Acute reflux attacks

[ButtterflyLady]

I have gastro-oesphageal reflux disease (GERD) and it is well controlled with medication, except for when I have an acute attack. I would like to know if anyone else gets these attacks, and if you have any tips on how to prevent them.

I've discussed it with my GP and there doesn't seem to be anything she can suggest, other than taking my meds, having the head of my bed raised up on blocks, and avoiding eating just before bed.

I have had 3 of these attacks in the last year or so. The first time, I thought I was having a heart attack, because the chest pain was severe, I was drenched in sweat, had difficulty breathing, and felt like I was about to vomit. Apparently these can be heart attack symptoms in women (I knew from reading about them earlier - I was in no state to be googling at the time). I was checked out by a doctor that night and reassured that it was likely to be reflux.

The second time I knew what to expect but it was still extremely painful - 10 out of 10, off the scale. The attacks last about 20 minutes, which is about the only thing I can cling onto while it's happening, to help get me through it. The third time the pain was even worse... unbearable, and then it stopped as quickly as it started.

I wish I knew what was triggering these attacks, as I have had chronic reflux for over a decade, but only started having acute attacks recently. If you have had this condition you will know how bad they are.

I'm on the waiting list for an ultrasound scan to check my gallbladder, and my LFT results are in the normal range. I've never had gallstones but I imagine the pain is also off the scale.

Can anyone relate?

 

[Mr_H]

Hi I have acid reflux I know how you feel it sucks anything I eat pain and I end up holding my breath to ease the pain maybe your meds need increasing? I am on omeprazole 40mg since 2009 when I take it I have no pain what so ever but if i forget I am in agony My gp said it could anxiety related but I think I have done some damage back when I used to binge drink in my teens I would be sick and then blood would come out like strawberry red yuck!

 

[Shar67]

Me I have GORD (GERD is the Americanism) I have had to get extensive dental work in my teeth to keep them dissolving in acid.
I use pantaprozole every day, unfortunately there isn't a lot you can do, I take buccastem or domperidone to stop nausea but usually I have to throw up to get rid of it from stomach. My stomach lining has scar tissue and thickening.
Gall stones can be tiny smaller than a grain of sand these little stones can stop in common bile duct for just enough time to create a stomach full of acid then pass through, they are so small they usually don't show up in scans, if you have stones in gallbladder it is best to have it out although this doesn't guarantee that you will stop producing stones in bile duct.
At present my problem is avid pushing against diaphragm this makes me cough, gaviscon works a little bit but if you still have a gallbladder it can cause gall stones

Oh I very rarely get heartburn or stomach pain, just gallons of acid

 

[Shar67]

Hi I have acid reflux I know how you feel it sucks anything I eat pain and I end up holding my breath to ease the pain maybe your meds need increasing? I am on omeprazole 40mg since 2009 when I take it I have no pain what so ever but if i forget I am in agony My gp said it could anxiety related but I think I have done some damage back when I used to binge drink in my teens I would be sick and then blood would come out like strawberry red yuck!

Have you had your pancreas scanned, you might have a problem (not just diabetes) with it, acid reflux is caused by so many things it's worth getting it checked

 

[Mr_H]

No never have only tests i have had for it was blood and stool sample gp said if he reffered me to a specialist they would send me back because the omeprazole is numbing it. My mum had pancreatitis and gorestones she had to have her gore bladder removed maybe it could be a family thing

 

[himtoo]

Hi There
I have GERD or GORD ( take your pick )-- I take 80mg omeprazole per day -- i found on the 40mg dose i was getting a constant background funny acid type feeling that wouldn't go away.

 

[ButtterflyLady]

Hi I have acid reflux I know how you feel it sucks anything I eat pain and I end up holding my breath to ease the pain maybe your meds need increasing? I am on omeprazole 40mg since 2009 when I take it I have no pain what so ever but if i forget I am in agony My gp said it could anxiety related but I think I have done some damage back when I used to binge drink in my teens I would be sick and then blood would come out like strawberry red yuck!

Thanks for posting, somehow it helps to know others can relate. I think you are right about my meds and I will ask about it next time I see my GP. I'm on 40mg, which is enough for the chronic GERD/GORD but not enough to prevent acute attacks. I know increasing it might not prevent them but it's worth a try.

