HEARTBURN

[theresa49]

Just wondered if anyone can advise please? I am suffering with severe heartburn and don't know if it is the Prednisolone (down to 15mg now), Omeprazole or Alendronic acid that I have been taking since last July? I wondered if anyone else has this problem as it is keeping me awake at night?

Thanks.

[Celtic PMRGCAuk volunteer]

Theresa - I have never taken Alendronic Acid but Omeprazole caused immediate and severe problems with my bowel so was stopped after a couple of days. Either of those medications can cause heartburn.

Have you had a DEXA scan showing that your bones are thinning, hence the treatment with Alendronic Acid? If not, then do ask for a scan - if your bones are fine, then you don't need the AA, but just Calcium + Vit D.

A 'live' yoghurt with your breakfast, before taking the steroids, can help prevent problems, and warm water with a few squeezes of lemon juice before a main meal can help with esophagus/heartburn problems, plus Manuka honey taken daily. These were mainstays of my PMR/GCA years, which included a high steroid starting dose of 40mgs, and I never had any further problems after stopping the stomach protectors, Omeprazole and Lansoprazole, taken in the first couple of weeks.

[Annodomini]

I haven't had problems with Omeprazole which I have used since long before PMR to prevent reflux which was damaging my vocal chords. However, the ENT consultant also prescribed Ranitidine (aka Zantak) and this helped a lot too. I strongly recommend a dose of Gaviscon Advance last thing at night which should deal with your heartburn.

[polkadotcom]

Prednisolone does irritate the stomach, but then so does Omeprazole if it doesn't suit you. Having said that, could part or all of the problem be down to how you take your meds? We are ever the advocate for taking them early with a decent breakfast (a couple of biscuits is not enough) and the Omeprazole should be taken at least half an hour before that.

Alendronic Acid is also well known to cause digestive/gastric symptoms. Has it been established by means of a DEXA scan that you really do need them as you have osteoporosis or osteopenia (the pre-osteoporosis stage)?

It most definitely is not the wonder drug which many doctors believe and you might to well to do a bit of research on it.

[theresa49]

Hi Everyone,

Thank you for the advice. I had a DEXA scan last August & was told that I needed Alendronic Acid because I do have osteopenia, I do take my Pred early with my breakfast (always hungry so a good breakfast) but usually I take the Omeprazole at the same time. It has been a very difficult year, with one thing after another & all these drugs have taken their toll I'm afraid. a friend did mention Manuka Honey so I will treat myself to a jar & try that.

[Badgergirl]

Hello theresa49. Apologies if you already know this but it is best to avoid coffee, strong tea, orange juice, cakes, chocolate, puddings, biscuits, vinegar and fatty foods (especially animal fats and strong cheeses) as all can make heartburn worse as can a large meal late in the evening. As well as Manuka honey, slippery elm helps with heartburn.

[Hidden]

Ask your GP for Zantac, instead of the anything with prazole at the end, ie Ome or Lanzo.

[PMRpro Ambassador]

If you are taking a PPI (omeprazole) you shouldn't have heartburn - it stops the production of acid. If it more of a problem the day or so after the AA since you only take that once a week? You are obeying the instructions for taking AA to the letter I hope. There are other bone-building medications besides AA and it might be worth asking about that - at least rying a few weeks without the AA to see if things improve.

[theresa49]

Thank you for all the information. It does seem worse a couple of days after I take the AA, I do take it on the same day each week & with a full glass of water etc. but I have always had a sensitive stomach, so I'm beginning to think it may be the AA. I am due for my monthly check up at the end of the month, so I will talk to the Doctor about it & see if there is an alternative. What would I have done without all the good advice that I have received from you all over this last 10 months, I really don't know.