GERD symptoms

[diana16]

Hi does anyone suffer with GERD. I am sure that is what I have with continuous burping, some bloating and regurgitation. I take Esomeprazole which means that the stomach acid is neutralised but the regurgitation is still unpleasant. The GP says I just have indigestion (!) so I have self-diagnosed this as GERD as it fits all the symptoms. Could it be another symptom of ibs or maybe a side effect of medication?

[userotc]

Obviously all drugs can cause side effects. The link below lists them in terms of serious and other (!!). GPs tend to misdiagnose as often as correctly diagnose in my experience so I'd recommend you see a qualified Nutritional Therapist specialising in gastro issues. Neutralisation of stomach acid is often NOT the way to go anyhow As a student NT, I cured a GERD patient but am specialising in other areas initially before likely adding gastro later. Good luck.

drugs.com/sfx/esomeprazole-...

[JimmyJackson]

I suffered badly I went on Gluton/Lactose free diet & it 90% cleared up in. a week Try it it can't hurt

[xjrs]

IBS and GERD can go hand in hand. IBS can cause gas to be trapped in your system which puts pressure on the valve that sits between the stomach and throat, that allows stomach contents to flow back. Gas can also get trapped due to stress which prevents it moving through your system properly. If this is the case, you could try the Nerva Gut Directed Hypnotherapy app.

My GERD is normally worse when I am constipated, due to food getting backed up, sitting around for longer and generating more gases. If this is true in your case you could try increasing fibre to make sure that you are clearing out regularly.

If you are suffering from food intolerances, you could try Alflorex probiotic, since food intolerances can often be caused by a gut bacterial imbalance. Failing that you could try the FODMAP elimination and reintroduction diet - though best to try Alflorex first since there may be less foods that you need to eliminate.

To protect your throat at night, you could raise the head of your bed by 20cms using bed risers found on the internet. This helps to keep stomach contents in place overnight. I've slept this way for years now.

You can also try DGL licorice:

medino.com/product/fsc-degl...

You suck a tablet 20 minutes prior to a meal and before bed time. It lines the throat with a coating to help protect it from acid. Not that DGL licorice has a chemical removed that increases blood pressure, so best not to use plain licorice.

Using all the measures above, you might find that you end up not needing PPIs at all.

I had a very poor experience with nutritional therapy - the therapists are not medically trained and base their recommendations on studies that have not always gone through clinical trials. I analysed every one that I could find in the UK, picked the ones that I thought were best qualified and not charging £100s per hour (although they do charge not far from that) and both of the 'best' ones that I used made my condition far worse and I ended up wasting thousands on their 'treatments'.

[xjrs]

By the way, were you prescribed Esomeprazole or did your GP recommend it? GERD tends to accompany pain in the chest and/or throat. Do you get pain too? If this is the case your GP should be helping you to manage this, since long term untreated GERD can cause damage to the throat and lead to barrett's oesophagus which is a pre-cancerous condition, which you may already be aware of. If you are also getting pain you probably need a proper diagnosis.

Some of the measures I described may help. In some instances the valve doesn't work properly due to physical anatomy such as hiatus hernia. This can only be diagnosed with endoscopy. In these cases, unfortunately, PPIs are needed long term in order to protect the throat (though DGL licorice can be used as an additional measure). It is the trade off between long term use of PPIs vs the possibility of barrett's oesophagus. On rare occasions surgery is possible to tighten the valve. I think I read that this can have varying success and may not fix things long term for everyone.

[diana16 in reply to xjrs]

Thank you so much for your very comprehensive reply. My GP prescribed Esomeprazole years ago as I have a hiatus hernia and was suffering from an acid stomach. Up until a few months ago I was OK. I wonder if my steroid therapy for RA has caused the problems? Anyway I will definitely try DGL licorice. I have no pain thankfully and I will speak to my GP again about this.

[xjrs in reply to diana16]

Good that it was under control until a few months ago. Probably worth asking your GP whether your steroid therapy might contribute. If you have the name of the drug involved, you could look it up on websites such as RX list:

rxlist.com/

These will tell you what the side effects of the drug are or it will be on your information leaflet.

[diana16 in reply to xjrs]

Yes will do that, thanks x

[Blearyeyed]

Been reading through your replies.I see you have begun steroid therapy.

This can bring GERD as a side effect , especially if you already have digestive problems like IBS.

It would be worth discussing this with the GP or Consultant as they are more likely to recognise the link and add GERD as a diagnosis on your medical history which will help with future appointments.

