AF and acid reflux (gerd): I read an... - Atrial Fibrillati...

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AF and acid reflux (gerd)

Fight-the-good-fight profile image

I read an interesting article suggesting PPI medication used for acid reflux could help lessen AF episodes.

Some studies suggest there may be an association between acid reflux and AF..

This is of interest to me given my episodes of AF occur mostly after a heavy meal and or alcohol.

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Fight-the-good-fight profile image
Fight-the-good-fight
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34 Replies
BenHall1 profile image
BenHall1

I think the connection is the Vagal Nerve. Since I identified food as my trigger for AF I have followed diet recommendations aimed at calming the VN, thereby calming the heart. However this connection does not apply/ follow suit for everyone or every sufferer with AF. Certainly is true for me but, I must say acid reflux isn't applicable to me, never has been. There again, alcohol nor cold drinks or ice cream doesn't affect me whereas some folk are affected. For me its just food aggravating or inflaming or in some way making the VN dysfunctional, thus triggering an AF event. I have never needed PPI medication nor used it.

Fight-the-good-fight profile image
Fight-the-good-fight in reply to BenHall1

Hi BenHall1,

Thank you for your response. I believe food is the trigger for my AF.

Since diagnosis I have eliminated alcohol, caffeine and dark chocolate from my diet.

I do not eat after 6pm in the evening.

You mention “diet recommendations” to calm your heart rate. Can you tell me what those recommendations were?

Thank you.

BenHall1 profile image
BenHall1 in reply to Fight-the-good-fight

Hi Fight-the-good-fight,

Well, Long story short. Once I'd convinced myself food was the issue I eventually consulted a Nutritionist. She immediately got me to exclude Gluten, Wheat and Oats from my diet. She also suggest that I maintain a food diary on a range of other foods to see which maybe affecting me. An interesting exercise spread over a considerable length of time. Other exclusions over time, some years in fact, became, lettuce (Rocket is okay ), tomatoes, onions, ( spring onions - shallots are okay ), soft cheese ( hard cheese okay ), pasteries, roast duck, roast turkey, pork with the crackling on it but 'Butterfly Pork' steaks are OK, scrambled eggs are out, yet poached and fried eggs are fine. Porridge is out. No eating my main meal late - usually 6 pm ish works well. Eating small too.

Amazingly, caffeine, alcohol and any forms of chocolate do not in any way affect me. (Thank goodness 😂😂 ). So for my point of view it is a matter of not just the food itself, but the ingredients of food that causes the problem, not forgetting how the food changes when and how it is cooked. I stayed with this dietary process over many years. Some foods I have been able to return to, others not. Another weird feature of all this is junk food. I can eat very little of Mcdonalds products ... yet I could eat the whole KFC chain outta business without any bad side effects at all. 😱😱😱😂😂😂

As I've said on here before I can't remember when my last AF event was, at least 18 months, maybe as long ago as 4 years. But even with my diet I have always remained totally dedicated to my medication .... none of this on again off again with meds although I have recently successfully changed my beta blocker from Bisoprolol (5mg ) to Nebivolol (2.5 mg ).

Sorry, I did say a long story short ..... went wrong there !!

Stay well.

John

Fight-the-good-fight profile image
Fight-the-good-fight in reply to BenHall1

Thanks John,

Glad you have managed to find a plan that works for you.

I may look further at process of elimination in relation to diet. Although, (touchwood) since abstinence from alcohol, caffeine and chocolate I have not encountered an episode for 2 months. 🤞

Do you find the side effects of Nebivolol less than the Bisoprolol?

BenHall1 profile image
BenHall1 in reply to Fight-the-good-fight

Hi Fight-the-good-fight,

Yes, definately. I have more life - get up and go in me and cetainly less brain fog Generally less tiredness too. On the down side an increase in BP and HR. This year my average BP and HR when on Bisoprolol has been 132/75 with HR of 62. Since I have been on Nebivolol it has been 138/81 with HR of 71. I have reported to my Surgery Pharmacist and with my approval the decision has been made that its OK to stay with Nebivolol for another 8 weeks and see the result then, for two reasons, one - that will see me back at work in a bus driving work environment and two - during August I had to make a couple of long haul road trips one of which involved visiting my brother in law who is receiving end of life care at home. We've known each other for some 60 years since he started dating my sister. Seeing him rips me apart - gutting.

