Post surgery late acid reflux

bmw71
bmw71 Member Posts: 3
edited November 2023 in Esophageal Cancer #1

Hello to all,

 

This board helped a lot early on in my husband's esophageal cancer journey. He is 6 years out from chemo, radiation and Ivor Lewis surgery at Mayo Clinic and has "graduated" out of the cancer department.  The past year, he has started to get bad acid reflux in the middle of the night, even almost wake up time....long after eating. He has done all the things they told him to do such as eating small meals, not eating or drinking for at least a few hours prior to going to bed, sleeps on a wedge pillow with head propped up.  Why is he getting this issue long after his food should be out of his stomach?  He also has nasal issues at the same time and has to blow his nose a lot.  Since he has graduated, I am thinking he now heeds to go see a gastroenterologist versus his cancer doctor.  Any thoughts?

Beth

Comments

  • paul61
    paul61 Member Posts: 1,391 Member
    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

  • bmw71
    bmw71 Member Posts: 3
    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

    Thanks Paul! We will try this

    Thanks Paul! We will try this. He does not take a PPI. So opposed to prescription meds, unfortunately.

  • Deathorglory
    Deathorglory Member Posts: 364 Member
    edited March 2019 #4
    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

  • Lee Christensen
    Lee Christensen Member Posts: 49 Member
    edited March 2019 #5

    Thanks for the info Paul, I also have the bile problem. Will try the Gaviscon, Thanks

  • Lee Christensen
    Lee Christensen Member Posts: 49 Member

    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

    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
    Deathorglory Member Posts: 364 Member

    I too take reglan and a

    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.

    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

  • Lee Christensen
    Lee Christensen Member Posts: 49 Member

    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

    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
    paul61 Member Posts: 1,391 Member

    Thanks for the info Paul, I also have the bile problem. Will try the Gaviscon, Thanks

    You might try pickle juice next time you have bile reflux

    Lee,

    If you do end up having bile reflux one of the things that is hard to get rid of is the burning and bitter taste afterward. Many people find that drinking some pickle juice after the reflux helps get rid of the burning and vile taste. I know it sounds a bit strange but it does work.

    Paul

  • Loveall
    Loveall Member Posts: 3
    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

    Acid reflux

    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
    paul61 Member Posts: 1,391 Member
    Loveall said:

    Acid reflux

    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 

     

    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

     

  • Loveall
    Loveall Member Posts: 3
    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

    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. 

  • paul61
    paul61 Member Posts: 1,391 Member
    Loveall said:

    Thanks Paul for a quick reply

    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. 

    I have been taking omeprazole for about 10 years

    I have been taking omeprazole since my surgery in 2009 so I am coming up on just about 10 years. I know there are recently various articles about long term issues with PPIs but I think like with all medications you have to evaluate the benefit risk equation. 

    Best Regards,

    Paul

     

  • sideways
    sideways Member Posts: 24 Member
    edited December 2020 #14
    Hey Paul, thought I'd come here instead of messaging you on FB.

    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.

  • paul61
    paul61 Member Posts: 1,391 Member
    Bile reflux episodes

    Hello Sideways, 

    I used to have bile reflux episodes about three times a week. I usually work up about 4 AM with that "burning" feeling. However, since I began chewing a Gaviscon tablet every night before retiring I very seldom have reflux episodes. I am not sure what component in pickle juice helps with bile but it certainly does. Other people have had good results with sauerkraut so the Kombucha idea may work. 

    One day at a time…

    Best Regards,

     

    Paul  

  • Waco Gigi
    Waco Gigi Member Posts: 5
    edited January 2021 #16

    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.     

  • sideways
    sideways Member Posts: 24 Member

    I wanted to come back and share my recent experiences, or lack there of, with regards to bile reflux attacks. While I know everyone's situation and physiology is different my approach just might help someone, so I thought I'd share. It started with my daily timed release nitro I take for my heart. I was waking up between 3-5AM with angina like symptoms. This was basically in the 20-22 hour after taking my medication window. My Cardio doc suggested I take it before bed instead of the morning. Voila! it worked! I haven't had an episode since.

    About a month later, and after a few nasty Bile reflux episodes, I thought why not do the same with my Esomeprazole 40mg. So I started taking it before bedtime instead of 6am. That was about 5 months ago and I haven't had a single reflux episode. Where as before I would get 1-4 a month. I know it sounds like a simple fix, but it's worked wonders for me so far. I actually have been able to even lower my bed a little bit more.

  • MrsHudson
    MrsHudson Member Posts: 6 Member

    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!

  • dodgemahal
    dodgemahal Member Posts: 3 *

    Pickle juice from dill or sweet pickles? Or does it matter?