Acid reflux driving me mad help!

Ive suffered with acid reflux for as long as I can remember, the last few months its got to the point where at times I cant eat if I do I'm sometimes sick, the burning is so bad its sometimes unbearable. Ive been on omeprazole nearly 10 years now, I had an endoscopy when I was 15 which showed oesophagitis, so when I eat its painful as it goes down. Its making me very wheezy and im usually a non wheezer. Im already on 40mg of omeprazole twice a day (ive also tried esomeprazole and various other things) and metoclopramide for sickness, gaviscon dosnt help at all anymore, I sleep sitting up dont eat late at night the usual recommended things to prevent it, con wasnt very helpful last time i told him. Ive also got a large hiatus hernia according to a chest ct i had a few years ago, so thats obviously not helping too! it's making me very misreable any suggestions as what could help please?? sorry fot the long ramble its getting me down.

9 Replies

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  • Hi Clare,

    Went to a conference last week & heard a good lecture from a Prof Morice from Hull (spelt correctly) but he spoke about none acid reflux. Might be worth doing a literature search on his papers to see what he suggest. Failing that get a referal to him.

    A

  • Hi Clare,

    I am sorry to hear that you're suffering so much with your reflux, it is miserable, I know. I can sympathise - I've had reflux for a number of years, now made worse by slow gastric emptying due to gastroparesis (due to damage to my autonomic nervous system (the automatic part) from a prolonged ICU admission last year). I'm on high dose esomeprazole, supposedly the 'best' PPI, as well as domperidone (which works in the same way as metoclopramide to speed up gastric emptying - I can't take metoclopramide), copious amounts of Gaviscon and various other anti-sickness meds as needed. I still get symptoms on that little lot, particularly if I eat too much at once, and at night. I get heartburn and indigestion, as well as acid regurgitation and sometimes vomiting. I've also recently developed an iron deficiency anaemia for which no other explanation can be found, so it looks like I've probably got an ulcer or gastritis/oesophagitis which is bleeding a little. I'm currently waiting to see a gastroenterologist to see if I need further investigation for this - normally they would just automatically do an upper GI endoscopy, but my respiratory consultant is concerned that this might be dangerous as my asthma is so brittle.

    Like you, I feel that the reflux contributes to making my asthma worse, particularly the night-time symptoms. Bronchodilators such as beta-agonists and aminophylline/theophylline can also make reflux worse by having a dilating effect on the valve in between the stomach and the oesophagus, so it's a bit of a vicious cycle.

    It sounds like you are on a good combination of medication and are doing all the right things. The only other thing I would add - which I am sure you are probably already doing - is that eating little and often usually works best for folks with reflux. You probably know if there are any particular foods that trigger things or make your symptoms worse.

    If you're still getting significant symptoms on all that medication, I think you need to ask to be referred to a gastroenterologist for further investigation and treatment. There are other thing they can do. A procedure which is becoming more common these days is one called Nissan Fundoplication, which is a surgical procedure where a portion of the top part of the stomach is wrapped around the lower oesophagus to tighten the valve and help to stop food from refluxing up. It's usually done using minimally invasive laproscopic (keyhole) surgery and is generally well tolerated. Obviously, any operation is potentially risky when you have bad asthma, but this procedure is done on people with severe/brittle asthma and doesn't usually cause problems provided the surgeon and the anaesthetist are experienced and aware of the issues involved.

    I'm not a gastroenterologist or a surgeon, and I don't know enough about your specific problems and what tests and treatments you've had done, so I can't really say whether Nissan Fundoplication would be appropriate for you, or whether there are any other treatments that could be considered. I think you definitely have grounds for asking for a referral, though, given that you're still having symptoms on all that medication and that it's making your asthma worse.

    Hope this helps

    Em H

  • Hey em thanks for your excelllent reply.

    I'm deffinately going to ask for a referral, I used to see the gastro docs when I was a teenager thats when they did the endoscopy and found esophagitis, ive tried domperdone, ranitadine and a few others that I cant remember the name of, my dose of omeprazole has been increased over the years. With interest i notice you said you was anaemic, I too whilst in hosp in jan was found to be anaemic with no real cause found, now thinking could be the esophagitis.

