting after ops.
cheri JOY. 74. (NZ)
Omeprazole in the morning and before bed has controlled my acid reflux for 20+ years. It doesn’t interfere with my AF prescriptions.
Anyone with experience of taking PPIs for GERD/acid reflux together with AF? 
Robitussin for chesty cough, ok to take with AF?
Acid reflux
When to take PIP flecainide?
