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British Lung Foundation
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Link with Gerd and ipf

I have just found that there is a link with gerd and ipf and I am waiting to be referred to a gastric consultant. I have had years of taking lanzanaprol for acid reflux and suffered breathlessness and chest pains with constant visits to a and e to be told they could not find reason for this. Now I need to find an alkaline diet.

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I argued with my doctor for several years that there was a connection between gerd and respiratory problems, she would never believe me! A chance blood test managed a referral to a specialist who diagnosed Barrett's which had been caused by the large amount of steroids I was given for pmr. Very few doctors see the damage they have done by curing another ailment!

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Lung disease seems such a minefield to go through.

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I can sympathise with you on that one. I've suffered for years with reflux and ended up in A and E several times. They've never once considered digestive issues, always gone down the heart attack route......really frustrating. Hope you get something sorted with the specialist. Take care. Pam XXX

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Pam, Very interesting - I ended up having a Cardiac Catheterisation after having pains in my chest. Specialist wanted to know why on earth had I been sent to him! At least I did know there was nothing wrong with my heart and arteries.

Regards Pete

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😁😁Hi Pete. Same here. I had to have a nuclear stress test........arteries and heart absolutely fine, but I wasn't concerned about them anyway, lol.

Take care.

Pam 😊

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Thank you for responding. Take care

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I have suffered the same as you, but mine has turned out to be lack of b12 causing the breathlessness. Sometimes wonder if it is the brain ruling the stomach or the other way round.

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Thank you for responding. Maybe one day these issues will be addressed

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I was wondering about that too!

Aidi-Joll

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I think the connection between acid reflux and lung conditions is due to what they call silent reflux (so called because many who have it don't have standard reflux symptoms like heartburn). This is when the acid breaches the upper oesophageal sphincter (top of neck) and leads down the windpipe. It can reach the bronchi and even into the lung tissue itself.

The best foods to avoid for reflux are tomatoes, onions, garlic, hot spices (chilli and cayenne), caffeine, chocolate is a killer, citrus fruits. Several of these make the lower oesophageal valve at top of the stomach loose, allowing acid to leak out. But everyone is different - I find there are very few fruits I can eat raw apart from bananas, but i can tolerate most of them if they are cooked.

It's quite confusing working on an alkaline diet - for instance lemons will make the body more alkaline but that's after they have been digested and metabolised. When they go into the stomach they are still acid and can cause problems.

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Yes I think your right about no heartburn but acid refluxing into lung causing so much pain in centre of chest which causes breathlessness when bending or exerting and mimics heart attack symptoms. As I have never been able to eat spicy food and have a pretty bland diet but still suffer as I am sure lots of people with lung conditions do I think information is lacking. America and Canada are trying to find out if there is a definite link, so maybe one day we will know.

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10% of asthma cases are thought to actually be reflux related, not real asthma.

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Interesting!!

Thanks

Aidi-Joll

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You are so right.......Have had reflux since the start of 2000. I have tried everything None of which work well for long. The only medical man who acknowledged a connection between Gerd and lung conditions was an ENT consultant ...Who was checking out my vocal chords./throat. ......I stay away from those foods you listed listed plus vinegar and pickles and coffee .........But I have found that an apple is tolerated very well. (Braeburn)........Lemons are a certain No no for me.

Jo. πŸ˜€

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I am very interested in this connection Jo.

I would be interested learning more about it.

Thanks,

Aidi-Joll

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If I can answer any questions ....Please ask.

Jo.😊

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Hi Jo

I have been developing digestive difficulties for a while now. I have always eaten very slowly and found when I was stressed, certain food would just not digest. Occasionally I would go through an episode of feeling dizzy then almost being sick and not quite passing out. It was awful! It seemed to be related to foods that were more difficult to digest like bread for instance. Last year I took a whey protein drink and my throat became very tight and constructive, so I stopped drinking it immediately. I had thought at first I was having an allergic reaction, but it settled down. Lately I have been experiencing more of a problem with actually swallowing. Omeprazole hasn't helped so far. Not sure where to go from here! Thanks for your interest.

A-J

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Don't want to frighten you, Jo, but if you have regular difficulty swallowing this is a red flag for oesophageal cancer. It's likely not to be that but good idea to mention this to your GP or consultant just to rule it out.

I knew nothing about silent reflux and poo-pooed any mention of reflux but when i had an op to remove an oesophageal cyst they found Barretts Oesophagus which is a precancerous manifestation of acid reflux around the bottom of the oesophagus, so I have regular endoscopies - every few years - to check it hasn't progressed

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Thanks for information

A-J

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Hi Jo, apples are rubbish for me, though cooked is ok. Strange how we vary. In the USA there is a new discipline which makes more sense: Aerodigestive medicine - being promoted by Dr. Jamie Kauffman. It was she who coined the term silent reflux. She became interested after treating a number of opera singers (I think opera) who were losing their voices. You can google her. She's done a cookbook for people with reflux.

Edit: forgot to say how ridiculous the medical profession's splits are. I get seen by a lung consultant, an ENT consultant (occasionally) and a gastro consultant which is why Kauffman's approach is so much better.

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Thanks again!

I will look it up too!

A-J

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Hi, I can't eat cooked apples, am unable to eat any fruit ....have been eating fresh peeled apples since Christmas I could not even tolerate vitamin C tabs. My skin is showing the benefits of those apples ,am so surprised and very pleased.

Thank you for information Re. Kauffman .....Will check out.

Jo.

