I burped up some acid in my sleep. It usually just burns a few minutes, but this is getting worse and worse. I melted some Tums in my mouth, drank milk, gargled baking soda and Alka Seltzer and drank Mylanta. The burning is in my chest more than my throat now.
_________

After 15 minutes, it finally got better. I have been taking 150 mg Ranitidine before bed and haven't had much trouble in over a year. Before I started the medicine, I would get burning in the vocal cords (I think) once a month or so. This episode stared off not so bad, but got worse and worse after I got up and mdrank some milk and melted Tums in my mouth. I didn't spit up any blood and could burp OK.

I don't have a doctor's appointment for 3 weeks. This was really bad compared to what I have had before.

Can I add an OTC anti-acid to the Ranitidine? I have been taking lots of Tums through the day lately for discomfort from a gall stone. Any tips to keep it from happening again? This was awful.

You may have gotten acid rebound from all of the Tums.

My mom takes prescription priolosec and will occasionally need to take an additional otc med. But she can usually point to exactly what caused the need. Like garlic. It's not a daily thing.

Dennis,

I apologize if I sound gross, but does it feel like you have a sticky stuff in your through that is contributing to the burning and pain and, if you can see said glop, is it clearish pale white? If so, it could definitely be bile reflux along with acid reflux.

Not much you can do except wait it out for now. Have you gone to a gastroenterologist? You may need to switch from Ranitidine (aka Zantac) to something like Prilosec OTC. You may still get bile reflux on occasion - especially if you sleep on your stomach and/or eat a heavy meal before going to sleep. But, your acid reflux will improve dramatically.

One thing to be aware of... The crazy thing about acid reflux is that you may not even feel it, yet, still have it and possibly suffer damage to your esophagus as a result. If you have had acid reflux more than just once in a long while - if you're taking Ranitidine this is likely the case - the gastro specialist will want to do an upper endoscopy. This is to ensure your esophagus hasn't suffered damage from the reflux.

Any reason why you have to wait three weeks prior to seeing the doctor? In a situation like this, I'd try and see if you can get an appointment sooner. Also, definitely see if you can see a gastro doctor before switching meds and/or doing anything else. The only thing I'd recommend prior to see him/her is to monitor your diet and avoid acidy food, eating late at night, and/or sleeping on your stomach.

Robert



Edited 1 time(s). Last edit at 04/14/2012 09:28AM by Robert M.

See if you can get an earlier appointment. In the meantime, avoid fatty foods and others that may irritate your stomach (e.g. coffee, chocolate, OJ—these are some my wife avoids for that reason), and eat only light meals, not big ones.

Since you're already taking an acid-reducer, I wouldn't add another one without a doctor's advice. Your doctor may also want an upper GI study, to see if you've got an hiatal hernia or other problems.

/Mr Lynn

---

"Hillbilly at Harvard"
Honky-tonk Country and Bluegrass
Founded in 1948 by Pappy Ben Minnich
Saturdays 9am - 11am Eastern
WHRB-FM, Cambridge, MA
Streaming at [www.WHRB.org]
Be there!
The HAH weblog: [hillbillyatharvard.wordpress.com]

Topical weblog: [walkingcreekworld.wordpress.com]

On the river in Saxonville.

Don't drink milk!
It's soothing immediately, but then stimulates more acid production.

You can also take more ranitidine throughout the day. Your goal would be to not need any Tums or similar antacid. I'd add another 150 in the morning or mid-day.

Quote
bik
Don't drink milk!
It's soothing immediately, but then stimulates more acid production.

You can also take more ranitidine throughout the day. Your goal would be to not need any Tums or similar antacid. I'd add another 150 in the morning or mid-day.

You can and may need to use both the ranitidine and something like Prilosec together.

The older H2 histamine antagonists are pretty instant in the way the work. In addition, you can spool that up to 300mg a pop without difficulty.

The proton pump inhibitors (PPIs) can take as long as 4 weeks to spool up in some people. It isn’t something
you take “as needed.” This is the reason you see some combos out there - one has Pepcid in it, IIRC, which is
about as effective as ranitidine. Tagamet/cimitidine is the original. It also has the possibility of side effects
that aren’t that big of a deal depending on how old you are, but overall, it isn’t as effective.

I was using it in the early-mid 80s, and found that I was at 900mg (and got gastro doc “OH MY GOD!” - when
the pharmacology didn’t support that kind of idiot response). Now it comes in 800mg tabs, supporting my
increase from 300mg at the time. When Pepcid hit the market, I was the first in line. 40mg a day a few times a day saved me.

150mg of Zantac is fine on a low caffeine day, but 300 is required on a high day. Given that you have GERD
and a gall thing going, you need to stay away from EVERYTHING (unless you like pain and want a goat’s
esophagus stuffed into your chest) that aggravates that. Caffeine, chocolate (from the cocoa butter to
the caffeine) to fatty or fried foods, high fat veggies (someone mentioned garlic - the oils in garlic
and other foods can be enough to set off the whole chain of events).

