Nocturnal Acid Reflux Help Needed

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Hi, I've been suffering with Gastro Oesophageal Reflux Disease for the past 4 years and whilst the symptoms are bearable during the daytime, my acid reflux really flares up of a night-time and causes me no end of problems getting a decent nights sleep. I was on 30mg Lansoprazole once per day up until Nov last year, but then started developing a catchy throat, water-brash and a chronic (productive) cough every evening, so my GP has put me on Omeprazole (20mg 2x per day) and Domperidone (10mg 3x per day). I had a Gastroscopy about a year and a half ago and all this found was mild duodenitis, but there was a lot of reluxed liquid in my oesophagus.

The new medication hasn't really helped so far.

As soon as I lie down of a night-time, I get gurgles and a lump in my throat, I can't swallow and start coughing. Eventually I have to get up and try and expel all the mucus in my throat. I have also had problems with my sinus' and have had cold after cold this winter. However my GP doesn't think my sinusitis is related to GORD.

I have been strictly following all the recommended GORD lifestyle modifications, (avoiding alcohol, caffeine, chocolate, fatty foods, tomatoes etc), not eating 3+ hours before bed, and I also prop up the bed on 7inch blocks and use a Wedge pillow and try to sleep only on my left hand side). The only way I get some respite is sleeping on the sofa with the wedge pillow over the arm of the sofa so I am at effectively a 45 degree angle.

Does anyone have any other tips that they can recommend as I am nearing my wits end and am struggling with my work and homelife with the constant lack of sleep and energy.

Are some PPI's more effective than others?

Thanks,

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  • Posted

    Poor you,

    You could try metaclopramide instead of the domperidone, you can add in an H2 antagonist such as ranitidine 150mg bd to the present regime. But it sounds like you need to be referred to an upper gastrointestinal (GI) surgeon( if you would consider surgery. They can perform a laparoscopic fundoplication....key hole operation which stops the reflux. It is a bit unpleasant eating ( initially liquid and slowly building up to solids) for 6-12 weeks. If you get a good surgeon the results are fantastic and you probably won't need any medication and will be able to eat anything and sleep horzontal. Some people find that after 6-10 yeas the "magic" wears off and they may need intermittent omeprazole 20mg again. I don't think there is a more effective PPI. Lansoprazole and omeprazole are equally effective and the most cost effective. You can take gaviscon advance in addition to all that has been mentioned above.

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  • Posted

    Thanks very much for replying, I really appreciate you taking the time to write back.

    I think I will go back to my GP and seeing if ranatidine and metaclopramide might help. I'm a bit terrified of surgery and have read that the nissen fundoplication does have quite a long recovery time and potential side effects, so I really want to leave that as a last resort.

    thanks again

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    • Posted

      I've been suffering from nocturnal GORD for over 20 years and have had the Nissen Fundoplication. I found I recovered quickly with no side effects. However, although it improved my daytime reflux, it didn't stop the nighttime breakthroughs so I have had to stay on the PPIs. I am on 80mg of Losec MUPS which, because you don't need food to take them with, you can take them at nighttime. They worked for quite some time but I'm having to review right now. Do give the operation a go - it does work for some people.
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  • Posted

    Having suffered with chronic reflux/heartburn symptoms for many years,ultimatley leading to an internal stomach bleed; and having

    tried every medication on the planet; I thought there was no end to my misery.

    About 3 yrs ago, I did a little research into the importance of a

    PH balance in the diet, and learnt that to maintain a healthy body

    we require an equal alkaline/acid balance.

    Most people have incredible acid lifestyle i.e. stress, smoking , drinking and working hard etc.

    My point is increase your alkaline intake; and hydrate your body

    I started drinking Wheatgrass juice, which is incredibly alkaline.

    The healing effect was almost immediate and other countless health benefits have changed my life for good.

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  • Posted

    Maybe you could try being more strict with your diet.

    I was taking PPI and following loose advice regarding my diet (no tomatoes, no spices, little fat, ...) and not getting any better.

    I had problems sleeping as well.

    Then I tried following a very strict diet based on the book by Jamie Koufman: no fat at all (no nuts, no oil, no fatty meat, no cheese), only food with Ph above 5 (no yoghourt, no fruits except melon watermelon and bananas), no trigger food (coffee, chocolate, spices, tomatoes, cucumber, bell peppers, ...).

    So I eat only oatmeal with bananas, vegetables except trigger food, melon watermelon sometimes pear, chicken breast and lean fish, rice, potatoes, lentils and beans, nothing else, and no oil or dressing.

    Also I am drinking water Ph 8.8 in between meals (evamor).

    I started getting better very quickly, the improvement has been tremendous after just one week.

    I sleep most of the night now.

