Refux

[welcome_123]

Hi guys can anyone tell me what does the most damage acid refux or bile reflux please...i have a problem at both ends top of oesophagus at a deformity at the lower end leading to my intestines...

[Hidden]

The additional comment about this coming from a serious operation some time ago ended up as a separate post that has been removed so that it all gets dealt with on this one:

Acid reflux can injure the lining of the oesophagus the lining of which is designed differently from the stomach, where acid is required for digestion and other purposes. This can lead to Barrett's Oesophagus and, eventually, dysplasia (cancer risk), but it is normally a slow -moving thing that can take years to develop. Some people would say that it may not be just the acid that causes damage, but possibly pepsin as well. Alkali / bile can probably have just as harmful an effect and I think it is likely that people simply refer to reflux as 'stomach acid' regardless of what type it is.

Reflux can be harmful higher up, to the lungs and throat / pharynx as well.

From what you have said I think you definitely need to continue with the guidance of a good doctor / surgeon. The only thing I can say that is helpful is that Gaviscon should work against both acid and alkali (for a short period) because it is an alginate that creates a protective raft inside your system. And the underlying causes of the reflux do need to be properly diagnosed and dealt with.

[welcome_123 in reply to Hidden]

Thank you Alan for getting back to me...i am sorry if I had said something wrong on my post... My surgeons secretary contacted me yesterday and I am being sent to see a doctor who deals with the pancreas.....have you any idea why I need to see. Him?

[Hidden in reply to welcome_123]

I think it was just a slip of your finger on the keyboard that created the extra post. Don't worry.

The pancreas is part of the digestive system (releases insulin) and I imagine that seeing this specialist would help them to understand the complications of your condition better. Bile, by the way, is created in the liver and stored in the gall bladder, so it is probably a matter of checking to see how all these are all working and perhaps creating the imbalances / reflux.

[welcome_123 in reply to Hidden]

Hi Alan thank you again for explaining this for me...i have had my gall bladder removed about 8years ago as I kept getting attack and it was full of stones...

[Hidden in reply to welcome_123]

I am sure that would be a relevant thing for the doctors to take account of. Hope it gets sorted out OK.

[welcome_123 in reply to Hidden]

Thank you

[Killerwhale]

Hi

have checked for Esophegeal Rings/Web

[welcome_123]

Thank you I will have a look...

[gutlesswonder]

Hello Welcome_123

If we knew the answer to your question the world would be a much happier place and not a few medics would be out of a job!

HOWEVER-

I see that you have had your Gallbladder removed. The consequence of that is that instead of storing and maturing the bile produced in the liver and then releasing it on cue when a meal containing fats begins to descend from the stomach into the duodenum you will have a continuous drip, drip of raw, fresh bile.

Generally for Cholecystectomy patients this has several deleterious effects:

(1)The normal function of alkaline bile is to act as a detergent (much like Fairy Liquid in washing up the dishes) and break down globules of fats into smaller and smaller spheres so that they can be absorbed. In you (and me) this activity is impaired because there is insufficient concentrated bile available at the right time. Hence the classical feelings of nausea/indigestion after a rich meal.

(2)The continuous stream of fresh bile (which can be as much as 2 litres in a 24 hour period) is not passivated because it was released prematurely, between meals, so before there was fat available to react with it (remember how half-way through washing up the Fairy Liquid seems to have lost it's power and you have to add another squirt?) and/or HCL stomach acid was available to neutralise it . This then has a catastrophic effect further down the gastro-intestinal tract where, instead of being re-absorbed and returned to the liver for recycling, the surplus bile acid salts continue on down into the large intestine where they interfere with the water recovery mechanism which is responsible for solidifying the faeces - the result - diarrhea.

(3) Unpassivated bile is continuously swilling about just below the exit from the stomach - the pyloric sphincter.If that sphincter is less than 100 per cent efficient and, similarly the next upstream barrier, the lower eosophageal sphincter is weak (or has been surgically removed) then it is almost inevitable that some will find it's way back up into the stomach and thence up into the gullet (Heart Burn/Barretts/Cancer) the throat (Laryngitis) and, possibly the lungs (Pneumonia) and mouth (Tooth Decay). Obviously this is near inevitable when lying down asleep - particularly for those who have had an Ivor-Lewis gastro-oesophagectomy.

The only defence against this very real danger is to sleep on a properly raised bed.

Some questions:-

A] Do you suffer from diarrhea?

B] When you spit and/or cough up reflux what colour is it ?

[welcome_123 in reply to gutlesswonder]

Yes suffer a lot with diarrhea..and when I bring up bike it is yellow/ green.. Thank for responding..

[welcome_123]

Hi guys just had a letter from my surgeon...the results of my tests..from the 24hr pH testvand the mametry!! Test and i have both stomach acid and bile coming up...so i have to go and speak to another surgeon to get a second opinion so they can put there heads together to see if they can do anything for me...i do hope so...this is terrible living with this...

[gutlesswonder]

Hi welcome_123

Can you please describe your sleeping arrangements?

[welcome_123 in reply to gutlesswonder]

Bed raised and loads of pilows

[welcome_123 in reply to welcome_123]

Bed raised and lots of pillows

[gutlesswonder in reply to welcome_123]

Pillows are not an ideal arrangement for three reasons-

1) It is so easy to slip off them sideways if you are a restless sleeper.

2) being bent at the waist can constrict the stomach/eosophagus so squeezing reflux back up.

3) similarly being bent at the waist can inhibit the normal action of either or both of the pyloric sphincter and the lower eosophageal sphincter - depending upon if you still have them and they are functional or otherwise.

Are your bed head legs ( not a lift-up platform?) raised at least 8 inches - this is generally considered the minimum so that gravity is your ally, not your enemy?

Can you give any more details about " problem at both ends top of oesophagus at a deformity at the lower end leading to my intestines" ?

Good news that your Consultants are getting their act together.

Please send me your email via private message so that I can send you the definitive medical research paper regarding Bile Acid Diarrhea. You should discuss this with your medics. The solutions put forward in this paper have absolutely worked for me.

[welcome_123]

Hi I am not sure about getting around this site yet...so not sure how to private message you with me email...can you let me know how to do this please...