Get yourself some BRAND Gaviscon - both liquid and the extra strength tabs. USE AS DIRECTED - with the
proper amount of water.

That will give you temp relief - and provide the floating layer to buffer things.

Get moving on the PPI and up the Zantac to 300mg. Note the warnings on the links below until your doc appt.,
get tested (or just take the “cure” for H. Pylori - and note that H. Pylori can be given BACK to you by a spouse, etc.)
and make certain you aren’t taking any other critical drugs that a PPI will interfere with their proper metabolism.

Note that 10mg is the OTC strength, and 40mg is typical Rx strength. If it sits right with you, find the dose
that works and do the math. Your insurance company will bitch if they think you should be on the lesser
dose at OTC strength, and arguing with them will just change your pH!! So know ahead of time if you can.

The doc needs to state that the low dosing didn’t work, IF it really doesn’t, in order to get them to cough up
for your Rx strength.

Read for 10 minutes and DO something. Note that any baking soda cures have the highest rate of “rebound”
so, while immediate to an extent, the aluminum/calcium routes are better long term. Once you try Gaviscon,
you may not need any other “chewable/liquids.”

Above all… don’t eat anything anywhere near bedtime. Cut it off after 7pm or some reasonable hour. Also,
if you have the sense of food hanging around in your gut too long, look into Reglan. This is a
serotonergic, so if you’re eating any SSRIs, you’ll be warned about “Serotonin Syndrome.”

It’s proper name (and is what I went to school to specifically research, but didn't do the time) is
serotonergic neurotoxicity. And generally speaking, people do not have issues with SNT unless
they have a specific type of thymic disorder & one also pulls the plug prematurely on a short half-life SSRI.

If SSRI or tricyclics mean nothing to you, don’t worry about it. If they DO ring a bell with you… don’t worry
too much about it anyway. Just be aware, and always use the lowest dose of anything that gets the job done.

And do something… before you have to have yourself disconnected - and reconnected. It happens more often
than people realize.

ALTER THE DIET IMMEDIATELY.
The fatty foods have absolutely got to vanish from your diet for the near term. Caffeine too.
Anything that signals acid release. Go get yourself a bottle of 150s of ranitidine, the omeprazole, Gaviscon
(don’t buy generic… it’s too high in sodium and the taste can be horrid compared to the brand) in tab
(get the RED extra strength — you get 2x as much for 15% more $$) - and call me in the morning.

edit - forgot to include the required reading.

[www.ncbi.nlm.nih.gov]
[en.wikipedia.org]

What you understand is more important than what you do not.



Edited 3 time(s). Last edit at 04/14/2012 10:34AM by Jimmypoo.

Actually, carbs contribute more to acid reflux in my opinion than fatty foods - try going "Atkins" and see if you do better.

There's no sticky or gloppy stuff. Nothing yucky. It's been a couple of hours and my throat is ravaged feeling. I don't sleep on my stomach. I had some food before bed, but I don't remember what. I did have some cashews last night, which made me sick. I remember before I went to sleep that I didn't double-up my pillow and left it flat.

I don't have insurance or money for the fancy tests, so I hope my doctor prescribes something good.

I remember I had the hiccups last might and melted a spoonful of sugar in my mouth and they went away. I don't know if that would be a connection.

I have diabetes and I can't get to sleep if I don't eat something before bed. (That is in addition to often taking Benadryl.) I always assumed the two were connected; maybe not. I have wondered about taking a slug of honey to satisfy the carb "yearning" without the added calories and other stuff in a mini-meal.

Regarding Reglan, I have had several serotonin reactions before, according to one doctor and my own theory.
_________________________________________________________
"Actually, carbs contribute more to acid reflux in my opinion than fatty foods - try going 'Atkins' and see if you do better." - vicrock

I am already going "Atkins" for my diabetes. I almost never eat over 30 grams of carbs at a time. As for fatty foods and my gallstone, carbs have always been worse for it than fatty foods, pasta, rice, and cornbread being the worst.

Quote
Dennis S

I don't have insurance or money for the fancy tests, so I hope my doctor prescribes something good.

If you have diabetes, you really need a regular primary-care doctor, and you may need GI tests to look for causes and effects of your GERD. If you really can't afford out-of-pocket medical expenses and/or insurance, every state has Medicaid plans for indigent folks. Many localities also have free clinics.

/Mr Lynn

Dennis,

Sounds like plain ol' acid reflux. If Zantac has helped control it all this time, likely, your next stage will be to replace it with Prilosec OTC. You might not even need to take it each day. Depending on severity, you can easily get away with skipping a day or two.

I doubt the teaspoonful sugar is the culprit or contributed to the problem. Just not enough of anything in a single teaspoon to cause acid reflux. Best bet is something else you ate, i.e. cashews or dinner.