    Could also be the reason why i have had a very productive cough lately, I'm usally very productive anyway but more so since reflux has worsened, I was started on Carbocisteine last week for this reason. I've only ever had the endoscopy, when I did the difficult asthma protocol at RBH they wanted to do a ph study but never got round to it, they did prescribe esomeprazole but it worked just like the omeprazole and I was still getting symptoms and because my local hosp where unable to prescribe it I ended up just taking omeprazole again.

    oh well will keep guzzling the gaviscon till my next appt in a few weeks, works for about 10 mins.

    clare

  • Dear Clare,

    I hope you don’t mind my being drawn into this thread, as my case is probably very simplistic –and may not be entirely helpful, but is my own experience.

    I do believe that I suffered from acid reflux during most of my thirty-something years, but have been much better since. At the time I thought it was just acid indigestion, and it is only now in reading posts on the site that I now think that it may have been acid reflux, but never had a doctors’ opinion.

    Typically I would have just a minor irritation, like a mild heart burn during the day – but at night it could be intolerable. I also used to wheeze sometimes after a large meal, especially in a smoky environment.

    I was always doing these very little burps where I would release part air and part fluid into the throat. Sometimes I couldn’t entertain going to bed with it and would stay up and actively encourage myself to bring up this content with lots of these little berps –it would be like a white frothy phlegm (Please excuse the graphics but perhaps it was last port of call of the excesses of my rhinosinusitis!) which I would expel as much of as I could, then have a glass of water. I would then follow this by a very small glass of milk from the fridge, sipping it very slowly over an hour or two or so whilst watching a film and this seemed to bring the burning down enough to be able to lie down and go to sleep.

    The condition was always worse if I had a beer or slice of toast before going to bed, but loosing these didn’t cure it. My breakthrough came when I gave up my Wimpy toasted tea cakes at 4pm in the afternoon habit! (A habit of many years and might add). I can only assume that they had a small egg ingredient, to which I am allergic -and this created the conditions for heightened reactions with other things such as yeast etc.

    I still allow plenty time before any bites and hitting the pillow, and only occasionally resort to that slow milk drink routine – in fact this year I don’t think I have.

    I think I am very lucky not to have had this as a chronic condition.

    Best wishes with your journey to beating it.

    Twizzle

  • Side thought but just in case things have got worse i was taken off carbocysteine as it makes me feel and be so sick

  • Thanks for the warning marmite I've been on them over a week now, not noticed any side effects like you describe, but then again reflux could be masking the side effects of sicky feeling, as I'm constantly feeling sick with it, seems to be helping the phleghmy side of things though!

  • acid reflux

    dear clare, i used 2 get acid reflux nearly every night. was on same meds as u. it caused lots of chest infections needing intermittent i.v. antibiotics and cyclizine i injected. stuctually it scarred my oesopegous and interfeared constantly with my type 1 brittle asthma. i know am almost acid reflux free just the odd flare up. we found i had a allergy 2 wheat after it gave me anaphylatic shock. i stopped eating wheat and this improved the acid reflux it's been no cure but is much better. could it be something u r eating? shaz

  • Hi I am 43 and waiting for nissan fundoplication op, been waiting since Feburary 08. I am new to asthma (although did have symtoms and blue inhaler during my teens.) This problem has caused my asthma. Resulting in the last two weeks calling out an ambulance twice, finding the whole thing a nightmare, hoping that the asthma may go when i have the op, had a bad asthma attack at work in march and was diganosed with asthma then, now continues to be a problem. Been suffering with GORD for years, i also have a hiatus hernia, which will be sorted during surgery. The reflux at night is the worse regually vomiting,chocking can't eat hardly anything, I have lost 2stone + in weight (which i could afford to lose!)

    If anyone else has had this problem has had the surgery please tell me the asthma will go after surgery! Julie

  • Poor you

    I had acid reflux for many years and was treated with renetidine before discovering I had a sever aspirin (salycilates) allergy. Aparently ranitidine was making things worse. Could Ranitidine also be agrivating your symptoms? Just a thought.

    Hope you improve soon

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