Hi all. I'm looking for some advice from those suffering from asthma and GERD/ acid reflux. My asthma has been difficult to control the past few months and I've had a continuous crackle in my chest at night, along with post nasal drip, and chest and stomach pain. A chest Xray was clear, and after posting here and hearing others have similar symptoms, I'm now convinced that acid reflux is at the heart of my ongoing issues.
After speaking to my gp and asthma nurse, I've now been moved up to Fostair 200/6 to see if that gets the asthma side of things under control ( l am also a long term montelukast user). My GP has prescribed me Peptac Liquid Peppermint antacid to take after meals and before bed - but the problem is I cant take it after mealtimes because according to all the drug interaction checkers it has a negative effect on some of the meds I take for Rheumatoid Arthritis - which need to be taken with food, and I've already had to move them around to stop them causing other issues or clashing with other meds.
So I guess I'm asking for advice on what else I can do to get the reflux under control. It would be nice to have a day where I wasnt short of breath or had pain and discomfort!
I'm planning to do an elimination diet but the nurse wants me to wait a couple of weeks to see if being on the higher dose of Fostair has an impact. What else can I try?
Thanks!
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mjrminor
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Thank you. I should have mentioned I already take 20mg Omeprazole daily and have done so for a few years to help protect my stomach from the amount of meds I take.
Omeprazole/Lansoprazole helps some people’s reflux (PPI - protein pump inhibitor) others do better with famotidine/cimetidine (H2-agonist). Reflux is known to be both a trigger and a mimic for asthma, so it’s definitely worth trying to get on top of it.
If the peptac liquid is contraindicated with your RA meds then go back to your GP and ask to try something different.
The other thing to do is to try and raise your head etc when you sleep (lie on a slope etc) as this can reduce night reflux.
Thanks Emma. I forgot to mention I've been taking 20mg Omeprazole for the last few years to help protect my stomach from the meds I have to take for the RA and other lesser issues. Maybe I should ask about the H2-Agonist instead. And I'll talk to my GP again - and look into a wedged pillow or something.
If you can raise the legs at the head of the bed it works better than a wedge because you will slide down a wedge. Also watch the type of food you eat. There’s lots of books for low acid diets. I have The Acid Watchers Recipe book. Have you tried cutting out dairy?
I'm lactose intolerant so I've had a dairy-free diet for years, but that book sounds great - thank you for sharing.
I'm not sure how my partner will feel about raising the bed. 😊 To be honest we end up sleeping in separate rooms half the week at the moment anyway, either because of my health issues or his insomnia. Thank goodness we have a solid relationship!
I suffer from the same issues and it is better to raise the feet at the head end of the bed because just using a pillow or prop could cause your back or neck strain. You will hardly notice the tilt and it could help you. Also, I am sure you know that it is preferable to not eat for several hours before sleeping. Some sufferers who take a PPI in the morning also do better with an H2O blocker like famotidine in the evening too. I hope you find some relief.
Thanks for all that useful information Lynxy. I've started eating earlier which has helped a bit. Next I need to try the bed thing and look into H20 blockers.
Hi I had the same problem. I saw my gp. She prescribed me omezaparole. I am on low dose of fostair. My gp didn't change it. She said it depends how strong your lungs. After that I eat early and I changed my diet. Have you tried gaviscon. Best wishes. 😀
Hi Kitty, thanks for replying. I've been on omeprazole for a few years now to help protect my stomach from taking a lot of meds. Unfortunately gaviscon has the same effect on my RA meds as the peptac liquid so I can't take it after meals. I've started eating dinner earlier, which is definitely helping. I definitely think I need to look at cutting acidic foods out of my diet though, which is pretty frustrating - I'm already dairy free and last year I cut sugar completely because it was causing an RA flare. At this rate I'll be left with rice. 😥
I don't eat rice that much.usually vegetables, herbal tea, meat. Ginger tea helped me with my acid reflux. I am also avoiding acidic foods. I am following Dr chatterjee BBC doctor his diet plans for acid reflux. My gp said it can happen frequently if you put weight on
I guess I'll finally find out what foods affect me once I do an elimination diet. Thanks for sharing Kitty. I'll have teo take a look at Dr Chatterjee's diet plans too.
Hi, sorry to hear your suffering at the moment. I’ve struggled with GERD for over 15years now and definitely notice the links between my asthma.
I’ve been on maintenance steroids for over 2yrs now and it’s having a huge impact on my GERD.
It can be hard to differentiate them sometimes but over the years I’ve changed my diet, cut out some foods that were triggers etc and food that are hard to digest..I can’t eat a lot of red meat these days or potatoes and pasta😕
Walking more often helps me but some days none of that works and you struggle through the day...and it can be so hard because it can effect your breathing so much.
Do you take just 20mg omeprazole? Or twice daily?
I take 20mg an hour before breakfast and 20mg an hour before my dinner. I also try not to eat past 7pm.
I recently found when I have lots of stomach acid over the counter Andrew Salts have helped and Gaviscon peppermint after food and before bed.
Hi JustR. Sorry to hear you've been dealing with GERD for so long. I'm currently on 20mg Omeprazole in the morning. I've started eating dinner at 7, whereas before it was around 8, and that has made some difference.