John

Fight-the-good-fight profile image
Fight-the-good-fight in reply to BenHall1

Hi John,

I am so sorry to hear about your brother in law.

Hopefully, Nebivolol does the job.

Bisoprolol is in part being used to lower my BP, but it leaves me feeling like a zombie.

I shall speak to my GP to discuss alternatives.

Thank you for responding, good luck for the future.

BenHall1 profile image
BenHall1 in reply to Fight-the-good-fight

Hi Fight-the-good-fight,

I should have explained that my heart, BP wise, isn't probably in a good place. Structurally its OK, electrically its fine, mechanically not so good ........ the point is that I am also on Ramipril and Felodopine for BP control, so when you throw into the mix the Nebivolol, you can see an awful lot of drugs are being used to tame it in terms of Blood Pressure. I've been on Ramipril since maybe 2007 and the additional Felodopine was started in around 2013. I started the Bisoprolol in 2010 when the AF was diagnosed.

John

CDreamer profile image
CDreamer

Reducing gastric reflux to help AF - for sure, PPI as a solution to that - NO THANK YOU.

Stopping one problem for other, serious long term problems in my opinion. Very difficult to come off PPIs once started.

Fight-the-good-fight profile image
Fight-the-good-fight in reply to CDreamer

Hi CDreamer,

I am resisting PPI and eliminating foods from my diet.

I do believe Dabigatron is making my reflux worse.

I will be discussing alternatives with my GP.

CDreamer profile image
CDreamer in reply to Fight-the-good-fight

I had to switch from Dabigatran because of reflux, it is the worst of the DOAC’s for that! I am very happy on Apixaban.

BobD profile image
BobDVolunteer

Frankly I would rarther walk across burning coals than take PPIs. They tend to self perpetuate the problem they are supposed to stop and most difficult to come off once started as I discovered to my cost many years ago. Short term maybe (a couple of weeks).

Good diet and eating habits yes. and no or drastically reduced alcohol of course.

Fight-the-good-fight profile image
Fight-the-good-fight in reply to BobD

Thank you for your response - I shall be resisting PPI’s.

sunlovah profile image
sunlovah in reply to BobD

Agree, they gave me severe abdominal pain every time I ate, so basically I hardly ate. Discovered the culprit by chance, as I had to stop them 2 weeks prior to an endoscopy, then pain eased. I believe that it lowered my stomach acid (which is there for a reason)too much. Endoscopy normal, didn't start them again, 6 weeks in, not sure stomach has re-regulated the acid sufficiently, seems it can take months.

sunlovah profile image
sunlovah in reply to sunlovah

And.....I never suffered from acid reflux previously, even when all this was going on, I could lay down with no problem, no reflexetc , in fact laying down eased stomach pain.

jeanjeannie50 profile image
jeanjeannie50

I've had AF for 18 years..

A long, long time ago when I had acid reflux. I noticed PPI's would certainly help to reduce my AF attacks, but as soon as I stopped taking them back the acid would come. I managed to find a natural cure which I've often written about on this forum. Cut out as much fat and all vinegar from your diet as you can, raise the head of your bed and take a course of Mastic Gum capsules. Oh yes don't eat yogurt in any form either. Once totally cured you can go back to a normal life eating those things occasionally and lower the bedhead. I left my bedhead raised for years afterwards, just as a precaution.

Jean

Fight-the-good-fight profile image
Fight-the-good-fight in reply to jeanjeannie50

Thanks JeanJeanie,

Do you know if Is it okay to take Mastic Gum capsules with Bisoprolol and Dabigatron? I know GP’s don’t subscribe to natural remedies.

jeanjeannie50 profile image
jeanjeannie50 in reply to Fight-the-good-fight

Sorry, I don't know if it's compatible with the drugs you take. Try the other things first.

I'm on warfarin and always take it mid breakfast or that can make my stomach sore.

Vonnegut profile image
Vonnegut in reply to jeanjeannie50

I have head of bed raised and do an exercise every morning (which a friend found on the internet) every morning first thing. And careful with diet etc. I read PPIs are bad for us!

