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Home > Archive > Heartburn Support > January 2005 > Anything we can do for breakthrough?
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Anything we can do for breakthrough?
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| I'm on a 30mg dosage of a PPI, lanparazole (sp?). Had some chinese
food tonight (ate too much, darn it), now I have that "stuck belch"
feeling and actually had, uh, high reflux, something that actually
rarely happens.
When we get a breakthrough attack of reflux, is there anything we can
do to lessen the attack? I'm unsure if it's OK to take antacids or a
OTC histamine antagonist while on a PPI.
Oddly, my only pain is in the right LOWER quadrant, just to the side
of my hipbone (I'm female), dunno if this is just gas - it's a pain I
get very infrequently, but which has been bugging me on-and-off the
last few days - it was gone till I had the chinese food.
Chinese food never caused an attack before, thinking it was more the
quantity than the quality - I'm more likely to have an attack if I
overeat. I know this, but sometimes forget.
Anyway, anyone have suggestions?
jmc
usenet [at] jodi [dit] ws
Any day you learn something isn't a total waste.
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| John Que 2005-01-20, 7:07 am |
| > > JQ
empty[vbcol=seagreen]
[vbcol=seagreen]
> HMc
> While there may be some change in gastric motility mediated by hormones,
> these play a small role that likely has negligible symptomatic effect on
the
> patient.
I beg to differ. The reason being my personal experience with betaine HCL
and abandoning PPI meds. The symptom abated somewhat by going
Prilosec free and has been eliminated by my
taking 40 or 50 grains of betaine HCL with pepsin.
per meal especially fatty meals. Smaller less fatty meals
don't seem to require the acid supplement.
I recognized this isn't in orthodox play book and I do appreciate your
stating the standard understanding. And I appreciate your tentative
wording of that understanding. Perhaps the air swallowing and belching
as a secondary effect resulting from an
irritated esophagus and possible motility issues
due to hormonal issues you discount. It seems to work for
me, thus I grope for an explanation. Of course,
I sleep in a recliner most of the time with my
torso at 30 to 40 degrees as opposed to the ~5 degree the medical
refresher manuals (i.e. Merck Manual) suggest to the Docs as useful.
Understand, I don't oppose the use of PPI med during acute
esophagitis, but I consider it unwise to put patients on PPI meds
as if they were meds for diabetes.
> The reason for increased belching is almost entirely due to the air
> swallowing that GERD patients develop as a habit they use to repeatedly
> clear the lower esophagus of refluxate. It's a losing battle, of course,
> since air swallowing leads to belching which in turn leads to more reflux,
> but it is neverthess the primary operative mechanism. It's a difficult
habit
> to break, and is the major contributing factor in the gas-bloat symptoms
and
> increased flatus that are often exacerbated after gastric fundoplication
> wherein the patient often has more difficulty belching.
After my Nissen fundoplication, I found this to be a very minor effect.
It was several years later after I was on the PPI med again that the
belching effect came to the fore again. I've never had flatus to
any meaningful degree after my gastric fundoplication.
>
> HMc
And finally Howard may I suggust you check out the
Yahoo groups on the topic of
heartburn/GERD at least the most active one.
Proton Pump Inhibitor Free for the majority of a year.........JQ
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| quietguy 2005-01-27, 7:31 am |
| I can't speak from a medical practioner perspective, but I have been on
60mg of lansoprazole for the past 8 years and taking OTC antacids when
needed hasn't killed me yet, and has let me sleep when I have indulged
in food that isn't good for me. (chinese, tomatoes, strawberry jam etc)
David
jmc wrote:
> I'm on a 30mg dosage of a PPI, lanparazole (sp?). Had some chinese
> food tonight (ate too much, darn it), now I have that "stuck belch"
> feeling and actually had, uh, high reflux, something that actually
> rarely happens.
>
> When we get a breakthrough attack of reflux, is there anything we can
> do to lessen the attack? I'm unsure if it's OK to take antacids or a
> OTC histamine antagonist while on a PPI.
>
| |
|
| quietguy wrote:
> I can't speak from a medical practioner perspective, but I have been on
> 60mg of lansoprazole for the past 8 years and taking OTC antacids when
> needed hasn't killed me yet, and has let me sleep when I have indulged
> in food that isn't good for me. (chinese, tomatoes, strawberry jam etc)
>
> David
>
>
> jmc wrote:
>
>
>
>
60 mg??? Argh, and here I thought 30mg was a lot. What kind of OTC
antacid do you find effective?
jmc
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| quietguy 2005-01-27, 7:31 am |
| Just the garden variety stuff - Quickeze if it isn't too bad, Eno if it's
persistant. Usually does the trick and lets me go back to sleep
David
jmc wrote:
> 60 mg??? Argh, and here I thought 30mg was a lot. What kind of OTC
> antacid do you find effective?
>
> jmc
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| John Que 2005-01-27, 7:31 am |
|
"jmc" <NOnewsgroupsSPAM@NOjodiBODY.HOMEus> wrote in message
news:cc7ou0l19rhi8p33e3ceeg5rpost2pd1vs@4ax.com...
> I'm on a 30mg dosage of a PPI, lanparazole (sp?). Had some chinese
> food tonight (ate too much, darn it), now I have that "stuck belch"
> feeling and actually had, uh, high reflux, something that actually
> rarely happens.
>
> When we get a breakthrough attack of reflux, is there anything we can
> do to lessen the attack? I'm unsure if it's OK to take antacids or a
> OTC histamine antagonist while on a PPI.
I've seen mention of the use of H-2 blockers in conjunction PPI meds in
Medscape articles and in Pubmed abstracts including linked articles.
There such a thing as night time break thru with PPI meds. One the
Medscape article has some nice charts. I recall it was a larger article
so it took while to download.
I suspect that belching is caused by overly motile stomach trying to empty
too much of its contents in duodenum. The result is likely a mix of
bile and pancreatic enzymes in the stomach and
the cause of belching and meals that just SEEM to set in the stomach.
Possible solutions are another drug to
alter motility, small meals, or an acid supplement
in persons not on the PPI meds. The last suggestion is alternative medicine.
In a healthy person as compared to GERD patient on PPI meds,
when the stomach contents/chyme become sufficiently acidic and are starting
to pass into the small intestine, the highly acid chyme triggers the
release of hormones that modulates the stomachs motility among
other things.
>
> Oddly, my only pain is in the right LOWER quadrant, just to the side
> of my hipbone (I'm female), dunno if this is just gas - it's a pain I
> get very infrequently, but which has been bugging me on-and-off the
> last few days - it was gone till I had the chinese food.
>
> Chinese food never caused an attack before, thinking it was more the
> quantity than the quality - I'm more likely to have an attack if I
> overeat. I know this, but sometimes forget.
Quantity is a good way for me to in trouble. I like watermelon
and it fine is restrict myself to a small slice but if I eat more
................
>
> Anyway, anyone have suggestions?
I believe the bulk of GERD damage is done at night when people
are laying in their beds on the level. If you start sleeping is a
recliner in will help tip the balance toward getting healed.
Remember it takes weeks to heal so be patient.
It is vital that a GERD patient sleep with their torso
inclined such that stomach acid can't leak into the
esophagus. Six inches blocks under the head of
the bed will help but it isn't enough incline to
attain best effect. I'll suggest you sleep in
a recliner as much as possible. If you
want to "sleep" on the level in the morning
with the husband after a night in the recliner,
take a Carafate tablet or perhaps some
Gaviscon.
> jmc
> usenet [at] jodi [dit] ws
> Any day you learn something isn't a total waste.
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