Soph is having problems with AUK - she can't seem to start a new thread, just reply. So she's asked me to start a thread so she can reply with her query.
(She also appears to be under the delusion that I'm going to give her some chocolate. I don't know why - I don't share chocolate!) 
Thanks for both the thread and the free choc Philomela! im really excited about it!!
Basically - im on omeprazole (BD), gaviscon (QDS) domperidone (TDS) but still having reflux symptoms an awful lot. stomach pain, sore throat, acid taste, sicky taste in mouth a lot etc. GP is doing a few tests to check there is nothing exciting going on as he seems to be a tad reluctant to up any treatment for reflux as im 'already on everything so surely it cant be that' which as nursefurby syas isnt a particularily accurate representation but there you go. I am more looking for a bit of advice with feeling less rubbishy while we work out whats going on
Are there any foods i should go for, or avoid (im currently assuming fatty and spicy are bad)?
are there many common asthma meds that make reflux worse and is there much that can be done to protect my stomach whilse taking them (i try to eat with pred if possible)? what about strong painkillers?
im having a really hard time making my bed prop up more than a few degrees - its a rubbish matress so just flops if i put anything significant under it, so currently its just whatever clothes i can spare which doent really do much!! any ideas/alternatives anyone can think of?
how long should i stop eating before bed? im keen for it to be as late as possible as i get very hungry in the night and it keeps me up - but also dont want to make it worse!
i have bad stomach pains and sore throats a lot - whilst i wait for the underlying reflux stuff to be sorted what is the best way to treat this?
how does gaviscon work? i like to know how things work so i can take them in the best way possible!
what would be next in terms of treatment? GP wants to try a few non-reflux things to see if they solve the issue, and if that doesnt work do some kind of test (he didnt say ph but maybe its just a different name for it) to see ifit is actually reflux as he's reluctant to treat reflux any more than he is without clear proof! but where would we go next? i do feel like im on everything for it??
any thoughts other than this??
thanks guys!! x
Basically - im on omeprazole (BD), gaviscon (QDS) domperidone (TDS) but still having reflux symptoms an awful lot. stomach pain, sore throat, acid taste, sicky taste in mouth a lot etc. GP is doing a few tests to check there is nothing exciting going on as he seems to be a tad reluctant to up any treatment for reflux as im 'already on everything so surely it cant be that' which as nursefurby syas isnt a particularily accurate representation but there you go. I am more looking for a bit of advice with feeling less rubbishy while we work out whats going on
Omeprazole isn't to stop reflux, it simply reduces acid production - so what you are refluxing is less damaging. Domperidone is helpful, as it promotes gastric emptying. The less time stuff is in your stomach, the less that is there to reflux! Im on both of those, now on omeprazole 20mg at night (was on 40mg twice daily!) and domperidone 20mg three times a day/8hrly. Gaviscon works by attempting to provide a barrier layer over the food in your stomach, preventing it from refluxing. I don't know how well it works, have never tried it.
gaviscon.co.uk/how_does_gav...
Are there any foods i should go for, or avoid (im currently assuming fatty and spicy are bad)?
Prior to being peg fed, I didn't notice any difference regarding particular foods, but with regards to eating etc, see my comments below.
are there many common asthma meds that make reflux worse and is there much that can be done to protect my stomach whilse taking them (i try to eat with pred if possible)? what about strong painkillers?
Again, personally the only thing which has REALLY made my reflux worse, were mucolytics - things like carbocisteine (Mucodyne). While I was on this, my reflux was absolutely horrific 24/7. Stopping it resolved all reflux symptoms.
im having a really hard time making my bed prop up more than a few degrees - its a rubbish matress so just flops if i put anything significant under it, so currently its just whatever clothes i can spare which doent really do much!! any ideas/alternatives anyone can think of?
not a good way to do it. The best thing to do is raise the bed frame at the head of the bed, by placing things under the feet of the bed (a few yellow pages or something similar, bricks etc). You want to aim for a minimum 30 degree raise (you will be surprised at how tilted this is!). By doing it this way you are still sleeping 'flat' and aren't putting pressure on your spine by sleeping in a bad position. If you have a huge issue with doing that, you can get wedges, which you can have over or under your mattress, but speaking from years of experience, the problem with doing it this way, is you simply slide down during the night. Be aware that a lot of the wedges for sale are simply not high enough or long enough - you need one which comes down to your hips/bum to prevent sleeping with a wonky spine and with a minimum 30 degree angle. Having gone through all this and still had numerous episodes of aspiration pneumonia, we now have an electric bed, which has reduced infections by about 80%. Because I can have the head end at 45% and then raise my legs, I don't slip down at all (its also really comfy!).
how long should i stop eating before bed? im keen for it to be as late as possible as i get very hungry in the night and it keeps me up - but also dont want to make it worse!
On average, food stays around in your stomach about four hours. Going to bed with food in your belly is a risk factor for refluxing and consequently for potential aspiration pneumonia. Fatty foods will cause whatever is in your stomach to stay in there longer. So, prior to being peg fed, I wouldn't eat after 7pm. If I was starving, I would ensure it was something small and bland, and non fatty - easily digestible (rice crackers, toast without butter etc) so that I would digest it as fast as possible.
the gaviscon website makes recommendations, which you can see here: gaviscon.co.uk/understandin...
i have bad stomach pains and sore throats a lot - whilst i wait for the underlying reflux stuff to be sorted what is the best way to treat this?
