Post surgery late acid reflux

Hi Beth,

Unfortunately the 2 or 3 AM "acid attack" is fairly common for those of us who have had an esophagectomy. It is probably bile rather than acid. When the stomaphagus is empty bile has an opportunity to work it's way up and cause burning and nasal issues. I used to have this issue often, then at the suggestion of another survivor I started chewing a Gaviscon every night before going to bed. Since then; no more middle of the night "acid" events. Since I also take a PPI (omeprozole) I checked with my gastroenterologst and he is fine with the Gaviscon.  

Gaviscon is a bit different than many antacids as it creates a layer over the top of the stomaphagus contents and holds them from moving up into the reminant of the esophagus.

Best Regards,

Paul

Hello Beth,

I had my esophajectomy in 2008 and still have reflux problems.  I take reglan, which is supposed to help push the stomach contents on to their next stop.  I take protonix 2x a day (Geastroenterologist had to get into a fight with insurance to get them to pay for more than 1x a day).  I sleep on a wedge pillow.  I try not to eat/drink anything for a couple of hours before bed.  Still, I woke up and threw up last night.  It's about 50% of the time that I vomit.  It sucks, but I just view it as part of the price I have to pay for being alive.  My nose has been running since 2012, when I stopped folfox.  And when I say running, I mean just dripping/pouring out.  No doctor has had a suggestion for that.  Oh well, I'm still here to complain about it all, so that means I'm winning.

Best Wishes,

Ed

Deathorglory said:

Hello Beth

Hello Beth,

I had my esophajectomy in 2008 and still have reflux problems.  I take reglan, which is supposed to help push the stomach contents on to their next stop.  I take protonix 2x a day (Geastroenterologist had to get into a fight with insurance to get them to pay for more than 1x a day).  I sleep on a wedge pillow.  I try not to eat/drink anything for a couple of hours before bed.  Still, I woke up and threw up last night.  It's about 50% of the time that I vomit.  It sucks, but I just view it as part of the price I have to pay for being alive.  My nose has been running since 2012, when I stopped folfox.  And when I say running, I mean just dripping/pouring out.  No doctor has had a suggestion for that.  Oh well, I'm still here to complain about it all, so that means I'm winning.

Best Wishes,

Ed

I too take reglan and a protonix, may I  ask what time of day you take your reglan. I too have the nausea problem early in the morning, and it is vile. Paul says it from a empty stomach, but I take reglan before bedtime to help move things along, I wonder if that helps in the reflux problem, I have my last meal between 4pm-5pm.

Deathorglory said:

Hello Lee,

I take two pills of Reglan twice a day.  The 1st dose is about an hour before dinner, to hopefully make some room for it.  The 2nd dose is about an hour before bed, to hopefully clear things out of my stomach so I can sleep without reflux/vomiting.  I also eat dinner as early as I can, usually between 4:00 and 5:00.  I also take the protonix twice a day to try to help with reflux.  The combined results of everything are mixed.  I still wake up to vomit about 50% of the time.  But the good news is that throwing up usually relieves the reflux and I can then go back to sleep.  

I don't know if any of this is useful information for you, but it's what I can offer.  I hope your results are better than mine.

Best Wishes,

Ed

Ed, Thank You, sounds pretty much like my regiment that I do. But my vomiting is speratic, usually between 4-6 am. And usually is quite hard, and takes alot out of me. The burning sensation in my throat usually lasts a few hours, so going back to sleep is out of the question. Again, Thanks

paul61 said:

The 3 AM Bile attack is a common problem

Hi Beth,

Unfortunately the 2 or 3 AM "acid attack" is fairly common for those of us who have had an esophagectomy. It is probably bile rather than acid. When the stomaphagus is empty bile has an opportunity to work it's way up and cause burning and nasal issues. I used to have this issue often, then at the suggestion of another survivor I started chewing a Gaviscon every night before going to bed. Since then; no more middle of the night "acid" events. Since I also take a PPI (omeprozole) I checked with my gastroenterologst and he is fine with the Gaviscon.  

Gaviscon is a bit different than many antacids as it creates a layer over the top of the stomaphagus contents and holds them from moving up into the reminant of the esophagus.

Best Regards,

Paul

Hello! Paul

In the past , reading your posts had been very helpful. And I need your advise one more time. I read your post on that you take omeprazole for acid reflux and gaviscon at night.

