Severe GERD / LPR

Even better than a pillow wedge is raising the entire head of you bed by using blocks of wood, bricks, bed risers, or a combination of any of those under the legs.  You should aim for 7-8" (around 20cm).  It works better than a wedge, and is actually more comfortable. The wedge is great for when you travel and are sleeping in flat beds.

Surgery could help you, but it's a last resort, and your doctors will try to control your symptoms with medication first.  They are correct in doing this.  Be very careful with your eating, and watch out for reflux triggers.  Also wait 3-4 hours after eating before going to bed. 

Good luck!

Denise

I'm not sure how a bed holds up that is a true bed with side-rails attaching the head to foot.  My bed is a metal frame with a headboard, and that works fine and holds up well.  I detach the headboard so it doesn't have to slant down when the legs are raised.  I just wedge it between the head of the bed and the wall, and it works just fine.  I can say, though, that I've used the wedge and the raised bed, and the raised bed is much more comfortable.  Also you won't slide down and get your stomach in a pressured position like you may with a wedge.  It's always flat, and though you may need to reposition yourself, you're never in a position that puts pressure on your stomach.

Since the surgery is an extreme fix (I had it in Feb. 2009 and am glad it did) that it's always better to try all other options first.  If you're actually getting a mouthful of acid in the morning, you definitely need the elevated bed.  Also...when do you take your PPIs?  Do you take one in the AM and one in the PM?  My PCP is a stickler on taking it an hour before dinner (on an empty stomach), as it's more likely to be effective when sleeping, which is when most reflux tends to occur. 

It took many years before I got to the point where my GI doc felt comfortable referring me to a surgeon.  Have you had testing yet?  I had my surgery because it was making my asthma uncontrollable.  My reflux wasn't as bad as yours, either.  You'll need an endoscopy, PH monitor, barium swallow, and manometry.  Some also require a stomach emptying test.  All these are critical in deciding whether or not you're a candidate for surgery. 

You don't want to let it go, though.  Especially if the reflux is getting into your lungs. 

Wish I could offer more help!

Good luck with your search for answers!

Denise

Here's a document that explains the importance of taking PPIs properly:

http://www.practicalgastro.com/pdf/January07/Jan07FrankArticle.pdf

My GP believes it is very important to take the PPI before dinner because nighttime is when many have the most reflux because of lying down (no gravity to keep the acid down).  Here's what he told me after I sent him the article.  Since my major symptom was asthma, he was especially concerned about nighttime reflux.

"The article you sent puts forth one theory. However people who aspirate generally do so at night, not during the day.  I believe that taking the medication before the evening meal blocks nocturnal acid production which is stimulated by the evening meal and thereby can decrease chances of nocturnal aspiration.  Taking the medication the morning is less likely to prevent nocturnal aspiration than taking it before the evening meal. I recommend taking it on an empty stomach before the evening meal, giving it at least a half-hour, and preferably an hour, to be absorbed."

Before my surgery I was on 40mg Protonix (ppi) before breakfast and 40mg before dinner.  An hour before eating and on an empty stomach will make sure you get the best use of the PPI.  Also, the article recommends that the first meal after the PPI is high in protein.  You can read it in the article. 

Just be persistent...I took me several years to get my GI doc to agree to surgery.

Good luck!

Denise

It is frustrating that our prescribing practitioners aren't more informative regarding taking PPIs.  When I found document I provided in your link, I was amazed.  That's when I sent it to my primary care doc.  I'm still taking a 40mg Protonix before dinner because I have asthma/very reactive lungs, and even after a Nissen, the reflux isn't taken to zero (or you couldn't swallow), and it doesn't take much to get my lungs going.  Anyway, I was wondering if I should take it in the morning, rather than before dinner, since I'm only taking one. That's when he responded with the quote I included.

There's one other thing you could do.  Before my surgery (and as mentioned in the article) I was taking 300mg Ranitidine (Zantac) at bedtime to aid in breakthrough acid control.  Just another option you could discuss with your doctor if you continue to have trouble.

This is a great forum.  I found it when I was looking for information shortly before my surgery.

Glad you've joined us!  Don't forget that once you start taking PPIs properly it'll take some time to work.  Just be consistent and patient.  We'll be here as your sounding board, and to provide support.

Best wishes!

Denise