 

[ButtterflyLady]

Me I have GORD (GERD is the Americanism) I have had to get extensive dental work in my teeth to keep them dissolving in acid.
I use pantaprozole every day, unfortunately there isn't a lot you can do, I take buccastem or domperidone to stop nausea but usually I have to throw up to get rid of it from stomach. My stomach lining has scar tissue and thickening.
Gall stones can be tiny smaller than a grain of sand these little stones can stop in common bile duct for just enough time to create a stomach full of acid then pass through, they are so small they usually don't show up in scans, if you have stones in gallbladder it is best to have it out although this doesn't guarantee that you will stop producing stones in bile duct.
At present my problem is avid pushing against diaphragm this makes me cough, gaviscon works a little bit but if you still have a gallbladder it can cause gall stones

Oh I very rarely get heartburn or stomach pain, just gallons of acid

Thanks for your post, it helps. I actually think in Americanisms for medical terms but I try to use the UK spelling here, lol. I also try to use UK spelling when I am talking/writing to my doctors, in case they think all my medical info comes from "dr google".

Good to know more about gallstones... pesky things, aren't they? I'm "fair, fat, female, and forty(ish)" so I know I'm at risk of gallstones, unfortunately. I'm committed to LCHF but I sure hope there isn't a link between eating a little more fat, and getting these attacks (or getting gallbladder problems). I'd be more than happy to have my gallbladder removed if needed, and I didn't know you can still have problems after, so thanks for the heads up. Also didn't know about the risk from using Gaviscon. If I have no gallbladder, I can still do LCHF but it sounds like it would need a bit more planning. But, if I'm in agony, I will probably say get the darn thing out asap, lol.

I have assumed that since I can no longer taste acid in refluxed liquid that the PPI is reducing the acid sufficiently all the time, but is it possible that during these attacks there is some acid being produced? When I read about acute attacks, it said the pain is caused by acid, and I didn't really understand that, being on a PPI.

Somehow, understanding what is going on inside my body usually helps me cope with symptoms.

 

[ButtterflyLady]

No never have only tests i have had for it was blood and stool sample gp said if he reffered me to a specialist they would send me back because the omeprazole is numbing it. My mum had pancreatitis and gorestones she had to have her gore bladder removed maybe it could be a family thing

I was referred to a specialist and had an endoscopy done after my first acute attack, because my GP wanted to rule out other causes. So it might pay to keep in mind that if your symptoms are bad enough, and your GP is unable to manage them with what they can do, you might qualify for specialist care and tests if needed.

The blood test can pick up if you have prolonged internal bleeding from a stomach ulcer because you would be anaemic. They also test a stool sample for the presence of old blood. Old blood looks different under the microscope and can come from the stomach, whereas new/fresh blood is more likely to be from the bowel. These tests can rule out a big ulcer that has been there a while, but endoscopy is needed for newer, small ones, or other visible changes like narrowing of the oesophagus or thinning of its lining.

 

[ButtterflyLady]

Hi There
I have GERD or GORD ( take your pick )-- I take 80mg omeprazole per day -- i found on the 40mg dose i was getting a constant background funny acid type feeling that wouldn't go away.

Thank for your post. I didn't know I could take more than 40mg so I will definitely ask about it.

 

[Shar67]

Pancreatitis and gallstone can run in families, if you are getting regular pain and acid then GP should be looking at other causes, if you have stone on common bile duct and'or pancreatitis it can only get worse without correct treatment, remember it is your body not the GPs

 

[mfactor]

I have common acid reflux off and on , I am guessing that as well as putting the head of the bed up, you all know to sleep on your left hand side, ....... that was what my doc told me ....something about a flap being held down by gravity or somesuch.....

I sure someone can explain the medical reasons better than I.............


Was also watching a documentary the other day that said it was not spicy foods but rich foods that were a problem

 

[slip]

I'll +1 gallstones - not me but the B(etter)H had serious attacks just like you @CatLadyNZ, can't remember but I think she had an ultrasound that confirmed stones, and then had hers removed (a week before a once in a lifetime holiday!). All went well, as did the holiday and she's been fine since, she still takes omeprazole on the odd occasion she over indulges in something hot (not me!) or very fatty (me!) just to be on the safe side, she doesn't want any repeat performances of the near death like experiences she had before.

 

[Shar67]

Gall stone are made with bile and cholesterol, if you keep cholesterol in check you should be able to eat normal.

Sleep on left the transverse section of colon, the muscles move from right to left as does the start of the small intestine.

I am a fully qualified massage therapist and I do this to my self, Put the heel of your hand (the bit where wrist and hand join) push gently into tummy with heel of hand then slide hand heel to the left whilst gently pushing in, go about 5/6 cm then push and slide down to just below belly button then drag finger to the right of button then fingers up to start position. Repeat 5/6 times

 

[ButtterflyLady]

I saw my GP today and asked her about increasing the dose and she said she would be reluctant to... I normally ask why but as she was running well behind time and I trust her to be right about this, I didn't ask why. I suspect she thinks it wouldn't help much, and I'd have more drug in my system than I needed.

I also asked about switching to a different PPI and she was willing to try that, but I said I didn't want to risk the alternative not being as effective as the one I'm on. She said it can be idiosyncratic - ie different people will find different PPIs more effective than the others... so I know I would be gambling and I'm so scared of further reflux attacks I don't want to risk it. I guess if I'm still struggling in a few weeks I could try one of the others.