My husband recently had endoscopy,  they didn't find any cancer which is a very good news but marked inflammation and ulcer. I heard a lot about omeprazole long term side effects. I am wondering how long are you taking and are you still taking omeprazole? He has been taking Zantac but still he is having issues. Endoscopy another finding was intestinal hernia . I don't know if hernia has anything to do with it.

We have app scheduled with doctor in 2 weeks but I have noticed the people who have gone through it are even more helpful 

Thanks 

paul61 said:

I am still taking omeprazole

Hello,

I am still taking omeprazole but a very low dosage. I take 20 mg in the morning and 20 mg when I go to bed. Even though I was taking omeprazole I was still waking up with with burning discomfort in the middle of the night. So at the suggestion of another esophagectomy survivor I started chewing one Gaviscon prior to going to bed. After that I have had very few middle of the night issues. 

I am also careful to stop eating anything at least two hours prior to going to bed and if I have anylthing in the evening I make sure it is something bland like an apple or ice cream. If you husband does have an ulcer I would think Gaviscon would be helpful since it tends to coat the esophagus and stomach lining and create a barrier to hold the acid down.

Best Regards,

Paul

 

Thanks Paul for a quick reply

Do you mind if I ask you how long you are taking omeprazole.

are you taking since surgery?

my husband started taking Zantac and symptoms  were alright so far until one month back he felt some heart burn but more so on late eating in evening or when he missed his meal. He didnot think much of this and continued with Zantac until now with the results of endoscopy when we are thinking zantac is not going to be enough.

Giess what his doctor was also not specific about dosage  of omeprazole. 

Thanks for the great info on the Gaviscon, I will pick some up today.  My bile reflux issue has been intermittent since my MIE surgery in '12.  Recently it has become more frequent.  I actually had 2 episodes last night, one at 4am and one at 7:30 am (still feeling the effects right now). I've been on Esomeprazole 40mg since surgery.  Not sure how episodes present with everyone else, but mine includes some very uncomfortable wretching (our version of vomiting).  The burning of my throat and sometimes nasal regions is pretty brutal.  Pickle juice sounds interesting, but not very palatable...LOL.  Do you think it's the vinegar, or more specifically the acetic acid in the pickle juice?  If so I was thinking of maybe trying some Kombucha, which has 1% acetic acid and maybe more enjoyable. I sleep in a tempurpedic bed that has me pretty elevated, so I'm not sure how the bile defeats gravity?  Also, for me it doesn't seem to matter when I last eat or drink before sleeping.  I've had episodes when not eating or drinking (except maybe water).  

Do you have frequent episodes, Paul?  It surely can't be good for our stomaphagus.  Have you gotten endoscopes to routinely check for damage?  Thinking maybe I should.

As I type this my throat is raw so I thought it wouldn't hurt to swig a mouthful of my wifes Kombucha.  It did give me some instant relief from the throat pain and bitter, nasty bile taste!  Next time I have an episode I think I'll immediatly drink some.  Thanks to everyone in this thread for the great info!  I'm feeling like an idiot for trying to tough it out instead of using the great resources here to help.

I havent been on this site for a while but want to report that I am doing very well three years after my esophagectomy. 

I have few episodes of night-time reflux now but I am very strict about my diet.  Some of the foods that cause my problems are caffeine, acidic foods such as tomatoes, raw salad greens and carbonated drinks.  Strangely enough, I eat ground beef at home but have found I do not tolerate it very well at restaurants.  This must be due to an ingredient in wholesale ground beef.  I developed a sensitivity to Soy while I was on the feeding tube so tI avoid anything with Soy in it.  All of this has been a trial and error journey.  I suggest first avoiding caffeine and acidic foods, then experiment with avoiding other foods that might be a problem.  

I agree with those who suggest taking an antacid before going to bed.     

Thank you for this suggestion!

My husband is almost 5 years out from Ivor Lewis at Mayo. He has done amazing until the need for hiatal hernia repair this past spring. That gave him instant relief from post meal pain and cramping. However, since then he has had severe reflux, especially at night. Even though he takes omeprazole a.m. & p.m. and sleeps elevated, he wakes up strangled and choking, ultimately wretching and suffering from burning the rest of the night. Last night he ended up in the recliner from about 1:00 am. I had him take some apple cider vinegar last week and he didn’t have acid that night but I don’t think I can convince him to do that regularly. I’ll also recommend the kombucha.

He’s averaging about 3 hours of sleep nightly, which is not sustainable as he still works full time.

I found this board this morning and immediately reported back to him about the Gaviscon. He will get some today on his way out of town for work. High hopes he has the success with it that you experienced. I will report back and let you know. Fingers crossed!

Thank you again!