Vonnegut profile image
Vonnegut in reply to jeanjeannie50

I have a little vegan yogurt and interested to know what you think is bad about that? I haven’t had vinegar for years - except used to combat fungus on my toe nails!!

jeanjeannie50 profile image
jeanjeannie50 in reply to Vonnegut

When my stomach was sore someone on this forum asked if I was eating yogurt. Well yes I was, a healthy natural one as we're told it's good for us. Stopped having it and soreness went.

Vonnegut profile image
Vonnegut in reply to jeanjeannie50

My stomach isn’t sore so shall continue with my spoon of vegan fruit yogurt on my muesli and fruit with almond ( or other vegan) milk. I have sadly stopped having citrus fruit which I was told I should give up but my 88 year old cousin told me she hasn’t and it isn’t a problem for her! And I have a very little dark chocolate every day without ill effects as I like it and Dr Michael Mosely recommends it! As with AF, guess we are all different and respond differently to drugs etc.

Buffafly profile image
Buffafly

I had to buy a new bed when I moved and took the opportunity to buy a simple adjustable bed - wonderful! If I have reflux or breathlessness at night I just have to press a button instead of rearranging pillows. Or you can buy a wedge shaped pillow…..and definitely be careful with diet. A PPI was a disaster for me.

Ppiman profile image
Ppiman

I am much the same. Do you have a link to the article? I asked a cardiologist once if this was vagal nerve related but he assured me not. Apparently vagal irritation is very rare and leads to severe bradycardia cycling with tachycardia. He told me that vagal-AF was completely different, and often misunderstood. It is a theoretical cause of AF in people who get it while digesting food, or while asleep (i.e. when the sympathetic nervous system is quiet and the (vagal) parasympathetic is dominant).

Steve

Fight-the-good-fight profile image
Fight-the-good-fight in reply to Ppiman

Hi Steve, here is the link.

ncbi.nlm.nih.gov/pmc/articl....

Ppiman profile image
Ppiman in reply to Fight-the-good-fight

Thanks for that - very interesting. The author is correct that few other papers exist on the topic. My symptoms often feel like they are gastric as they often seem to be under my left rib where I presume my diaphragm is.

Steve

Auriculaire profile image
Auriculaire

Cut out the heavy meals and alcohol and see if you improve . To take a prescription medication like PPIs in order to continue with bad habits is silly. Especially if you are already having to take heart meds or anticoagulants.

Fight-the-good-fight profile image
Fight-the-good-fight in reply to Auriculaire

Hi Auriculaire,

Since AF diagnosis, I have eliminated alcohol, caffeine and dark chocolate from my diet. In addition, I no longer eat after 6 pm.

I believe Dabigatron is the culprit. I am going to discuss an alternative with my GP.

Auriculaire profile image
Auriculaire in reply to Fight-the-good-fight

Dabigatran can cause quite bad gastric issues. It did for me. I changed to Apixaban and still get them but much less. Size of meals is important too. Getting overfull will often kick off afib. At the other end getting too hungry and having blood sugar drop also kicks off mine!

Vonnegut profile image
Vonnegut in reply to Auriculaire

I tried to “like” what you had written but the number went down from 3 to 2, so I pressed again to get it back to 3 but really it should be 4 or more! Pity it can’t count properly!

Auriculaire profile image
Auriculaire in reply to Vonnegut

Interesting. It seems to have gone down to 1 now!

Vonnegut profile image
Vonnegut in reply to Auriculaire

I thought the system had got better at counting now, but apparently not if your likes have gone down! When I found it went down I liked again and it went up again but generally the forum is jolly supportive and friendly and “only Allah is perfect!”

Vonnegut profile image
Vonnegut

Those are both things we are told to stop having! I gave up the very small amount of alcohol I used to have before my diagnosis and never had large meals anyway but certainly don’t now!!

CHRISAF18 profile image
CHRISAF18

Absolutely try and avoid big meals also late and no alcohol for me but still get af breaking out. Drives me mad

custard1 profile image
custard1

definitely something in it, vagus nerve causes my afib, originally by sleeping on my left, but I also find indigestion, or overeating can trigger me. try best to avoid them, things generally ok . Good luck

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