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Definitely food for thought!!

Silent symptoms we need to be aware of!!!

Thank you.

Aidi-Joll

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I think it is very important to recognise the connection between gastric reflux and lung disease. I had a dear friend who had a rare oesophageal condition who was constantly getting chest infections and being treated with abs. She was tested for heart problems which was inconclusive but she died suddenly from heart failure aged 70. I had just been dxd with bronchiectasis but didn't know what I know now so was no help. Her doctors and consultants should have been more on the ball.

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Good point Carnival567. I have bronchiectasis too and when I was dx'd at RBH, in the 1990s, it was the first thing the Prof checked out. I'd avoided certain foods for years but wasn't aware I had gastric reflux. At RBH they go to great lengths to suppress it, as they say stomach acid is as strong as battery acid & breathing in even microscopic droplets is very damaging to the lungs.

winfar I'm sure the gastric consultant will be able to help you. I'm taking double-strength esomeprazole and also ranitidine, but have been told there is another drug I can have if it gets even worse. Hoping not, of course.

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I take Esomeprazole twice a day ,have done for years .My doc does not approve of me taking ranitidine as well, which I do when I get a flare up.

( Thank goodness for "Wilko's .....Cheap supply of ranitidine )

He just dishes out more Gaviscon, having taken so much for so long just looking at the large bottle turns my stomach.

It's interesting seeing what others take.

Jo.πŸ˜€

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Thanks for reply instead of appointment with doctor when I called for appointment I was passed to their pharmacist who prescribed esomezaprile 40mg twice a day and also gaviscon but will still have to awai appointment with doctor to arrange for referral to gastroentologist. As it is acid reflux I think it is seen as not an important problem, but it is to me.

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A very informative article.

Thanks Clare!

I didn't have to look far away for more information at my fingertips!

A-J

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Very interesting article and it answered a lot of questions for me .

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Hi all. This is why forums such as these are vital and life changing. Apart from sheer friendliness and willingness to share conditions we suffer, there is such a wealth of knowledge and experience to counsel and console; without which many would be lost. I was one who felt out of my depth with no prior knowledge of such conditions, how to manage them or what to expect until I found all of you wonderful people.

Always,

Aidi-Joll

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Thanks for bring this up. There is a huge literature on this but there are still some respiratory consultants who are either completely unaware of this or dismiss the link.

I had silent GERD caused by a hiatus hernia for at least 5 years before my lung problems (IPF) started and GERD seems to be the most likely cause of my IPF though this can never be proved. The only GERD symptoms I ever had were breathlessness, some coughing and severe upper left chest pain (instantly relieved by belching) whenever I did exercises that put a lot of continued pressure on my diaphragm for a few hours (heavy lifting, fishing, digging garden etc).

Controlling it has been be extremely difficult. I have to take Omeprazole twice daily and ranitidine at night and also have had to make a lot of lifestyle changes (smaller meals, raised bed, avoiding most foods/drinks I like, nothing to eat after 6pm). I'm prepared to do this as my IPF peristent cough went away once I started GERD treatment and, even though this could be a coincidence, its enough to keep me on the treatment as I do not want that cough back.

Esebriet/Pirfenidone has made my GERD worse and I'm told there is still a risk non-acid reflux could make IPF worse so it may be necessary to push for the hernia operation again or consider pro-kinetic type drugs. Unfortunately, getting time to ever discuss this with my consultants is nigh on impossible as they are so busy and struggling to keep up with their huge work load at this time of year.

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Thanks Winfar for sharing your experience of this topic. Please keep us posted on how you get on. Will you be supported by a dietician as regards the alkaline diet? Just a thought!

Aidi-Joll ☺️

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Hi I had a word with respiratory nurse about alkaline diet but she said not to try it as needed to see regular meal diet retained for now.

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Hopefully respiratory nurse has your best medical interests at heart.

A-J πŸ˜‰

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Hope so.

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I was turned down for transplant because of acid reflux,I questioned that I had never suffered from acid reflux,so they did manometry test and ph test,showed no reflux,but did show a patulous (baggy) oesphagus that has very little peristalsis,so that excluded me again from transplant,but they still want me to take lansoprazole as a precaution.so I decided to ask to see a gastroenterologist ,I have an appointment Monday,but while waiting 18 weeks to see him,I had a heart attack,possibly bought on by a choking fit,from trying to swallow a tablet,but my IPF consultant said they probably won't want to do anything because of the IPF,so this bloody disease I causes so many other problems,and yes I also have a hiatus hernia.Sorry for the rant,and to cap it all I now have a cold,oh and I am 4 weeks into a broken shoulder.😑 Sooki

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Here's hoping you get an upturn soon.

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Oh so sorry Sooki!

I hope your little ones can keep you smiling!

Aidi-Joll

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Hi Snooki so sorry to hear you are having all these problems.

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I have been on Lanzanaprol for around 10 years only become breathless over the last 3,let me know how you get on.

p.s. if there is any schoolteachers around lock up your chalk

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I could not tolerate lansoprazole at all, gave me stomach ache, have now been prescribed randitine and so far it agrees with me. Could there be a connection between mouth breathing and indigestion? I find myself mouth breathing a lot and dread getting trapped wind, very painful.

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I googled can reflux cough increase chest infections, due to loads of issues I had. The amount of info out there may be worth a look if so inclined without scaring yourselves.

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Thanks for responding. I know it's scary what you read but as so many people are suffering reflux issues along with lung conditions seems to confirm there is a link.

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