Have you told your GP you have stomach pains? Reflux itself won't give you stomach pain, it sounds like you have gastritis. Have they considered whether you have an ulcer? Having a sore throat or croaky voice is a common result of reflux, its horrid eh.
how does gaviscon work? i like to know how things work so i can take them in the best way possible!
explained above - so needs taking after meals, its pointless continuing to eat once you have taken it.
what would be next in terms of treatment? GP wants to try a few non-reflux things to see if they solve the issue, and if that doesnt work do some kind of test (he didnt say ph but maybe its just a different name for it) to see ifit is actually reflux as he's reluctant to treat reflux any more than he is without clear proof! but where would we go next? i do feel like im on everything for it??
perhaps he's considering a gastroscopy, where they visualise the oesophagus and stomach. And potentially oesophageal manometry and ph testing.
To be honest the things which have made the biggest difference to me have been
> sleeping quite upright (for me it needs to be 45 degrees but a minimum of 30 degrees is recommended)
> not eating for 4 hrs leading up to bedtime
> not eating until you are really full (when you are prone to reflux and you have a full stomach, food takes the path of least resistance and travels upwards!)
any thoughts other than this??
I wouldn't advise stopping any medication without discussion with the prescriber. What affects one person doesn't affect another.
thanks guys!! x
you're welcome lol x
My doctor's suggestion re: bed
a) too many pillows, clothes under pillow could cause neck problems
b) its better to tilt the bed by putting books, bricks, wood planks or whatever under the legs of the bed.
If you've already tried that, apologies for being redundant (not sure what you meant by ""im having a really hard time making my bed prop up...rubbish mattress"")
I believe Symbicort has triggered acid reflux for me and it affects my asthma. (Vicious cycle) I had to decrease caffeine as I increased my Symbicort as I get heartburn if I have too much. Can't think of anything else at the moment but will add if I do.
Sorry to hear this trouble, Soph.
For me, stress, and maybe symbicort, is what greatly exarcebated a pre-exisiting reflux condition that had been caused by pregnancies. I used to drink gallons of gaviscon, and latterly was prescribed with omprezaole, but have switiched to lanprazole as is more effective, with me.
Re your bed, you can buy, or make, foam wedges that gently incline the upper half of the body rather than strain back or neck.
Re diet - I am afraid that chocolate is one of the baddies and if you can desist for a while so the reflux can calm down, then you may be able to have some in moderation. I have some no-no things - tea, real coffee, whisky, sauces made with tomatoes, peppers - that make me very ill with reflux, and of course spicy food is not recommended, but I do find that I can have spices because the lanprazole (spelling?) is helping so much. In fact, it is helping so much, I often forget to take it.
There are quite good resources online about good diets to treat GERD; maybe follow one of those diets quite religiously for a while so that everything gets the chance to calm down, and then you can slowly re-introduce things back into your diet.
Are you still on AdCal Soph?
There's pretty much no point taking AdCal and omeprazole - they virtually cancel each other out according to what I've read. AdCal gave me heartburn that nothing could touch!
Your hydro can potentially cause heartburn too.
Personally I'd be tempted to strip your meds back down to minimal (stop your iron, calcium, bisphosphonates etc - anything that is 'long term' rather than day-to-day) and then reintroduce them when your symptoms are less bad.
There is a vicious circle you can get into where if you have a small (within normal physiology) haiatus hernia then the acid leakage damages the area around the valve itself, so it becomes less good at doing the closing off thing, a bit like an old elastic band.
My understanding is that chocolate is a no-no for reflux... sorry! In fact, it is the single 'worst' food you can eat - cocoa, caffeine and high fat content. *whistles*
The GERDs diets are really worthwhile as well - as others have said, doing the really boring diet until you're symptom free and then reintroducing stuff is a good plan.
There are different schools of thought about whether it's better to do away with 'meals' and just have multiple snacks, reducing the chances of any overspill at any time, or do the opposite and have 3 set meals, with domperidone taken at the same time, and not eat between them at all, which might give you gaps between reflux episodes. Different strategies seem to work for different people.
I'm assuming your GP is thinking about either an OGD (camera down your throat) or a probe test to measure acidity. I think they'd normally do the OGD first. Horrible but manageable, and it lets them get an idea of damage as it doesn't correlate at all well with symptoms. (People can have mild symptoms but terrible damage or vice versa). Reflux is such a big factor in breathing issues that I think it would be silly for them not to scope you and get it properly sorted if just following the GERD diet doesn't fix it.
Cx
Hello,
my first post and some of the things here sound familiar. I'm just diagnosed and just had my first attack in the night this week, I think caused by reflux (woke coughing and only getting small amounts of air in between belly coughs) - probably due to a heavy meal. I am on Symbicort and I do think this is not helping, but I cannot take Ventolin due to allergy. But having had minor acid issues over recent years (I am 42, so adult onset, and my father always had acid issues, guess we have the same plumbing!). I think the ideas of many here - smaller meals, less tomatoes/bell peppers, onions, caffeine, alcohol, meat(?), potatoes, gluten(?) etc are all good paths to try. On the bed front, there are some 'shaped' pillows, with a dip in the centre, that might encourage sleeping on the back (if thats better). Hoping you get some relief soon.
Mark in Wales
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