Severe reflux

[AnniesRyder5]

I am reducing my pred dosage, from 15 in March to 7 now. I have always suffered with reflux for which I have been taking esomeprazole for many years but I’m really struggling this week. Because the reflux is a lot worse to the extent I’m chewing a few gaviscon tablets each day and feel nauseous . The acid has given me a sore throat and I’m blown up like a football

I’m wondering whether the prednisolone is causing it and/or the Adcal but I’m felling really miserable . In addition my arms/wrists are painful.

When I started reducing my prednisolone the GP advised me to take extra5mg for5 days . I’m unsure what to do right now. As they say the cure can be worse than the disease but in my case I’m not sure which disease is worse

[jinasc]

Are you really saying you have reduced from 15mg to 7 mg in 5 months, or have read your profile incorrectly.

This has helped many people avoid all the 'prozales'.

Suffer from Acid Reflux (Heartburn)

Juice of one lemon, divided into three, add to glass of water three times a day – acid reflux gone. Put the lemon in the microwave for 1 minute – twice as much juice.

Read the paper that comes with your prescription for side effects, even better use your search engine.

[AnniesRyder5 in reply to jinasc]

Yes I’m on 7mg after 5 months

Is that too quick? I must admit I’ve been toying with idea of doing the 5extra for 5 days but then the reflux would get worse I expect!

Any advice would be much appreciated

[Rimmy]

I can relate. I was taking a PPI for years prior to my diagnosis of PMR and later GCA - I'm 3 and a half years down that track and back on a higher dose of Pred due to a recent flare. I have found taking my Pred tabs with at least half a cup of thick plain Greek yoghurt to be very helpful even though I still need to take 30mg twice a day of Lansoprazole. Regardless I still occasionally have what is called 'breakthrough' reflux despite everything I do. The fact I have been on a sustained 'higher' dose of Pred (over 20mg) for several weeks now has not helped. I also find avoiding foods which are 'gas' producing is important as too much 'gas' in your stomach (not necessarily in the gut) can literally 'push' any stomach contents - with associated acid back up your oesophagus. Although some may advise lemon juice - although it may work for them - I would be very cautious of anything at all 'acidic' for a while - this would really set me off - in fact even induce reflux. I recognise we are all individuals but after many years of dealing with this problem and later with Pred as an extra irritant I can only also suggest you may not be on a high enough dose of your PPI (you may need a twice a day dose)and you really must line your stomach well before taking Pred. I have not personally as yet experienced any side effects from my PPIs after taking them for about 12 years or so. This is just my experience as I said.

Best wishes

[PMRpro Ambassador]

You could stop the AdCal for a week or two and see if that helps - it doesn't agree with some people at all. You won't fall apart in the meantime while investigating.

Are you on anything else besides what you mention?

[AnniesRyder5 in reply to PMRpro]

I also take statins

[PMRpro Ambassador in reply to AnniesRyder5]

Not alendronic acid or another bisphosphonate for your bones?

[AnniesRyder5 in reply to PMRpro]

Only Adcal

[SheffieldJane]

Esomeprazole may have become the culprit. Inexplicably these drugs can provoke the very thing they are prescribed for. I couldn’t take Omeprazole. I think aches and pains are in the side effects too. You can suddenly become sensitive to a drug you’ve taken happily for years. If you come off it you will need a very gradual taper.

[AnniesRyder5]

Thanks for this

I’m not sure if my GP would or could look at the bigger picture and give the same advice - assuming I could manage to speak to him!

[PMRpro Ambassador in reply to AnniesRyder5]

Well the PPI is NOT doing what it says on the tin any more - so something isn't right!

[ipsidipsy in reply to AnniesRyder5]

I had same problem with acid reflux. Then read somewhere that prednisolone comes in a coated form (gastro resistant). Took that and have'nt had a problem since. Does anyone know why the coated tablets are not prescribed if a patient is having problems with reflux. I would have thought better than taking omeprazole/lansprazole etc.

[PMRpro Ambassador in reply to ipsidipsy]

They are only available in the UK and there has been a lot of discussion today on another thread about the fact that the 1mg tablets have been discontinued, stocks are being used up and their expiry date is November 2020. That means you will have to manage on 2.5mg and 5mg tablets which isn't easy (can be done) when tapering slowly.

There is a lot of controversy about using them - there are some claims that they do not absorb as well and at one time an edict was issued saying there was no advantage using them but possible disadvantages so the extra cost was not justifiable. At the time there was a considerable difference in price but shortly after the price of plain pred increased so there was far less difference particularly when you added in the cost of the PPI tablets. But many practices refuse to prescribe them despite the advantages for patients with gastric problems.

[Amkoffee]

You could ask your doctor for ondansetron. They give it to cancer patients but cancer patients usually get eight milligrams and non cancer nausea is usually given at 4 mg.

[AnniesRyder5 in reply to Amkoffee]

I had my telephone consultation yesterday with a different doctor who suggests I stay off the Adcal for a week to see if reflux gets any better and that I try Peptac to relieve the symptoms instead of Gaviscon

Do you ever wonder why you bothered?