Eating probiotic live natural yoghurt with a little honey before your steroid helps reduce this symptom and protect the stomach , it makes a nice mini breakfast with a few berries . You can also use a tablespoon of the yoghurt with herbs , tomato other natural flavours and have it as a dip with a few vegetables or little crackers before a meal to help reduce the acid with other meals. A probiotic supplement taken with food can also reduce acid symptoms and improve bloating.

It helps to reduce the general side effects and weight gain involved in steroids , and to reduce IBS and GERD to reduce processed sugar and "white" or simple carbohydrates to occasional treats. Substitute wholemeal , brown , wholegrain and potato with skin instead if you can with your digestion . Try and avoid artificial sweeteners altogether and reduce coffee consumption. Eating five smaller portion meals through the day rather than three big ones also helps reduce GERD . Reducing saturated fat foods and choosing lean meat or fish and dairy (including lactofree if you need it ). Increasing variety of vegetables and eating certain fruits with less acid are also useful nutrition for RA .

Liquorice doesn't always suit with steroid medication and certain other meds you might be taking so it's worth checking what the interactions are for the things you are taking. Garlic or ginger capsules and ginger tea can help , but again check your medications because you shouldn't have these if you also use blood thinners or certain other heart medications.

Eating early in the evening. Increasing the water and green tea you drink in the day also helps reduce GERD especially before and during a meal but sipping it through the day controls the acid. Sleeping on your left side or back with your shoulders and head raised on pillows also helps stop the stomach acid causing pain at night by moving into the oesophagus.

Have you been given any advice about taking supplements with your steroids?

You can absorb nutrients less well on this medication so it's worth asking your GP to check your full blood count , Vitamin B 12 , Folates , Vitamin D , Ferritin / Iron and Magnesium . You can request these and it's advisable if your steroid treatment is longer than a month.

Request a copy of your results from the surgery even if they say they are normal as if any results are low or borderline it is better to take supplements before the issue gets worse , or you could just need higher levels than others.

A combined supplement after your fattiest meal is sensible anyway with stomach issues taken with Vitamin C. If you are on long term steroid therapy you do need extra Vitamin D and K2 , even if you have been given Adcal , you can get a spray called BetterYou from Amazon and chemists for this , it's easy to take with a mild minty taste so pleasant after a meal. A separate B12 supplement taken with water, your yoghurt and no vitamin C is also helpful to improve your metabolism of food and your medication and reduce Fatigue and joint pain of RA. Folates may be needed if these are low for the same reason. Magnesium in your combined supplement, and used in skin cream or a spray on your joints , hands and feet can reduce any symptoms of neuropathy you might have at night with your steroid and the RA.

Hope things improve soon , I've been on steroids myself so I know that it can cause these extra stomach issues and other side effects , although the benefits outweigh the risks in terms of pain and mobility for your RA so a bit of adaption is worth it , take care ,Bee

[diana16 in reply to Blearyeyed]

Dear Bee, Thank you so much for your very in depth reply. I am already doing some of the things you suggest but the time has come I think for a radical change in my diet and living. I think trying to come off the steroids would help as I am now on biologics for my RA. I have had stomach issues for a long time but obviously as we get older things get worse unless we become proactive in helping ourselves, Diana

[Blearyeyed in reply to diana16]

Just be prepared that the Biologic itself will have short term effects in your IBS , as will the steroid taper.As you get down to 6-4mg of the steroid you will also get various side effects as your Adrenal system stutters back to doing the work as the steroid won't be keeping your cortisol level at a permanent high.

This will bring Fatigue and aches , twinges and spells of tiredness and neuropathy but it can also cause your stomach to be more sluggish , and if wether you have diarrhea or constipation the pattern of this will change too.

Just take care and give yourself time to recover and build your body balance back again between drops in steroid dose or it becomes far more difficult to do. I hope the Biologic works well for you , it does seem to bring success in managing your RA. Bee

[Terrym100]

I have suffered with Gerd for over 20 years. Regurgitation, food sticking, heartburn etc. Comes and goes but when gerd is bad, it tends to set off IBS at the same time.

[diana16 in reply to Terrym100]

Yes I agree, how do you manage your symptoms?

[doris22]

Hi there. Omeprazole, for me, helped with the acid but made me feel awful. As you say burping and very bad bloating. I had a phone consolation with a gastroentoroligist specialist and he changed me to an H2 blocker if not try Lansoprozole. That was better for me than Omeprazole . All the best.