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  • Posted

    I feel it may be better asking your GP to prescribe Lansoprazole , possibly the fast tab ones that dissolve on your tongue & taking them twice a day. I thought when you said you had a scope done they might have found a Hiatus Hernia which could be the answer to your reflux , but if they have not then you have an over production of acid. Very painful & can rot your teeth . My brother takes Lansoprazole & he has been finding this helps.
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  • Posted

    I was doing very well with taking dexilant (PPI) and following the low acid diet.

    Unfortunately when I stopped the dexilant some of my symptoms came back even though I was still following the diet.

    I suffered for a few days then decided to try DGL licorice three times a day 20-30 minutes before my meals.

    The effect has been spectacular, I feel normal again.

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  • Posted

    Hi - thanks to all for taking the time to respond to my original post.

    I don't know about other GERD sufferers in general, but the longer I have had this illness, the more I realise that for me this is really a 'mechanical' problem: as in the LES valve between my stomach and oesophagus simply doesn't close properly, (when I had the gastroscopy, the specialist noted this also).

    Whilst watching what you eat and eating slowly makes a minimal difference, it is the affect of gravity (i.e. when laying down) or doing things like bending over to pick things up, playing with my children, or heavy physical activities that might put pressure of the stomach which I think really causes my reflux problems.

    I also realise that sadly there isn't a miracule cure (& believe me I have tried every homeopathic remedy to no avail). Ultimately, your oesophagus takes time to heal (it doesn't get much respite as you have to eat confused ), and, whilst the PPI's reduce the acid sufficiently to reduce the symptoms, it is simply due to the LES valve not functioning properly that the reflux of liquids still occurs - however, as my stomach contents is not as acidic it doesn't do the damage or is as noticeable it would be without the use of PPI's. I'm still on the same dose of Omeprazole 2x per day along with Domperidone and whilst I still need a wedge pillow at night I'm overall at lot better, and sleeping better. It took a good six-to-nine months or so for some of the nasty symptoms in my original post to start to dissipate. I just have to be more careful about what activities I am doing, and try to avoid the affect of gravity on my throat and oesophagus.

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  • Posted

    I can identify exactly with your ailment.It is exactly like my symptoms .I take one Dexilant 30 60mg in the morning.In the night in order to get a good four hours continual sleep I must take two or three Gaviscon xtra strength just before bedtime. I find that I can sleep much better lying on my right side I have had it this serious for at least two years. Before that it was mild but now it is day and night. I do not drink alcohol or smoke.I have raised my bedhead about six inches but no improvement.I must say that I feel as though I am producing less stomach acid than before.I am also looking for some help. Good luck.
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    • Posted

      Have you tried pinenut oil twice a day  eating a apple just before bed time and eating licorice before meals avoid fizzy drinks  I have had minimal acid since taking the pinenut oil in particular.
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    • Posted

      Hi,Trev96621 where could I buy the pinenut oil ? Also can you explain the eating of an apples as these are very acidic for a bedtime snack!! Also any particular licorice ?
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  • Posted

    Hi, BoOtsy sorry to hear about your Noctunal reflux. I've been reading an article by a professor Katz who recommends that 20 mg of omeprazole be taken before breakfast and 20mg before dinner followed by 150 mg to 300mg of an H2 receptor eg. Ranitdine at bedtime you could ask your doctor about this and his advice on it I have practically exact symptoms as yourself.
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    • Posted

      Thanks for the replying, and I'm very sorry to hear you and others have the same symptoms as myself. I'm still taking 20mg of omeprazole before breakfast and again before dinner as well as Domperidone 3x per day before meals. Generally this keeps the reflux manageable, but when the reflux is particularly bad I do also take a Zantac 1/2 hr before bedtime or 20-40mg of Gavisconn. Sometimes this helps, & sometimes it doesn't. I find the nocturnal reflux, & excess mucus problem to be at its worst when I'm recovering from the tail end of a cold and it generally means I have to sleep at a steep angle or be virtually sitting up to get any chance of sleep. When you have severe GERD, it can be a very unpleasant chronic illness. Wishing you all the best.

       

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  • Posted

    I also fogot to mention your weight plays a huge factor in the treatment of noctunal reflux as the fat around your stomach tends to push the acid back into the gullet so losing weight might alleviate the reflux while lying in bed at night.
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    • Posted

      Are you calling me fat? ;o) Only joking, I'm a 6ft 3" bean-pole who goes to the gym regularly without an ounce of fat on me. You are right though, that losing weight can help some people with reflux. I didn't mention also that I think exercise helps me, although I avoid exercises or crunches etc that put any pressure on my stomach. Swimming, gentle to moderate aerobic exercises, sparring on the punch bag, light weights etc, all help motility and aid digestion. I do find reflux is worse if I haven't exercised in a couple of days.
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