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up and down and up with GERD

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GERD & Acid Reflux
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Posted 5/15/2012 4:40 PM (GMT -5)
I haven't posted here in a while ....

My GERD is not as bad these days. It does flare up 2 or 3 times a week, but with Gaviscon at night, it seems to go down and gives me some relief. I am now in two minds about getting the TIF done (still waiting for the appeals process to finish). I know my GERD does not get triggered by foods (I have tried several experiments). My symptoms include: bitterness in mouth and heartburn (my throat was quite bad back last year but seems to be ok now). It does bother me a lot when it does flare up though ....to remind everyone, I can not take any PPIs or H2 blockers as they all give me varying degree / types of side effects.

I know GERD is chronic and I am not going to wake up one day and be cured. However, if I look back over the last several months, the severity and frequency of the symptoms has reduced considerably (without taking any medications and without following excessively rigid diet). So, I was wondering if this can continue to settle down even further ... in which case, do I need to address it with the surgery - if I can get by for now? I've had this for over a year now and although from what I've read, I know I don't have to fear barretts or cancer at such an early stage, I do worry about leaving this untreated like this (without the ppis or the h2s)

GERD is a perplexing condition for sure!!
Posted 5/18/2012 9:29 AM (GMT -5)
without following excessively rigid diet?

I am surprised you do not follow one! Following a GERD-safe diet helps tremendously! Even as simple as lowering the fat content, splitting the meals help! flare-up 2 or 3 times a week isn't very serious. If you get one or two days heartburn-free, your esophagus can heal.
Posted 5/18/2012 10:57 AM (GMT -5)
I do watch my diet - but it is not as rigid as it used to be last year (when my throat used to hurt with anything acidic going down). Further, I am unable to correlate any changes in the diet to the symptoms getting worse or better.

Even though the esophagus heals, if one continues to reflux, one will continue to experience the symptoms. I agree that if the reflux continues to go down, then eventually the esophagus may get to be strong enough to withstand occasional flare-ups. However, at this time, I am not convinced that anything other than the passage of time has contributed to the reduction in my symptom severity and frequency. Further, I am not without symptoms and I am not really sure if I ever will be (without the medications or the surgery) since that is what the statistics of this disease indicate.
Posted 5/18/2012 7:20 PM (GMT -5)
Statistics are misleading.... "10% of population will get (something)" It contains the assumption that everyone is living the same life, and on average by 10% chance people will go on and contract certain disease. In fact, our actions influence our future. By doing something and not doing something, we can either avoid or cannot avoid becoming something. I never take statistical statements like "10% GERD patients will develop barrett, 0.1% of barrett patients will develop cancer yearly" seriously. To me the chance is 0% if I do things right.

I have been observing my symptoms and continuously improve the way I deal with them. It gets better and better. Things that I once believed couldn't help me, like taking a PPI (I used to not tolerate them well), changed as I find a different way to approach them. I tolerate PPI well now after changing to other formulation and changing the dosage pattern, surprisingly.

I used to get flare-up every day. Now I can manage to stay symptom-free for 3 days straight. That's an improvement. By trying new things I picked up - accumassage, diet, probiotics, manuka honey, etc, keeping the things that work, drop the things that don't, I gradually see an improvement. I'm sure I can hit the total recovery one day.
Posted 5/19/2012 3:25 PM (GMT -5)
WJF, what different formulation did you try of PPI? I'm having to stop mine due to some quite serious side effects. I'm on half dose now with lots of Zantac - I can't believe the number of things (not GERD related) that have got better since I reduced the dose. I have very poor tolerance of PPIs. I've tried Lansoprazole, Pantoprazole, Esomeprazole and Omeprazole. I've tried them in the morning or at night. The side effects now mean I cannot take them long term - unless the new problems turn out not to be related to the PPI, but things got better overnight when I halved the dose, so the PPI is my No 1 suspect. I'm going to try acupuncture as I'm at the end of the road medication wise.

MMM
Posted 5/20/2012 7:05 AM (GMT -5)
Hi MMM,

This is my story:

Initially (last year) I was prescribed Nexium 2x 40mg a day. It was an overkill. I had aweful constipation and diarrhea. Then the doc suggested 1x 40mg daily before dinner. Heartburn symptoms remained relieved but I developed insomnia and panic attack after that. Then he changed to rabeprazole 1x 20mg nightly. This was the worst drug and dosage pattern. It gave me slow gastric emptying, indigestion, nocturnal heartburn, insomnia and panic attack. I was forced to stop after 1month.

2 weeks ago, when I had to retake PPI. I took pantoprazole 1x 40mg before breakfast + Zantac 150mg at bedtime. Great relief with tolerable side-effects - stomach cramp, no insomnia, no panic attack. I did have slow gastric emptying, but it was not so bad. After a few days, my nocturnal symptoms cleared up, i decided to skip the Zantac. The side-effect reduced. In addition I no longer felt hyperacidity before breakfast. A few days more later, my esophagitis healed, I tapered down to rabeprazole 10mg before breakfast, and yesterday I stopped completely. Now I am on the natural route.

Yes when you can't tolerate PPI, you could try a lower dose. I think taking PPI before breakfast is better than before dinner. Zantac works superb to stop nocturnal symptoms when taken before bedtime (you can't take a PPI before bedtime).
Posted 5/20/2012 11:00 AM (GMT -5)
Hi, interesting story, thanks.

I was taking my PPI at night as that was the only way to have any impact on the morning nausea. I'm now taking high dose Zantac at night instead and a low dose of PPI before breakfast, but I need to get off the PPI altogether :-/

MMM
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