Oesophageal Patients Association
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Any effects of chloramine as a water additive in patients with Dumping Syndrome?

I know that this may be an unusual question, but I think it worthwhile to ask.

I received a letter from my water company stating that they were about to switch to chloramine from chlorine as a water additive for the water supply. The letter stated that there was no problems for any except dialysis patients in machine use, as stomach acid breaks down the chloramine before it can be absorbed by the body when taken orally.

No to mention the fact of high-dose acid suppression, but it seems to me that with dumping syndrome there should be at least a passing cause for concern.

Has anyone here had any experience with this issue? I imagine it perfectly safe, but I found no information out there as to this issue.

4 Replies

Could you contact the water company and ask them directly about the issue of acid suppressing meds and chloramine ?

They must have pharmacists they can consult ?

I think you're right to be concerned ,I know I would be .


The EPA was considering banning Chloramine for use in drinking water owing to it's persistence and toxicity in discharges and hence effect on nature.

You should find out the result of that deliberation.

The attraction to the utility over conventional Chlorine is the aforesaid persistence and the formation of fewer carcinogens from reactions with other contaminants in the water. .However its' germicidal action is lower. The regulated concentration is circa 4 ppm.

Certainly there is potential for reactions with medication which may prove to be undesirable.

Is your concern that as a result of Dumping the ingested Chloramine may have less contact time with stomach reagents and therefore not be destroyed, as seems to be the case with a normal GI tract ?

That appears to me to be a possibility especially since our level of secretions is reduced owing to cut-down gastric surface area, de-enervation etc and not forgetting PPI meds also surfactants such as Gaviscon.

One wonders if a correctly worded letter to the utility's CEO might ring alarm bells with their corporate lawyers concerning public liability.

I cannot see any way in which this chemical could be causative in either promoting or inhibiting dumping;

which is primarily a mechanical plumbing issue. Also I cannot see how it could be implicated in any subsequent onset of hypoglycemia.


It would certainly need an expert to make a judgement on this, but my first reaction is that, like many other chemical issues, it depends on the scale of the chemical content (I believe that London drinking / tap water and bank notes have a certain amount of cocaine in it/them which is retained after recycling, for instance).

A lot of people take PPI medication so I suspect that they would not be able to do anything that would have a significant implication for so many people's stomach acid balance. The other thing that might happen is that people talk rather loosely about stomach acid dealing with digestion and it might feasibly be other stomach chemicals, or a more complicated process in the digestion system that combats chloramine.


Thank you all for your replies. My main concern with chloramine was that it is especially toxic when in direct contact with the blood, causing damage to hemoglobin. In a patient with a horizontal stomach transplanted in the thoracic cavity and reduction of the pyloric sphincter, foods and liquids move very quickly into the small intestine. Even if there is stomach acid present in the stomach, there is very little contact time for the acid or enzymes to break down this chemical before it moves to the duodenum where it could be quickly absorbed intact. With PPIs you then remove most stomach acid from the conversation.

It may be perfectly safe, but without any clear guidance I feel it best to be careful. I have bought a Mavea water pitcher that filters out to standards NSF 42 and 53. This filtered water is what I have been using for all oral intake since my water utility switched from chlorine to chloramine. If nothing else, it gives me peace of mind. I do have severe dumping syndrome after the esophagectomy which shows no signs of improvement 4-1/2 years out. I feel better in knowing that I am not making my medical situation worse.


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