So, no real solutions at the moment. And that's ok, I know she would offer them if she thought there were any. I asked about rapid acting pain meds, because with these attacks you only get 5-10 minutes warning, and pills take 30 mins to kick in. By then, the attack is over. She suggested calling an ambulance as they have meds they can use, like nitrous oxide and something else she couldn't remember the name of. (Does anyone know what meds they use?)

I asked for more info about what is going on when the attacks occur, as that helps me to cope with the pain. She said it's not an increase in acid, because the PPI reduces that to a very low level... it's more likely a spasm of the muscles around the oesophagus and top of the stomach.

About the only thing that gives me hope I can beat this is that the opioid meds I take for chronic pain may be contributing to reduced stomach motility... so I am now thinking about trading off the pain relief for preventing these attacks.

If anyone has ideas for managing this condition please let us know.

 

[Marjack]

I had severe GORD back in the nineties. I had the barium meal, an acid test to test the strength of the acid in my stomach and of course an endoscopy. The conclusion to all of these tests was that the sphincter at the top of my stomach was weak and was allowing the acid to come out of my stomach and into my digestive tract causing heart burn and acid reflux.
Eventually it was decided that I should have an operation. It is called a laparoscopic nissens fundoplication. This meant that they cut my stomach off my oesophagus and made a new flap that would stop the acid from leaving my stomach.
After a 4 and1/2 hour operation I was in hospital for 4 days. I then had to eat mushy food for months but eventually returned to normal food.
Now have no bother with reflux. Still remember how bad the pain is though.
Good luck finding a solution

 

[maureen5752]

I suffered with reflux for about 17 years or so, thought I was having heart attacks, was so bad it frightend the life out of my daughter was on omerpraxerole, had endoscope, much later finally had scan and had to have my gallbladder removed as it wS full of stones, now I can eat things couldn't eat before, well I could until I became diabetic and went on meds, now don't know why get acid reflux every day sometimes few times each day, I'm on raperazole now, think that's how you spell it. I sleep with several pillows to try to help, good luck, ask for a scan to check everythink

 

[Mep]

I have GORD as well and I get oesophageal spasms which can give me real bad pain. Sometimes I'm hanging on to walls and things as it is like I'm being choked, etc. My gastroenterologist explained that our bodies don't know the difference between oesophageal spasms and heart attacks as you described. I hate it. I've had quite a few severe ones and the longest lasted about 35 hours. I'm seeing a neurologist right now because my gastroenterologist said that temporary paralysis of one I had in April was unusual and not something he has heard of happening. Basically I had this spasm that lasted bout 13 hours and when it released I couldn't feel the left side of my oesophagus or throat for 3 weeks. It was weird swallowing or anything. It came right after 3 weeks though. I have been on quite a few proton pump inhibitor meds and various dosages. I got told 80mg was the max dosage and only allowed to be used short term as it puts you at risk of something I forget... but not good for you. So my docs tend to keep me on the 20mg or the 40mg dosages. I'm on 20mg at the moment but my docs are ok if I take a 20mg in the morning and a 20mg at night if I need it. I use gaviscon when I need to as well but I find it burns my throat so I don't like it too much (I have reflux laryngitis). I have my bed raised on pavers, plus I now sleep with a wedge pillow and a normal pillow on top of that so I'm quite high up. I can't sleep lower now as I tend to wake up choking if I do. I've only had GORD since 2008 really after 3 gastro bugs end of 2007 suddenly bad reflux started up and it hasn't stopped since. I have other digestive problems as a result.

 

[maureen5752]

I suffered with reflux for about 17 years or so, thought I was having heart attacks, was so bad it frightend the life out of my daughter was on omerpraxerole, had endoscope, much later finally had scan and had to have my gallbladder removed as it wS full of stones, now I can eat things couldn't eat before, well I could until I became diabetic and went on meds, now don't know why get acid reflux every day sometimes few times each day, I'm on raperazole now, think that's how you spell it. I sleep with several pillows to try to help, good luck, ask for a scan to check everythink

Snap exactly the same as me! Everythink you said is exactly the same as me, reflux back since become diabetic! Gallbladder removed was full of stones! Good luck

 

[Stallen]

I've had chronic reflux for a number of years combination of lansoprazole and peptac was a good combo for me, however recently I stopped all my medications including those, I switched to having a no carbs and a high fat diet, since then I've not suffered any acid reflux, which surprised me, as when I'd forget to take my meds for it, it always led to horrendous projectile acid reflux.

For me I did get a touch of it at first but soon realised, it was products containing wheat that caused it, vegetarian sausages now completely avoided. No reflux in several weeks.