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GERD & Acid Reflux
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Posted 11/23/2015 8:36 PM (GMT 0)
I have had a chronic cough since July. I thought it was related to allergies and treated with OTC allergy meds. That didn't work and after 2 trips to my PCP who also thought it was allergies he referred me to an ENT who after doing a scope decided it was caused by reflux and prescribed 40 mg of omeprazole. The cough eased within a few days but on the 4th day I felt miserable -- like I was not digesting food and it was just sitting in my stomach. I called my gastroenterologist (I have ulcerative colitis) and she told me to try OTC Nexium instead and if that didn't work to keep trying different meds. I was ok on the Nexium for 6 days before that horrible feeling happened again. That was last Monday and was the last day I took any meds for acid reflux. I found on Dr. Google that many times reflux isn't because of too much acid, but rather the opposite and it said to drink lemon water before meals. That's what I have been doing for the past week. The cough is now starting to come back again so I guess I need to be on a reflux medicine.

My questions:
1) has anyone here had a similar problem on a ppi where it didn't feel like food was digesting? What did you do about that?
2) Are there any lower dose ppis than 20 mg?
3) I should note that over the summer I had tried Zantac for a couple days but didn't see any difference. Does that class of drugs take longer to work and should I try again and give it more time?

I would like some suggestions before I keep buying different meds.

I rarely eat much of the foods listed on the internet as causing reflux, so I don't think diet is my problem. If not for the cough and throat clearing I don't have other symptoms reflux.

Thanks in advance for your suggestions
Posted 11/24/2015 12:53 AM (GMT 0)
As far as I know 20mg is the lowest. PPI's can slow down gut motility, thats why people often find they make them constipated. I have always been treated with omeprazole, which was incredibly successful for 12 years. I only needed to take 1-3 months worth at a time to settle things down so it wasn't continuous, and the motility issues caused by it resolve once you stop taking them.

I was put on Zantac, but that was after mine had spiralled out of control so it had no affect, but my GI told me that it could take up to 2 months to see some improvement from it.

If the PPI's help, maybe you could try a month long course of them, and make sure you are eating plenty of fibre and drinking plenty of water, eat smaller meals more frequently. Grapes and prunes are good for that. Or you could supplement the PPI's with a stool softener or a prokinetic like domperidone maleate, but I imagine you'd want to minimise the amount of medication you have to take, plus prokinetics can cause their own problems. A month long course could be enough for the problem to recede, if that doesn't work maybe try a few more months. Sometimes thats all it takes to get things back under control.
Posted 11/24/2015 2:43 PM (GMT 0)
I don't think I could tolerate feeling like that for a month. I don't get constipated -- it just feels like the food stays churning in my stomach -- I was burping a lot, feeling very nauseous and in a brain fog. These sound more like typical reflux symptoms, but I don't have any of them when not on the ppis -- just have the cough which goes away on the meds. (this isn't just a little cough -- it's a hard hacking cough -- I feel like I want to reach inside my throat and scratch an itch!)

With having UC I have to be careful of the amount of fiber I eat -- too much just moves everything too fast through my system. No stool softener needed lol.

I did take a nexium yesterday about an hour before I ate dinner. I am thinking of maybe trying to take it every other day instead of every day once I can get the cough back under control. And taking it later in the day rather than first thing in the AM. Hopefully that will minimize the side effects.

Thank you for your suggestions and if anyone else has any ideas I would love to hear them!
Posted 11/24/2015 11:59 PM (GMT 0)
I was just giving constipation as an example of slowed motility, its not the only symptom you can get from slower motility, food taking longer to transit through your stomach is related as well.

Try avoiding harder to digest things like meat (esp red meat), bread, starchy carbs etc. while you are taking the PPI's, then food shouldn't hang around in your stomach for as long.

I know what the cough is like, for 12 years that, and then heartburn, were my only symptoms. Before I was diagnosed and put on PPI's (about 6 months) it was thought to be a drug resistant chest infection, so not a minor cough at all.
Posted 11/28/2015 2:13 AM (GMT 0)
I can't speak to the other two of your questions, but regarding the feeling that food is 'not digesting' while on PPIs, yes, I have had that problem and had it today, actually. I didn't actually do anything to solve it besides try not to eat anything super greasy, oily, heavy... generally, nothing hard to digest. It just tends to go away on its own for me, but I can understand the feeling.

I agree with the poster above that I find things work themselves out better if I am sure to increase fiber (but not TOO much so you don't wind up super constipated). I also tend to eat a lot of pineapple and probiotic yogurt when I notice this happening. I don't know if they actually do anything for me, but I feel better when I eat them, so I say they can't hurt!
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