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Sleeping and Reflux Issues

deleomeyer
Posts: 2
Joined: Aug 2012

Hi all--

I had an esophagectomy two months ago and am still marching up a sometimes slippery learning curve about many issues. I am hoping I can get some advice from those who know best.

To keep stomach acids from migrating up to my throat, I have been advised to not eat for three hours prior to sleeping, sleep on a wedge, and take omerzapole before going to bed. This usually works but sometimes, in my sleep, I slip off the mountain of wedges and pillows and end up in a more traditional sleeping position. In short order, stomach acids migrate up to the back of my throat leaving me with a burning feeling and (no other way to put it) pukey taste.

I am sure this sort of thing has happened to others. I would welcome advice about two things: Are there other things I could do to prevent it? And once I have it, what are the best ways to rid myself of this acid and bad taste? I spent an hour coughing this morning, eating toast, etc. trying to rid myself of this taste and burning feeling.

Thanks, in advance, for any thoughts you might have!

D

lenlee65
Posts: 47
Joined: Aug 2012

First, hang in there, its gets much better over time. The bed wedge takes some getting used to. I had the same kind of problems but kept working at it and trying to improve upon the wedge. Now if you could see how I fix it, you might laugh but it works for me and I sleep pretty good. I have taken all kinds of Acid Reflux medications and the only one that has really worked for me is Pantoprazole (trade name Protonix) and I take mine every morning. My feeling is since this is a once daily medication, it is probably strongest after being in your system about 12 hours or so. Thus when I go to sleep there should be little if any acid backing up for me to worry about. It works well for me it might for you. The no eating a couple of hours before going to sleep is good advice for anyone, what you eat then is a big factor too. If you eat try to make it something low in acid content. Hope some of this helps.

Len

NGC1514's picture
NGC1514
Posts: 44
Joined: Dec 2008

I have been told that the vagus nerve controls, among other things, acid production in the stomach. A branch of this nerve is cut during an esophagectomy and what we experience now isn't acid reflux, but bile coming up. Antacids and PPI medications do nothing against bile.

But, as the years pass, I've discovered things I thought lost were coming back. It took almost 8 years after surgery before I felt hungry (another function of the vagus nerve.) I still eat by the clock, but feel a sense of hunger more frequently over the last few years.

Keeping that in mind, I just started with omeprazole in hopes that it might do something for my reflux which it didn't do years ago.

Eric in Atlanta
DX 10/6/2000
Surgery 04/09/2001
Still hanging in.

Cora11's picture
Cora11
Posts: 177
Joined: Sep 2011

We just saw our GI doctor for a dilatation. My husband is status post esophagectomy last Nov. Our doctor and our surgeon feel the best possible night time set up is a bed that you can adjust, like a sleep number bed. I know not everyone can get one, but that is their recommendation. Also it is important to have a foot board of some type to prevent you from slipping down the bed. Another aspect is when you take your PPI medicine. Our dr. recommends taking it before supper so that it peaks during the night. Some work better than others. A new one that is out is Aciphex and that might be worth a try. Some say it has better bio availability. Another recommendation we got today was to as you know, have dinner rather early. Our dr. said that plant matter takes the longest to digest, so he recommends avoiding salads at dinner and to have dinner be the smallest meal. The idea is to try and have your stomach as empty as possible at bedtime. Even though you eat early, it is likely you still have stuff sitting in your stomach due to delayed gastric emptying. Lastly, there are meds to help with gastric emptying. You might want to increase your PPI dose. Those are all the suggestions we've gotten over the past few months.

Cora

jtebo1955
Posts: 46
Joined: Apr 2012

Hi there,
I know this might sound stupid, but sometime over the last 18 months I heard not to sleep on your right side. That said I found out the opposite. I now sleep on my right side..flat no less. And as long as I avoid high acid foods. I sleep fine . No refex . But if I roll over on my left side within a few minutes I feel acid in my throat.
Maybe my diet has something to do with it . I eat very small portions nibbling more less and mostly fruits veggies nuts and berries. And I have very little problems.
Hope this helps..might be worth a try.

