Acid Reflux

Sounds rotten. Might be worth asking about testing for something else such as Helicobacter Pylori or even hiatus hernia. The heartburn previously may have been heralding more severe oesophagus inflammation. Definitely time to tell the doc it’s not helping especially when you’re using a PPI AND Gaviscon.

If it was steroids I would have expected to happen at higher doses rather than the lower ones you’ve been on recently. Omeprazole is usually prescribed at the beginning, not this late on.

Has GP considered a hiatus hernia - thinks he needs to think outside the box on this?

Might be worth having a look at that and also GERD/GORD to see if your symptoms are similar. Then go back and ask, but in the meanwhile give the medications time to work.

I've had chronic reflux for years and take Pantoprazole very early in the morning (5-6 am) before anything else passes my lips. If you don't do that then you will experience symptoms. Anyone who has taken long term medication especially any type of anti-inflammatory will more than likely develop the condition and steroids do play havoc with your stomach which is why you should always take them with milk or after food.

There are stronger medications to control stomach acid. I don't know if there is a correlation between the amount of steroid taken to the reflux problem. There's lots of information online which explains it. You are like me, you produce a lot of stomach acid and I had the problem before I even started taking prednisone long term.My previous meds had caused it.

Ask if you can try taking Lansoprazole when you wake up in the morning and then wait 30 minures before eating or drinking anything

I really would ask for it to be checked out properly since you would have expected it to have happened before if it is just the pred. I agree with the others - this shouldn't be assumed to be the pred until proven otherwise.

But in the meantime, try Zantac/ranitidine instead of or in addition to the omeprazole. Omeprazole is said not to work for about a third of patients but it also doesn't work for 24 hours if only dosed once. Are you in the UK? Ask (tell) the GP you would like enteric coated pred - because that should eliminate pred being the cause of the reflux.

Once you are on the PPI there should be little or no acid during the day - but if the problem is at night it may be you need to change the timing of the PPI or add ranitidine at night:

ncbi.nlm.nih.gov/pmc/articl...

In plain English: Once a day, in the morning, PPIs suppress acid production after meals but new cells are produced during the day once the PPI is no longer in the body. At night there is effect of gravity to keep the stomach contents where they should be so you may have problems. Try raising the head of the bed as well.

“Disappointing” is acceptable - devastated is not! Keep at 10mg for a few days, then start reducing slowly slowly again, there’s no rush.

At times I have quite bad acid reflux (not so often now though thank goodness). Omerprazole works OK for quite a few people, as does Gaviscon. At night it has been suggested to take a little pot of porridge (raw) to bed at night and just eat a teaspoon or two when the reflux is bad (that’s what I do - and it works) I suppose it wipes up the acid when made wet!!!

I suffer from the same. Mine is attributed to gallstones. Check your gallbladder, I hope you find relief.

I also suffer with heartburn and it has become worse since l increased my dose of Pred.,and my stomach is really bloated,much worse than when l was on a higher dose.l am on 5 mg now,but seem to be putting on weight. I wish you a good outcome .

As reflected in the responses this can be a complex problem the cause of which isn't always obvious. I have had GERD for years but fortunately for me it is pretty well controlled by Lansoprazole - However I need a 'double dose' 30mg in the morning and 30mg again in the evening before dinner. This works for me BUT I have noted that if I eat certain foods I can still get a gassy feeling in my stomach (usually things like carbs/bread) - and if you do also happen to have a hiatus hernia this 'pressure' can push any residual acid back up your oesophagus - which can be terribly painful. If you burp a lot this can also be a sign of gall bladder problems as well as general indigestion and this can then be a problem. You do need to get to the bottom of this both for your comfort and to protect the lining of your oesophagus which can erode over time if exposed to too much acid. I am sorry for you I know this can be hellish and also impact on sleep. By the way if you do get an 'attack' which wakes you up drink a lot of water to dilute the acid and prop your pillow up as much as you can (semi-sitting up in bed) - just don't lie flat because that will make it much worse.

Hope it improves soon !

Rimmy

Hi Kate1978

When I had acid reflux a few years back just put some solid wooden blocks UNDER the head of the bed about 5" to 6" thick and and 10" long. Low tech but it works and I have never really had reflux again as severe, they are still under the bed after years later. You should go to the doctors to get it checked out, my period of intense reflux, heartburn bloating etc. was eventually found to be Helicobacter Pylori (Pylori H) which after taking antibiotics for a few months I was fine. Take care Angie x

This can help until you find a better solution. When it gets this bad, usually awakening you, take a tablespoon of apple cider vinegar. Be sure and rinse your mouth and swallow some water after to rinse the acid of it off your teeth.

I also suffer from gastric reflux and was diagnosed with an hiatus hernia. I am back on the Omeprazole having stopped steroids 2 years ago (post PMR) I did try ranitidine as there are less side effects but it did not help. I hope you get it sorted soon as it is really unpleasant.

I understand acid reflux is mostly due to imperfect closure of the sphincter that usually prevents the (acid) stomach contents from escaping. Maybe the muscle weakness characteristic of PMR affects this sphincter, making it less efficient. Just a thought.

I take pantoprazole 40 mg every morning and rantididine 300 mg before bed every day. Controls my acid reflux.