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So I am almost 2 years out and the heartburn is daily although I take a PPI (Dexilant).  I use antacids but am wondering if I still need to be on a PPI ?   I cut my dose in half 2 months ago and haven't had any issues with the reflux at night, just heartburn.   Wondering if there is a pill I can take for heartburn so that I can see if I can get off this PPI.   

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Have you tried one of the h2 antagonists?  Pepcid, zantac, etc?  The feeling of heartburn is actually caused by acid reflux so I'm not sure what you mean when you say that you're not having reflux, just heartburn?  Just not as severe?  Or that the acid isn't coming clear up?

Anyway, if it's not as severe you may be able to get by with the OTC h2 antagonists which seem to not have the same risk as being on ppi's long term.  Although they are not without risk long term either.  Having acid reflux/heartburn long term is risky as well so you have to figure out which is the least risk and go with that.

I sometimes feel like with my luck I'll probably get hit by a bus or struck by lightening and all my worry about long-term risk will be for nothing lol. 

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@msmarymac I don't have acid coming out my nose and mouth at night anymore.  I guess I am confused because I thought the heartburn and reflux were 2 different things.

Do you take a PPI ?

I had a bone scan done 2 months ago and they said everything was fine.

 

Edited by tracyringo

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@tracyringo Hello Tracy, I am sorry that you are having daily heartburn, it must be very uncomfortable. I do not have any advice (my own sleeve was done only two weeks ago), but I wanted to ask you when did you start having heartburn? My doctor said this is a common side effect and I wonder at what point does it start.

Many thanks and I hope that you find an effective treatment very soon!

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15 hours ago, tracyringo said:

@msmarymac I don't have acid coming out my nose and mouth at night anymore.  I guess I am confused because I thought the heartburn and reflux were 2 different things.

Do you take a PPI ?

I had a bone scan done 2 months ago and they said everything was fine.

 

Heartburn is a symptom of acid reflux, which is just acid coming up into the esophagus instead of staying in the stomach.  The coming out the mouth and nose is a difference (lessening) of severity, meaning the acid is not just coming up into the esophagus, it's shooting clear up into the mouth and nose.  Yikes, glad that is lessened for you!  That is no fun!

Yes I take a ppi, Nexium 20mg daily.  I also added Zantac 150mg at night and sleep with the head of my bed elevated (I have an adjustable bed) after a particularly bad run of the acid coming out the mouth and nose.  That actually happened while I was on a medical mission trip to Haiti and I forgot my Nexium.  We only had Zantac with us in our supplies for our clinic and it just wasn't doing the trick.  I went to my surgeon when I got home, had an EGD and Upper GI which determined I have a hiatal hernia which apparently was not there when I had my sleeve almost 5 years ago.  That is the main reason mine has gotten so much worse.  I have the choice of just fixing the hernia or fixing the hernia and revising to RNY.  My shoulder surgery was already scheduled (rotator cuff and bicep tendon repair) so I have put this decision off for awhile.  

While any of the choices (long-term ppi use, long-term h2 antagonist use, long-term acid) carry some risk, it is likely that having acid issues every day is the most risky.  So, I am staying on this regimen until I decide which direction to go.  I "should" do the surgery before the end of the year while my out-of-pocket maximum is paid up but I really don't want to.  After 8 weeks in the shoulder brace and ongoing Physical Therapy, I am just tired of being a patient.  Oh, and I fell right in front of the PT door about a month after my shoulder surgery, landing on my head which resulted in a lovely laceration and black eye.  I feel like I have been through enough for one year lol.  

Since your reflux seems to have decreased in severity you may be able to do OK with an h2 antagonist.  My surgeon recommended the chewable Pepcid but I feel like I get better results with ranitidine (generic zantac).  You can either take one big dose at night (like 300mg) or 150mg twice a day depending on the typical pattern of your symptoms.  Hope you find something that works, I know it can be miserable.

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4 hours ago, BrightDay said:

@tracyringo Hello Tracy, I am sorry that you are having daily heartburn, it must be very uncomfortable. I do not have any advice (my own sleeve was done only two weeks ago), but I wanted to ask you when did you start having heartburn? My doctor said this is a common side effect and I wonder at what point does it start.

Many thanks and I hope that you find an effective treatment very soon!

I had my surgery early in the morning. That evening I coughed all night and could not sleep, but they had me in an upright position.  It started immediately the cough was a prelude of what was to come.  I was discharged the next morning and the first night home is when it all started.  I woke up choking and was diagnosed with  reflux/ GERD.  Medicine has controlled it to where I cut the dose in half but I am having a lot more heartburn now, which I didn't realize was the same thing.  So mine was immediately.  Hope you don't develop this.  I will say that I would rather have this heartburn then weigh over 300 lbs.   I suppose I need to go see my DR. and re up my dose.

 

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@msmarymac thank you for the info, I am going to try ranitidine. Do I need a prescription for that?

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29 minutes ago, tracyringo said:

@msmarymac thank you for the info, I am going to try ranitidine. Do I need a prescription for that?

Nope, it's OTC. And pretty inexpensive so that's a plus over the ppi's as well :)

 

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22 hours ago, msmarymac said:

Nope, it's OTC. And pretty inexpensive so that's a plus over the ppi's as well :)

 

Thank you Mary.  I went out and bought a bottle last night and took one.   So far today I have not taken any rolaids or tums !!

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1 minute ago, tracyringo said:

Thank you Mary.  I went out and bought a bottle last night and took one.   So far today I have not taken any rolaids or tums !!

That's good news Tracy.  

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1 minute ago, cinwa said:

That's good news Tracy.  

I am thrilled !!   Just got off phone with DR. office and they want me to take the prescription one, so I will have both just in case.

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42 minutes ago, tracyringo said:

I am thrilled !!   Just got off phone with DR. office and they want me to take the prescription one, so I will have both just in case.

@msmarymac

For what it's worth, I have found that getting a prescription version of the OTC meds is often cheaper ... ranitidine (Zantac) is a good example; imodium for diarrhea is another. Costs $2 copay for me (for 60) or $10 for 18 OTC. 

and yes the risk of having heartburn / reflux is that you can develop a chronic irritation of the lower esophagus and cancer or strictures will develop in some people. So in addition to not having pain or discomfort, treatment or avoidance techniques can reduce the cancer risks. 

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22 hours ago, BurgundyBoy said:

For what it's worth, I have found that getting a prescription version of the OTC meds is often cheaper ... ranitidine (Zantac) is a good example; imodium for diarrhea is another. Costs $2 copay for me (for 60) or $10 for 18 OTC.

That's awesome, it's completely the opposite for me.  I thought I would try that with y Nexium since it's pricey.  At the pharmacy it was something ridiculous like $134 for the same thing I was paying less than $40 for OTC.  Turns out my insurance doesn't cover anything that is available OTC (plus I have a high deductible HSA plan).  And, OTC's are generally cheap here.  I paid less than $10 for 130 tabs of 150mg Ranitidine at Walmart.  I sure wish my insurance plan covered OTC's at the pharmacy because right now I have my out of pocket max paid because of my shoulder surgery and a mishap at PT.  So everything is paid 100% for the rest of the year!!  I would stock up for sure.  On everything!  That's probably why they don't lol.

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