proton pump inhibitors / acid reflux

hey everyone,

does anyone out there have asymtomatic acid reflux? I have just been asked to try proton pump inhibitors (again) they didn't have any effect last time I took them, but registrar (a new one !) thinks its worth re-visting at a stronger dose for more than a month, which is how long I took them last time. I don't have any noticable symptoms of acid reflux, and I was wondering if anyone else was in the same position. I am game for a laugh and I don't think the side effects are too bad so I agreed to have a go.

RI

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Hi RI,

I have been on PPIs for years for acid reflux, and am now on high dose esomeprazole (supposedly the 'strongest' PPI) as well as domperidone to make my stomach empty more rapidly and copious amounts of Gaviscon. I still get quite bad reflux symptoms on this combination, and am waiting to see a Gastro-enterologist to see if there is anything else that can be done, although the treatment I'm on is pretty much maximal medical therapy.

Gastro-oesophageal reflux disease (GORD) has an interesting interaction with asthma, in that reflux can certainly make asthma worse, especially at night, by the effect of small amounts of acid spilling over and irritating the lungs. However, asthma treatments can make reflux worse, by having a dilatory effect not only on the airways but on the valve between the stomach and the gullet.

It is possible to have 'silent' reflux, which doesn't have the usual reflux symptoms but can still contribute significantly to asthma symptoms. Because of this possibility, it's not uncommon for people with severe asthma to be tried on PPIs to see if it makes any difference to their asthma. There are tests for reflux, but they are all fairly invasive, so it's often seen as the nicest intervention to try treating first and see if that helps.

As you say, PPIs are generally very well tolerated with few side effects, and they are pretty effective - usually - at shutting off acid secretion almost completely. For most people, there's very little to lose from trying them, and potential for significant improvement.

Do let us know how you get on!

Take care

Em H

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I didn't have any symptoms but they did a 24hour probe thing at RBH and found i had reflux i just hadn't noticed any symptoms with all the other things going on. Am now on omeprazole Give drugs a try nothing to lose!