Acid reflux/digestive problems. One for FAQs?

[bussell]

Timely reminder from Grammy about FAQs. Thank you.

Recently I've had problems with acid reflux waking me agonisingly in the middle of the night. Currently on 10mg pred split between 8am and 8pm which works well for me, and had successfully weaned myself off Omeprazole. Or so I thought. Really don't appreciate being awake for two or three hours while this settles down (or not) so any suggestions would be welcome. I eat my evening meal between 6 and 7 usually, and only allow caffeine before midday, but I do like a bit of chocolate later in the evening. Is this my downfall? In a life before PMR and pred never had digestive trouble at all. Yet another unexpected side effect or old age or what?!

[SheffieldJane]

I think it is a side effect of Pred for some people. I was on it for a couple of years before I experienced any trouble. I just took it with yoghurt as I found omeprazole caused what it was supposed to cure. Then I started to experience acid reflux and very unpleasant and alarming oesophageal spasms that landed me in hospital with a suspected heart attack. I moved on to gastric coated Pred that I take at bedtime and this seems to have solved the problem as it bypasses the gastric system. I occasionally get heartburn that is easily remedied by over the counter indigestion tablets. I think that I have a sensitivity that I didn’t used to have, that may need investigating one day.

[Kendrew]

Hi bussell.Pre PMR I already had a few issues with indigestion that were managed well with over-the-counter remedies. I was concerned about this issue escalating once on pred and definitely didn't want to take omeprazole (or similar) so was fortunate in being prescribed enteric-coated pred. I take mine after my breakfast, and breakfast always includes yogurt. Two years down the line I've not experienced any major issues.

I do have to be careful if I have a spicy meal though.

[Rachmaninov2]

I found that Pred. caused stomach acidity and excruciating heartburn. Since adopting a low acid diet (including no coffee or chocolate) reducing Pred. and taking some other measures like raising the head of my bed etc. I have been OK. 🙂🤞

[bussell]

Already on coated pred. My digestive system seems to have developed a will of its own, but I'll certainly try cutting out caffeine and chocolate - woe is me, are we to have no pleasures left? Thank you all for the advice.

[Rachmaninov2 in reply to bussell]

I know it’s difficult but I decided that it was worth it if it stopped the pain. Good luck. 🙂

[PMRpro Ambassador]

It's fine weaning off PPIs but some people DO need something. If you don't want to take a PPI, try an H2 antagonist, famotidine or cimetidine these days (Pepcid and Tagamet), Or Gaviscon

[bussell in reply to PMRpro]

Thank you - I'll try one of those.

[PMRpro Ambassador in reply to bussell]

If your problem is overnight, take it before bed so its effect is greatest then.

[jinasc]

You could try this - a tip from a another patient years ago.

Acid Reflux

Unwaxed lemon, on minute in microwave (gives three times more juice)

squeeze lemon, divide juice into 3 and take with water, 3 times per day.

[Kendrew in reply to jinasc]

I'd completely forgotten how helpful that had been in the past for me. I used to start the day with a cup of hot water with some squeezed lemon juice in it. I found it always settled my stomach if it was a bit uncomfortable. Not sure why or how tho! I'm pleased you jogged my memory. Thankyou.

[jinasc in reply to Kendrew]

No problem, one find day we might just get all the Tips and Tricks I have learned over the years all in one place. All supplied by PMR & GCA sufferers and what they found helpful. Now I am not saying they work for everyone, but then we are all different.

[HeronNS in reply to jinasc]

It could be a book! You know, like the cookbooks churches or schools publish to raise money.

[Kendrew in reply to HeronNS]

What a book that would be!!

[bussell in reply to jinasc]

Definitely will try this.

[HeronNS]

I believe the chocolate is your undoing! If you are able to consume dairy, then this tip might work for you. I'm constantly amazed how a little yoghurt is enough to protect my stomach. I take my calcium near bedtime, usually not right before I lie down, but at least half an hour before, and unless I have plain yoghurt or kefir with it, it sits like lead. With either, no probs. Same with the pred. I was a bit nervous at first about taking it at 2 am and then lying down right away, but with a small helping of plain yoghurt there has been absolutely no trouble at all.

The actual tip is: have a little bit of yoghurt near your bedtime. Plain, unflavoured, unsweetened.

[bussell in reply to HeronNS]

A little voice of good sense is telling me you are absolutely right about the chocolate! I try to keep off dairy because I think it's unhelpful to the bronchiectasis, but do eat coyo, coconut yogurt which does have some live cultures in it, so will try that too.

Lots of helpful practical advice here. Thank you all. I'll try one thing at a time to see which is the clincher and report back in due course.

[HeronNS in reply to bussell]

It probably is the live culture which is effective, plus there is fat in the products I use - as there will be in a coconut-based product, and this seems to help "line" the stomach. Good luck with your research!

[piglette]

Why don’t you drop out items of food one at a time and see if it makes any difference starting with chocolate! Or you could do what my sister had to do for IBS where she just ate a couple of items a day to find out what caused problems. Probably not necessary in your case but this system is mentioned on the internet.

[bussell in reply to piglette]

This will be my first and hardest thing to do!

[piglette in reply to bussell]

I know how you feel. You only have to do it for a couple of days. If you find it is the chocolate you then have the choice of eating chocolate and suffering or giving it up and not suffering! You could do tests at eating it at different points of the day. Is it dark chocolate or milk chocolate you eat? Perhaps you could try darker chocolate??