I have limited systemic sclerosis. For years I have had very bad reflux and investigations have revealed oesophagitis (now controlled by PPI s), a Schatzki ring, hiatus hernia. Manometry last year showed completely absent peristalsis in the oesophagus and an ineffective lower sphincter.
Despite trying to do all the lifestyle stuff - bed on 2 bricks at head end, 4 pillows, not eating late etc, I normally wake 3-4 times a week in the early hours coughing as a result of reflux getting into my lungs.
Then I had to have 6 weeks of oral co-amoxiclav due to a finger infection. This was not much fun for my bowels and I am sure it made my reflux even worse.
After I stopped the antibiotics my reflux receded again and I have realised that it seems to have disappeared. I am not stopping my PPI s to check, but certainly I have not woken up with coughing since. Has anyone else ever experienced this, or have any suggestions as to why?
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cowhide
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In Lupus patients there is known to be a bacterial overgrowth in the gut which recent research is starting to show could be responsible for the illness. A small scale UK study reported in Dec 2021 how they had sent all their patients into a clinical remission by changing their diet.
Your antibiotics will have killed off some of your gut bacteria & I wonder if this was partially the cause of the reflux?
I have UCTD & had bad reflux. Last autumn I started to follow the Lupus diet & it settled all my reflux. I have even come off the PPIs.
Thanks for this, I had wondered, but I've never been diagnosed with SIBO despite some thorough goings-over by a decent gastro consultant. I'm seeing him in a couple of month's time so will discuss. With absent peristalsis I should still expect to get reflux, irrespective of gut microbiome.
Search on Dr Brooke Goldberg. It's her diet that she stumbled across trying to loose weight for her wedding. It sent her Lupus into a clinical remission.
She wrote a book called "Good-bye Lupus", but you can find most of what it contains for free online. It's a tough diet but in my case it totally transformed my life. Basically it's a vegan diet with the addition of avoiding high Omega 6 oils and drinking about 2 litres of green smoothie a day. I have heard some say that just the smoothie made a difference for them.
You'll need to make your own mind up. Personally I think it works but not necessarily the way Dr Goldner thinks based on the latest research. I think the science is only just catching up.
Hi Cowhide, I unfortunately do take rotating antibiotics for bacteria overgrowth (SIBO) and yes it does effect my reflux problems by causing oesophageal spasms. My Rheumatologist suggested changing to a different PPI namely Esomeprazole and it stopped the spasms. I was on Lansoprazole then omeprazole before then. I get other side effects from antibiotics such as irritable bladder etc but I’m between a rock and a hard place as SIBO symptoms much worse. The hydrogen breath test is available on the NHS at some hospitals but you may wait a long time. I got mine through a herbalist/functional medicine practitioner. Yes I have tried all sorts of diets and modify my diet but still have problems. I’ve got UCTD (with rnp antibody) with systemic sclerosis gut issues. The antibiotic for SIBO with least side effects is Rifaxamin which your consultant can/may prescribe. I’ve had mixed results with it.Hope this helps
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Reflux and heartburn
GERD (Reflux)
Ineffective oesophageal motility and excessive reflux questions 
More antibiotics :(
