Amitriptyline HCL for heartburn?!?!??!

I was recently prescribed a nightly dose of Amitriptyline 10 mg. Not sure what for - I suffer from nocturnal non-acidic reflux and was suffering from stomach motility issues. 10 mg is apparently not a high dose but my experience was it really knocked me out - I got a very good night's sleep but was a bit groggy the next morning.

Interesting as one of the side effects of Tricyclic antidepressants like amitriptyline (Elavil) is causing  relaxation of Lower Esophageal Sphincter or lead to improper functioning of LES resulting into GERD.

If you trust your Dr. and it helps your heartburn then hopefully it is just what you need. 

no heartburn today so far. i think its working

Hi all first time poster
I had the nissan wrap done about twelve years ago I was happy with the procedure until a year ago. It started with the ball in the throat feeling and quickly progressed from there to the typical hernia to symptoms. I was put on ppi'S but soon discovered that they gave me panic attacks. Had the gastroscapy. The wrap was still intact and all looked good. The pain in the chest, shortness of breath, foam in the throat and pain on left side of my body was still bugging me. The difficulty in swallowing spit also seems to be part of the problem. The worst though is the shortness of breat h and the constant gnawing pain just where the chest and stomach meet.

I went to another gastro specialist he did the scope, barium swallow, and a number of tests and probe. His conclusion, the wrap is perfect, well done, no sign of gastritis or esphagitus. He said the wraps do start giving trouble after about ten years and that it is a mechanical problem. He put me on amitrepaline ten mg to start and as the pain returns to increase the dose step by step up to 50mg.

I am on twenty mg at the moment and am getting headaches from the stuff. Don't know if i want to increase the dose. Has anyone else.experience this?

Is There something i can do about it to help relieve the symptoms. It feels like i am right back where i started although i have to add, i still cannot burb, or vomit and absolutely have no heartburn.
One Surprise item that came with all this is tinnitus, ringing, high pitched tweet in the left ear mostly. If my stomach is quiet, so is the tinnitus, so i know they are somehow related,

If anyone has some advice i would really appreciate it. Thanks

Hi pharcyder,
I've read your post and found it a bit similar to mine.
I've been having upper chest pain (burning), sour mouth, throat pain almost all the time, worse after eating - since aug 2013. It all started 6 weeks after my laparoscopic appendectomy with a sudden onset of very bad heartburn (upper abdominal pain) after just my normal dinner (I eat healthy). Well, the stress has been very high especially that I have a young toddler :(

Last week, my doc has prescribed me with with Nexium 20 mg twice daily and endep (elavil) starting dose 2.5 mg.
So far the Nexium hasn't given me much of help (after 6 days). I'm starting the endep/elavil tonight.

Would you mind to share how you've been doing after the elavil so far?

Thank you!

Rgds,
Vicky

I was wondering if anti-depressants also help agains recurrent respiratory infections or if they only release the nerve pain? I have a burning sensation in my throat almost all the time, but if it gets too strong (that happens if I don't stick to my diet strictly) I get sinusitis or laryngitis. Any experiences on that? (All my reflux tests came back completely normal.)
Thank you and the best to all of you!

Hi pharcyder,
Thank you for your reply :)
Saying that, previously you had recovered from your heartburn last year with elavil, but it came back again? Has something triggered it or it came back after you stopped the medications?
Are you still taking nexium?

Maybe you should go for endoscopy to see whether there's any damaged in your esophagus. I read several articles regarding esophageal hypersensitivity, where there's actually no damage done in the esophagus but it's just our anxiety etc that makes our nerves too sensitive to any amount of acid (normal reflux) that we keep feeling the pain etc.
http://www.cag-acg.org/uploads/cddw2013/2013_presentations/sgs_heartburn_gupta.pdf

pharcyder... so sorry to hear that your heartburn came back :(
My doc here also asked me to see a psychologist for gut hypnotherapy. The theory that my doc explained was when we suffer from anxiety, our mind becomes more likely to notice every single negative feeling inside of our body. As a result, it occasionally feels things that you never would have felt without anxiety.

I've seen my psychologist twice. The hypnotherapy isn't some kind that I thought I had seen in the movie... but it's more like I'm learning on how to switch my mind & relax. More like Buddhist's way of meditation (focusing on our breathing process). So far I haven't seen any improvement yet, but maybe you can give it a try to see whether this could help. I've seen several articles regarding success stories from people suffering from IBS using this method - so hopefully we can have our success stories too!