I'll have to look at Andrews Salts to see if I can take it. Having asthma, acid reflux and rheumatoid arthritis is a pain in the butt because the meds sometimes clash with each other and make things even more complicated - which is why I can't take Gaviscon after meals either. (Having asthma means no anti-inflammatories for RA pain relief either, but that's for a whole different post)
But I can definitely look at changing my diet. I love pasta! I'll cry if I have to cut it.
Thanks JustR. I've had to cut out things like sugar etc already because of the rheumatoid arthritis, so it pains me to think I'll likely have to cut out other foods as well - I'm such a foodie, so I feel your pain. I'll ask my GP about upping the omeprazole. Thanks again.
Have you noticed any correlation between your GERD and what you eat? I’ve found quite a bit of relief by avoiding tomatoes, any gassy drink, citrus, chocolate, curry etc. These are common triggers and it might be worth trying to cut down on them for a few weeks to see if it makes a difference. Everyone’s triggers are different though. I hope you do find some relief- it’s not a pleasant condition and really can derail asthma control.
Thank you Artichokes, I'm just at the beginning stages of figuring it all out. I've started looking at foods, but I think I need to do a proper elimination diet to work out exactly what's triggering it all. It's been going on for ages thought and I'd just assumed it was my asthma getting out of control, and my rheumatoid arthritis drugs upsetting my stomach. I'd never even thought to put two and two together and think of something like GERD.
I suffer from this and have done for twelve years. Until sixteen months ago it wasn’t too bad and I was able to control it with Gaviscon advance. But towards the end of 2019 it flared up again and has been a constant source of problems eversince.
I’m on cimetidine (I get rebound from PPIs so I can’t have them). It’s not enough by itself to control the reflux so I also still take Gaviscon advance after breakfast, after my (main) midday meal, and at bedtime. First thing in the morning and before a light supper in the evening I take the cimetidine. Because of problems at night I have the head end of our bed raised. Until last year it was raised 5 inches, but it had to be raised to six inches during a particularly bad patch. Just recently we have had to raise it again - to seven inches. It means we migrate down the bed a little during the night, but it is helping. I find it possible to distinguish between asthma flares and reflux breathing issues at night by changing my sleeping position. If it is reflux connected then lying on my left side will help to calm things down (because in that position it’s harder for the contents of the stomach to leak into the oesophagus). If it’s asthma, it doesn’t matter what my sleeping position is the breathing problems will persist.
Things that can help: if you are overweight it is important that you get your weight down. If you smoke (admitted unlikely if you’re asthmatic) it’s important to stop. As others have said, certain foods are known triggers: caffeine (and that includes chocolate); tea; red wine; fizzy or sparkling drinks; citrus fruits (and other acidic fruit - I can’t cope with rhubarb for example); tomatoes; onions; fatty or spicy food. I also have problems with reheated foods (so shepherds pie, reheated stew are not good news).
When you eat is also important (leave three hours minimum between finishing a meal and going to bed), so is what you do after eating and how you sit generally. Slouching is not a good idea (it puts pressure on that sphincter muscle at the top of the stomach).
At the moment I’m awaiting a test to check the levels of my stomach acid. It was requested in September but because of covid ... A stomach emptying test requested at the same time took place in mid December, and came back normal.
Thanks Maggie for all your helpful advice, especially about sleeping on the left side. I'll have to try that. I hope the acid level test helps to give you some answers.
Sorry to hear about issues with asthma and reflux. Im going thru the same journey but doctors here in the US are not really actively listening and just asked me to increase the amount of esomeprazole to combat the reflux. It's clear to me that the acid / reflux is worsening the asthma and making me more dependent on the inhalers. So I removed pretty much everything you can think of from the diet, included fennel tea, in the morning the first thing I eat is a banana to neutralize the acid and after that the tea, gluten free crackers. They suggested to start the day with oatmeal but I cant stomach that . I noticed nice improvements and not having bad acid reflux lately. Im now taking 20mg of esomeprazole every day and half of symbicort dose. One thing that is helping immensely is Ive been taking 10.000 units of Vit D every day to booster the immune system and reduce inflammatory disease. Im seeing quite a lot of people with asthma and other inflammatory diseases getting better taking the D as well. Are you taking D supplement to help with asthma and Rheumatoid Arthritis? There's a nice website vitamindwiki.com that has all studies and evidence there. Worth checking.
The one thing I bought yesterday that is highly recommended to lower the acid is to use organic apple cider vinegar. My plan is to dilute 1 tea spoon in bottle of water and drink during the day. I read in a few integrative medicine websites and seems that really helps
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. I noticed nice improvements and not having bad acid reflux lately. Im now taking 20mg of esomeprazole every day and half of symbicort dose. One thing that is helping immensely is Ive been taking 10.000 units of Vit D every day to booster the immune system and reduce inflammatory disease. Im seeing quite a lot of people with asthma and other inflammatory diseases getting better taking the D as well. Are you taking D supplement to help with asthma and Rheumatoid Arthritis? There's a nice website vitamindwiki.com that has all studies and evidence there. Worth checking. 
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