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Acid Reflux / GERD Message Board


Acid Reflux / GERD Board Index


Hi,

I completely understand your frustration. LPR is not easy at all. It can wear you down physically, mentally and emotionally when it is at its worst.

I developed my LPR/GERD symptoms in 2002. For about 5 years, I was able to keep it under control with mostly diet and lower dose PPI's. When I started getting worse symptoms, I upped my PPI's to twice a day of the higher dose PPI's. I was on the Prevacid Solutabs 30 mg/twice a day for several years. I'm not sure why, but the Solutabs that dissolved in my mouth worked much better than than the regular versions. I've been on the Dexilant 60mg since about 2008.

When my LPR cycled really bad, I supplemented with Gaviscon or Zantac. Most of the time Gaviscon in the evenings.

The rest of your question is tough. I found I needed a multiprong approach as I sought treatment. I ended up with a team treating me: PCP, Gastroenterologist, ENT/Allergist, and Pulmonologist.

The Gastroenterologist started off very conservative with me. I also had upper Endoscopies, Manometries and 24 hr. pH tests with him. I say say tests because I've had them repeated over the years which confirmed that my problem was getting more and more severe. I learned by refluxing was extremely severe, I had an extremely 'loose' lower esophageal sphincter, and I had a sliding hiatal hernia.

My ENT gave me a gargle and breathing exercises to help calm my throat. He had done some regular scopes of my throat to monitor the acid irritation. He also did an upper 24 hr. pH probe by ResTech. This particular brand and type probe can actually measure gaseous acid that comes up above the upper esophageal sphincter. I think this is a wonderful way to confirm the LPR vs. tpical GERD. Regular pH testing only measures acid in the liquid form. In my case, I have the gaseous acid hitting my throat and irritating my lungs.

My Pulmonologist has actually been the most diligent in helping me with treatment. He has had me do a sleep study, PFT's, and Esophagrams and Modified Barium Swallows. The Barium Swallows/Esophagram actually physically showed the acid coming up and irritating my lungs. I ended up wearing a custom sleep splint that holds my lower jaw forward to keep it from falling back when I sleep. For some reason reflux is directly tied to sleep problems for many people. I hadn't even realized I had a problem.

Have you had any testing done? If not, it sounds like it is time. The Manometry and pH testing is a good first step. The mamometry in particular will help you see how bad the physical problem of the closure of the lower esophageal sphincter is. The upper ResTech testing confirmed the acid hitting my throat.

I'm not sure why but my cycles of worse symptoms seem to be seasonal too. In case it is worse in the fall and winter in conjunction.

As for treatment, I have multiple health problems that trigger each other. For example, my reflux irritates my lungs and triggers my asthma. When my asthma triggers, I cough a lot which pushes the acid up even more and irritates my lungs more. It can be a viscious cycle. I actually have to step up treatment for both problems big time and at the same time to help. I've also been diagnosed with other digestive issues as well which my GI doc helps me with getting that under control.

It isn't something I recommend to everyone, but I ended up having a Nissen Fundoplication in fall 2008. Unfortunately, my asthma problems had become life-threatening at the time despite treatment. I'd say it was an absolute success for me. I'm still on the Dexilant though. While the surgery helped me compensate for the very weak LES, it doesn't stop all of the acid coming up.

Can you share what your symptoms are? It may help give me a different insight.

Hang in there till your appointment. Have you started your list of symptoms and questions for the GI doc yet?
The gargle is just for the throat irritation.

Are you on any asthma medicines at all? Advair/Symbicort/Dulera? Maybe Singulair? Are you using Albuterol? Do you have a nubulizer? Those can help with the breathing issues. The daily preventative meds come in varying strengths so you could start lower and go up depending on how you respond.

Because of the digestive issues, you might ask about Carafate as well for the digestive stuff. It is old school and not intended for long-term use, but may help in combination with the other stuff.

I'd also recommend asking about an epi-pen. If you ever had a breathing emergency, it would give you time to get emergency help because it opens the airways up quickly.

Be careful with the Gaviscon. It has been one of my go-to back-up meds to add in during flares, but it can cause diarrhea.
Thank you Mountain Reader <3 ...your help has been so valuable to me!!

I am continueing to write everything down so that when I go in the the Doc I will have my ducks in a row.

I am always cautious with the Gaviscon because I am afraid it will stop working so I use it only when I get really bad...which has been a lot in the past few weeks.

I am going to ask about the asthma meds too, I think it might be helpful.

Do you find that you symptoms get worse with you cycle?? PMS seems to make my symptoms so much worse and also increased the anxiety. I am in Perimenopause and this has gotten so much worse for me.

Thank you again!
b.
Crazy life,

Sorry to hear of your issues although it is somewhat comforting to know we are not alone!

You might want to be careful about taking Zantac and gaviscon together, I believe they have warnings about taking them around the same time.

Regards
Crazy life,

Sorry to hear of your issues although it is somewhat comforting to know we are not alone!

You might want to be careful about taking Zantac and gaviscon together, I believe they have warnings about taking them around the same time.

Regards
Mucous... Thank you...
I take them separately..usually I take the Zantac in the morning and then at night. Then I take the Gaviscon if I get into trouble during the day or before bed. I do really try to stay away from the Gaviscon if I can..I hate taking anything really!

I am really working on my diet...trying to stay away from carbs/gluten and hopefully that will be a big help.

Hugs and Healing!!
b.
I think the Dexilant 60mg. is most common. It does come in 30 mg. though. It is a time released PPI. In my view, the Dexilant 60 mg per day is equivalent to taking many of the other high-dose PPI's twice per day.

My GI doc has always had me on PPI's a minimum of 4-5 weeks to see if they will actually help. (I've rotated through all of them at one point or another. My issues were abnormally severe though.)

I've been on them for so long, I can't tell you how long it took to get relief. I expect you should have some idea within a week.

My GI doc and PCP both recommend Gaviscon or Zantac as supplements with the PPI's when I need them. Zantac does help. I like the immediacy of the Gaviscon. I can't use Gaviscon too often though or I will have issues with diarrhea. If I do supplement, I take it separately from the PPI's. I may take the Dexilant in the morning and supplement in the evening or before bed.

I share my stories and what I've learned over the years with others because I wish I'd had people to ask. I didn't discover the Health Boards until I'd been going through a bad time for a while. Because of how my symptoms presented, I think I went undiagnosed for a very long time. What I share may not be welcomed by everyone, but if it helps educate someone or prompts them to ask more questions to themselves or their doctor, I feel I've given back in some way. I'm glad to hear your thanks.

Good luck with the Dexilant.





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