Vicky, my doc seems to have the same philosophy as yours. He doesnt want to do any more endoscopies or any other tests at all. What you say about anxiety also makes perfect sense. Whenever I take Xanax, I almost never notice heartburn. I do believe my anxiety makes me oversensitive to the pain.

My doc also said he can almost say with 100% certain that I will never get esophageal cancer as long as I stay on Ppis.

Im on amitriptyline for stomach and esophagus hypersensitivity. I have been on 10mg a day for about a month, and recently been upped to 25mg. My doctor wants to ween me off my other anti-depressent and put amitriptyline up to 50mg to treat my depression rather than take two different ones.

They say you only notice the difference after a month, but I do think I started to feel better after a couple of weeks. My stomach would burn after eating anything a month ago, now as long as I am very careful what I eat then I don't have pains, but do still get occasional nausea.

Heartburn seems to have decreased but Im eating much less than I did before because of the stomach problems so that could be a factor.

This is pretty much my last hope of bringing my pain down to a level that doesnt disrupt my life so trying to stay hopeful that it will keep improving over the next few months.

To Vicky888: I am new to this forum. Your comment about developing GERD 6 weeks after having an appendectomy per laparoscopy definitely caught my attention! I had a laparoscopy done to correct a gyne birth defect so that I could have children, and also within about a 6 week window, I developed severe acid symptoms while on a plane. I had never had any problems with an acid stomach whatsoever prior to this. I could eat whenever I wanted, go to bed afterward, etc., and be fine. I have been plagued with this problem every day since that day, and was diagnosed with GERD, an irritable bowel, and a small hiatal hernia. I had food poisoning (Campylobacter) 2 weeks before the laparoscopy, and a very reputable GI doctor told me that these two incidents were 'insults' to my gut, with the resultant GERD. The interesting thing was that once I became pregnant, the symptoms completely went away! But, within a couple of weeks after delivering, they all came back.

I read that abdominal trauma can lead to a hiatal hernia. I believe that the laparoscopy procedure was definitely a precursor to my gastric issues. Have you ever pursued this in your case? I have mentioned it to doctors, but to no avail. You are the only person that I have ever heard who has stated this association. Is there anyone else out there reading this who is able to connect these same dots?

I have never tried the antidepressants. I take Nexium 40mg qAM and Zantac 75mg at bedtime. I develop gastric polyps from twice a day Nexium use. I have had laryngitis from GERD and have acid relflux-induced asthma. I have tried to wean off Nexium 3 times, only to develop wheezing and terrible rebound acid. I worry about the effects on my body. I receive a shot of Vitamin B12 once a month, by the way, due to the inability of the stomach to absorb this vitamin as the intrinsic factor is impaired with PPI intake. I was having some neuro symptoms in my extremities prior to figuring this out on my own. The doctors do not tell you this when on these PPIs, that I have found. Don't forget Calcium and Magnesium absorption, and the right form of Calcium- (citrate better than carbonate, I have read)

Can you imagine the quality of our lives if we could find a solution to our issues? I wish that we had more answers. I was never informed of any such risks, pre- or post- procedure. Were you? I would never trade my children for the world, but the very procedure that allowed me the miracle of them has changed my life most considerably. I guess that life is full of trade-offs. I am seeking better management of this very significant trade-off. Aren't we all? Thank you for your contributions!

Thank you for your response! Wow, you have been through a lot! How did you figure out that it was the antibiotics from the surgery? I am not familiar with vsl3. Maybe you could explain that. Funny, I cannot digest bananas, either. For as many protein smoothies that I make, that is the one ingredient that I have to leave out. So many recipes call for it. I use coconut oil/dried flakes or avocado to add the thickness. Sometimes I use nut butters if appropriate.

Yes, I know that the Nexium has to be weaned. Were you suffering with tons of acid when you weaned off of Nexium, and what did you do for that? I often wonder about gluten, even though the small bowel biospsy done with the endoscopy was negative. But, one can still have gluten sensitivity, not full-blown allergy. Are you allergic to gluten? I have heard of SIBO and fodmap, but never researched more about it. I have trouble with constipation, so I need to be careful, too. I have environmental allergies for which I receive monthly injections. Sometimes wholistic providers cringe at this. I have shown some food sensitivities with skin testing, but the allergist said that they are minor. I say all of this because of the food allergy connection in your case, and I wonder how much mine may be playing into mine.

You give me hope to not give up on this. How long did it take you to feel better again? I am thin so I get concerned about dropping weight with these dietary changes. Did you lose many pounds with it all? I apologize for all of the questions, it is just that it is refreshing for me to communicate with someone who has 'been there and back!' Thanks, again.