Hi does anyone know what i can do to prevent/relieve heartburn? I seem to be getting it more these days, i have had it all day today since waking up. I have taken my omoprazole first thing. ranitidine midday plus liquid Gaviscon in between with little or no relief. id there anything else i can do?
Margie
The only thing I can suggest is to go see your GP because I had a problem with increasing heartburn and he changed my medication from Omeprozole to Lanzoprazole and it seems to have worked for me. It might be that your body has gotten used to your current meds and a change might do the trick?
Go and see your GP and ask for an endoscopy so that they can check for underlying causes. There has been a study that says that taking PPI medication like omeprazole before eating breakfast can be quite important. It has a cumulative effect apparently.
Also think about whether anything might have been increasing the acid reflux (eg extra stress, diet and so on).
It does sound like a classic case where you need an endoscopy and a definitive diagnosis. The NICE guidelines on dyspepsia are in the course of being changed so that people in your position can have an endoscopy more easily than before. It is also important if you have any trouble with swallowing.
As Alan mentioned, the timing of the dose of any PPI (omeprazole, lansoprazole, etc) is important. They are best taken on an empty stomach about 30 minutes before a meal. This allows the medicine to go to work on the acid producing cells in the stomach, and to be in place when the meal stimulates acid production.
Taking the medicine in this way allows it to work better and longer. The timing is not as important (before breakfast or before supper), because most work well for about 24 hours. Certain foods also stimulate acid production or reflux, and avoiding these may help.
If you are taking it this way and it is not effective, then a dose increase or change to another PPI may be in order.
Sorry, forgot to mention one thing:
I don't know your medical or surgical history, but sometimes heartburn can be caused by food that is retained in the esophagus due to motility problems or a narrowing. The food ferments and produces lactic acid, which can cause the same symptoms as heartburn. This is not relieved by PPIs since it is not stomach acid that is the culprit.
Just wanted to throw that out.
i had esophageal cancer so had a esophagectomy with the removal of part of my stomach
After my esophageal myotomy and worse after my esophagectomy, my stomach produced much more acid and digestive enzyme, probably due to the trauma and dissection of the stomach. Given your history, I would want to make sure that there is nothing else at play. Perhaps adding ranitidine at bedtime to your morning PPI may help decrease the secretions of stomach juices. It certainly seems like you need a change in your regimen. Even a change to a different PPI or higher dose may help. Unfortunately, there's not much that can be done for digestive enzyme overproduction, but ranitidine (Zantac) or famotidine (Pepcid) could help. Hope you find an improvement to your situation.
Is it possible that it's bile rather than stomach acid ? IME bile tastes even fouler than acid and burns more .
Quite different from acid so I'd guess you know...
i only have burning no taste
You must be right then - must be acid reflux . Do hope you can get it sorted .
Hi Margie1, I agree with spanner16 that a change of meds may help. Do you sleep with your head and neck/chest elevated? This will help stop the acid running back up the oesophagus. You can try taking some Metamucil in the evening about an hour before bed and this has two benefits. The fibre will help keep you regular (not that you may have problems in that area) and it sets a bit gelatinous to keep a lid on stomach acid and prevent it flowing freely up into the trachea while you sleep. I am 14 years post op and a change of meds worked for me (went from Losec to Nexium) along with the metamucil to stop reflux. Hope this helps.
I have the same problem. 95% of my stomach was removed. The problem is that gas in the stomach and upper intestines tends to push acid and food up into the throat and causes coughing and reflux. What I have been doing lately is taking simethicone 125 mg tablets at bedtime and during the day as needed. Night time coughing has stopped and my esophagus (what is left of it) and throat are way less irritated. Hope this helps.
There is a thought that it may well be not acid as production of acid is reduced when the stomach is made into a tube to replace the oesophagus. Also motility, the muscular-driven process of food being taken through the system, is reduced. This may explain why you have not responded to lansoprazole.
A drug which stimulates motility such as mento loperamide might help, with gaviscon.
Hi, newbbie here. 5 & half months post esophagectomy (due to 6cm esophageal schwannoma, yes, i heard this condition was not common...1/3 of esophagus got cut off then stomach was pulled to connect) recovery has been going well (back to my pre-op exercise routine 2 months ago). Only problem i have now is indegestion... I was taking nexium not long after op, but i stopped it month ago since i felt my problem was not too much acid instead too little acid to help digest food. After eat, i burp with foul smell, bitter taste, i guess like Violetqueen montioned earlier that my problem was from bile. If this is the case, what's the best way to get rid of this problem? Anybody has similar problems?
Glad that your recovery is going well. It does take time, so don't rush things. It always takes longer then you hope! If your stomach is producing acid, you will almost certainly have some degree of reflux problems, especially at night, because the lower oesophageal sphincter valve is no longer there, and the acid will rise up without the valve to block it. But there might indeed be bile (which is alkali and tastes really foul), in which case something like cholestyramine may help. The foul smelling burps sound a bit like food is not clearing your new stomach as well as it should. If your stools are light brown, oily and floating, it might indicate that you are not digesting fat as well as you should.
I think you should contact the specialist nurse and probably arrange an appointment because there may need to be some adjustment in medication to help your system cope better. Sometimes the pyloric sphincter (valve at bottom of stomach) is given a stretch to help things along. It is a fairly normal procedure to fine-tune things after the surgery, so don't worry. But do contact the nurse.
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