Judy
Stage III
20 month survivor

sandy1943's picture
sandy1943
Posts: 883
Joined: Jun 2010

Hi., Welcome, Glad your surgery is behind you. I am 4 1/2 yrs from surgery and still have the reflux problem. I sleep with a wedge and pillow. If I roll off, I immediately have a problem. I have this problem no matter how I eat. I try not to eat anything two hours before going to bed. Nothing really works except to stay elevated.

I take omeprazole in the morning and the dr. just added 150 mil.of zantac at bedtime. The health food store has an acid reducer in tablet form. It helps the burning and bad taste if I put one in my mouth and let it desolve.

Someone mentioned Not feeling hunger. I've never noticed this discussed before. I feel no hunger, but my mouth will water at the thought of food.I love to eat now and have an appetite even without the hunger.

It sounds like you are doing good. What kind of surgery did you have and what stage were you?

We have a lot of experienced folks on here that have a lot of knowledge gained first hand. We are always glad to comment and answer any questions.

Sandra

Donna70's picture
Donna70
Posts: 920
Joined: Aug 2009

Hi,
I am 3 yrs out from dx and almost 3 from surgery. I had the same problems but I am on the same med, Prilosec, once a day. I also took liquid Zantac before bedtime for a long while. Now I take Maalox if I feel like I am going to have a bad nite. Also, I do not eat anything after 9 esp spicy stuff even before 9. Also,I slip off my 2 pillows and wedge and get that horrible reflux liquid in my throat. Now here comes my biggest warning, if you catch yourself choking and coughing, get up, get out of bed and go to a recliner or any kind of comfortable chair and finish the nite there. When you choke and cough, you can get aspiration pneumonia and it is not pretty. I choked badly last year, woke up with 104 temp and had to go to the ER. So that can be the consequence of that reflux. I have a sofa recliner and just sleep in that for the rest of the nite. Also, we had someone's husband pass away after having reflux during the night. If I am at a party and eat late, I sleep on the recliner to prevent choking. Good luck but your dr should be able to give the acid suppressing drugs that everyone is recommending and you know the precautions about eating and going to bed. take care,
Donna70

deleomeyer
Posts: 2
Joined: Aug 2012

Thanks, everyone, for your thoughts on this topic. Since I wrote my original note my doctor has prescribed a higher-dosage version of Omeprazole which I will take daily, starting today. We'll see if that helps.

Because the symptoms were occurring with increasing frequency, I have been sleeping on a recliner. My throat was getting raw due to contact with the acids and I was fearing additional harm. I hope the drugs do the trick, but I think an adjustable bed might be in my future--that is, if I want to sleep with my wife and not in the living room!

A website dedicated to reviewing beds notes "You may be able to deduct the cost of an adjustable bed from your taxes if it is for a medical purpose substantiated by a doctor." http://sleeplikethedead.com/mattress-reviews-adjustable.html#2 Has anyone here done this?

Thanks again for your thoughts on all of this!

Best,

Don in Seattle

cher76's picture
cher76
Posts: 302
Joined: Nov 2010

Don,
I have not posted here in many months but thought I would comment. My husband passed away in Jan. from EC and you can read our experiences in my profile. I too have suffered from acid reflux most of my life and have been on Aciphex for almost 8 years. It works wonders as long as I take it. :) We were fortunate in that we own a furniture store and were able to bring home an adjustable bed. It has worked wonders for me. Leggett & Platt make a very good model that is adjustable at both the head and feet. Sealy mattress company carries them. I find that raising my feet up just a little as well as my head keeps me from sliding down. Gravity is my friend and I have read that during sleep our bodies continue to produce and swallow saliva which neutralizes stomach acid. I try to stay on my back as much as possible, but when I feel I must be on my side I lie on my left side, as the esophagus connects to the stomach on the right side and stomach acid can slosh out and into the esophagus if you are on your right side. I also chew gum whenever I have reflux or feel it coming on as it also help your mouth produce extra saliva which helps neutralize the acid. I realize that those of you who have had surgery for EC have a different anatomy now, so not all these things may work for you, but perhaps they might be of help to those not able to have the surgery.

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