Robert

Have you tried deglycyrrhizinated licorice, DGL? Works great for me.

"If you have diabetes, you really need a regular primary-care doctor," - mrlynn

I thankfully have a regular doctor who treats me well and cheaply and has grabbed me by the shoulders and whipped my diabetes into much better shape.

My understanding is I can't get medicaid unless I am on SS Disability.

Dennis, I think the acute problem you have right now is pretty simple. The reflux you had in your sleep has caused a chemical burn to your esophagus and throat. It is inflamed and irritated and will take some time to feel better and heal. As long as you can still swallow ok, as uncomfortable as it is, you should be able to just wait it out.

(As for Medicaid, that is based only on income. It's Medicare that is tied to SSD or SSDI. But your income is probably too high for Medicaid.)

Quote
vicrock
Actually, carbs contribute more to acid reflux in my opinion than fatty foods - try going "Atkins" and see if you do better.

QFE. I was starting to have problems with nightly heartburn/reflux and it went away a few weeks after starting Atkins. [forums.macresource.com]

---

In tha 360. MRF User Map

All,

Exactly. At this point, it's just a situation of waiting it out. A good gastro doc will evaluate the situation and recommend an appropriate course of action, i.e. change in diet, different acid reflux med such as Prilosec or Protonic, etc.

For Dennis, the burns will probably take a day or two to resolve themselves. Hopefully, he won't get hit by another round of a/r that is as severe prior to see the doc.

Robert

Thanks, everyone. To sum up, my diet, for diabetes purposes, is already pretty low in carbs and fatty foods. I do eat right before bed, otherwise, I can't sleep. I attribute this incident to being sick from a reaction to the cashews (possibly) and sleeping on a flattened pillow, which I don't ever do.

Dennis,

Sounds like you nailed it. I didn't ask but what kind of doctor? General Practitioner/Internist or a gastro doc? If you're having acid reflux regularly, you should see astro doctor rather than a GP/internist.

Robert

jp is right on about Gaviscon being the best antacid for the relief but the PPI that I found works best (after trying just about everything else) is Protonix (pantoprazole). It's quite a bit more $$ than the others, so the ins. co do not like when docs prescribe it. I had to go years trying the other meds before my GI doc prescribed this. It's bogus, since I could have avoided much of my misery if I got this to begin with.

the diet is key to GERD: eliminate caffeine and fatty foods, but also *red meat.* by doing that, I've helped myself enormously.

---

So get back to work and sweat some more
The sun will sink, and we'll get out the door
It's no good for man to work in cages
Hits the town, he drinks his wages
You're frettin', you're sweatin'
But did you notice you ain't gettin'?

and nuts, like cashews, are filled with oil and fats, and require extensive digestion to get through the cellulosic material. And before bed? When you need to be vertical for proper digestion without GERD?

You need to switch to a fat free light snack like a large low carb fruit (melons are one) or sugar free hot cocoa with skim milk or the fat free blends that are sugar free as well (or use skim, baking cocoa powder and Splenda).

If you think you can’t sleep without eating something, how in the world do you sleep after eating a handful of heavy nuts, and the acid required to digest them?

Without a liver enzyme test, you’ll never know for sure which type of medication is ideal. People respond to different medications for a variety of reasons, but among them are their diets, natural levels of cytochrome P450 - and which variant, and which one is needed as determined by the pK/pD of the compound, as well as a urinalysis for those that are metabolized primarily via renal pathways.

Quote
Dennis S
I burped up some acid in my sleep. It usually just burns a few minutes, but this is getting worse and worse. I melted some Tums in my mouth, drank milk, gargled baking soda and Alka Seltzer and drank Mylanta. The burning is in my chest more than my throat now.
_________

After 15 minutes, it finally got better. I have been taking 150 mg Ranitidine before bed and haven't had much trouble in over a year. Before I started the medicine, I would get burning in the vocal cords (I think) once a month or so. This episode stared off not so bad, but got worse and worse after I got up and mdrank some milk and melted Tums in my mouth. I didn't spit up any blood and could burp OK.

I don't have a doctor's appointment for 3 weeks. This was really bad compared to what I have had before.

Can I add an OTC anti-acid to the Ranitidine? I have been taking lots of Tums through the day lately for discomfort from a gall stone. Any tips to keep it from happening again? This was awful.

Surprised nobody has pointed out--you're well on track for calcium overdose . . . confusion, blurred vision, digestive problems (not the upper tract kind.)
Be extra careful, second guess your every move, hold onto stable things when moving around the house, and if you drive, don't for at least a day.

Yikes.

I lifted the head of my bed 3.5 inches last night.

I had very similar problem for a while - waking up in the middle of the night, choking on acid. Prescription Prilosec helped after a while (and yes, I did have an edoscopy). But going on Atkins completely eliminated the need for any medication.