There’s nothing even slightly pleasant about 'em, that’s for sure.
I sincerely hope that the medicine you’re getting is of the wholesome quality variety, as I’ve heard plenty mentioned in the news that sometimes some places run a scam and the products they sell for very little have very bad things in 'em (though they may come in “legit” packaging).
I doubt it. Eating a pop tart or a bagel in the morning triggers it. Craft beer, triggers it (it can be debilitating within just a few sips (as in ‘hey guys, I’m gonna take off’)), NSAIDS (even via IV) can trigger it). I’ve never had it triggered by meat of any kind and spicy food doesn’t bother me in the least. Hell, being hungry triggers it.
So, the triggers seem to be random and while I haven’t kept any kind of diary, they certainly don’t correlate to eating meat, not that I can tell at least.
Unless you’re saying not that meat is causing it but that eating only vegetables (or leafy greens) might clear it.
However, barring this most recent bout, a milkshake or big bowl of ice cream usually gets rid of it.
And, FTR, a giant glass of (chocolate) milk doesn’t do it. I think. I think the actual cold helps somewhat.
Maybe it would help if your hospital would get one of those Sleep Number beds that are always being advertised?
Joey P, have you ruled out peptic ulcer?
Basically, the progression of drug usage as I understand it (I am not a doctor; this is just what I know from personal experience):
PPIs (Nexium/esomeprazole, Prilosec/omeprazole; Prevacid/lansoprazole, etc.): Use these drugs to suppress production of acid on a long-term basis. You take them daily, and it may take as much as a week or two for them to build up in your bloodstream and really kick in. So they’re helpful for a stomach that’s acidy all the time, but they’re not much good for a short-term attack on a single bad day (since they take a while to build up in your bloodstream).
H2 blockers (Zantac/ranitidine, Pepcid/famotidine, Tagamet/cimetidine, etc.): These drugs also suppress production of acid, but they do it on a more short-term basis. They may take about 45 minutes to kick in, and they reduce or eliminate acid production for the next couple hours. But they don’t neutralize the acid currently in your stomach, so you can still end up burping up acid even after taking them. In other words, even after taking an H2 blocker, you may still need an antacid to clear out the acid currently in your stomach.
Antacids (Pepto, Tums, Rolaids, Mylanta, Maalox, Gaviscon, etc.): These provide the most immediate relief by neutralizing acid that has already been produced and is currently sitting in your stomach. (I prefer Mylanta and Maalox over Pepto, Tums, and Rolaids.) On the other hand, antacids don’t stop the production of additional acid. So if you’re having a real bad attack, antacids can provide immediate relief but then the symptoms may return as quickly as 20 minutes later when more acid is produced. So you may need to take H2 blockers along with the antacid to really get a handle on a bad attack.
So the usual way to use these drugs is: Take daily doses of PPIs for long-term use, then supplement with H2 blockers on a bad day. And if you are burping up a lot of acid, then use antacids for immediate neutralization of that current batch of acid.
In addition, consider your diet. Some people find that fatty foods are really bad for them; with other people it’s acidy or spicy foods. With others, it’s roughage (raw greens). And so on. Also, look into problems like lactose intolerance and/or gluten sensitivity.
Basically, try cutting out one food item at a time for a couple days and see if it helps. In my case, cutting out fatty foods helped curbed acid production. But I still had a lot of bloating and gas in my stomach. Turned out I also had some gluten sensitivity: Cutting out whole wheat bread solved the latter problem.
(Again, I’m not a doctor.)
^ Chauve, you may not be a doctor, but I wouldn’t expect a better explanation from an MD; I’m copying your post and keeping it in my wallet. Nice job, KUDOS!
Protonix is my jam! I tried all the other PPIs before finally getting relief from Protonix. It just went off patent when I started taking it I think. My first bottle was $300 and now it is cheap. I woulda paid the $300 forever tho. So much pain without.
Not recently, but a few years back my GI doc did three endos in a row (for a different reason). He said he didn’t see any ulcers or damage from constant heartburn (it’s been a problem since I’ve been a teen). I know it’s been a few years and things can change, I’m just telling you the results form a while back.
That stuff I get. Each PPI I try, I stick with for several weeks to give it time to work, though I always figured jumping from one to the next would eliminate the wait time, don’t know if it does or not. Tagement/Zantac haven’t touched this either (and that’s taking it with PPIs already in me). The only thing that’s given me any relief is Tums, but I need to play more with the Carafate and Gavison (that stuff is weird, I understand how it works, but it turns to flavorless foam in your mouth).
If the current one I’m on, Protonix, doesn’t kick it in a few weeks, I’m going to try going back to Omeprazole (40mg), it’s always worked very well for me (and doesn’t give me the runs) and the doc said that just taking a break from it for a few months may help it to work again.
I haven’t adjusted my diet at all, even from before this started to now. I’m willing to believe that something could have changed, it would surprise me because a switch would have had to flip, but I’m not saying it isn’t the issue. This just started one day, it wasn’t a gradual onset.
Right now my doc is hinting at doing another EGD, but I’m hoping to avoid that. If they’re just looking for an ulcer, I’d rather to a breath/blood test first, but they may want to stick a monitor in me, which I’m kind of hoping to avoid (the EGD and the monitor).
I do think it’s funny when I, or someone else says ‘yikes, I have really bad heartburn’ and someone always jumps up and says ‘I have some Prilosec, do you want one’. I want to say ‘and I have a Prozac for the next time you get some bad news’, sorry, doesn’t work that way*
*well, it would for me, for a regular user of PPIs you can take usually double up or take a second one later in the day, but they don’t know I take it.
Here is one thing to possibly consider: The docs underdose the hell out of those medications.
To put it another way: When I first started taking these meds, the available selection was very limited. (When I first started, basically the only high-power meds available were Ranitidine and Maalox/Mylanta.) So if some drug didn’t work, the docs just upped the dosage until it did work.
Nowadays, OTOH they have lots of alternatives in each class of meds, so the docs try to keep the dosages low and switch you around between meds. They hope to find something that will work for you at low dose.
But there’s an argument for going high-dose on some of these meds. For example, for decades I took the following daily: the equivalent of 80 mg of omeprazole (4 times the usual dose) and also 300-600 mg of ranitidine (4-8 times the usual dose). And then when I had an upset, I drank half a bottle of Maalox/Mylanta on top of all that other stuff. That was for decades; and my doctor didn’t consider it a big deal. He said that hyper-acidic patients needed even higher doses than that.
He bugged me about paying more attention to diet and seeing what exact foods bothered my stomach. I didn’t bother for decades because of work and all that. But when I retired and was able to figure that out, I was able to drop the doses down to the equivalent of 20 mg of omeprazole and ranitidine only as needed.
Anyway, my point is: Your doses aren’t that big. And body size matters; if you’re a big fellow, then your doses may be small relative to your mass. Now, I’m all for working with the docs and letting them play with different drugs at low dosages. But when you’re working with lower doses, then yes, it may take a while to find what works for you. Frankly, some of these drugs just don’t work well until you take a shitload of them.
So I’m just saying: These are mostly OTC drugs, and they’re dosed in such a way that a 90-pound little old lady would be comfortable with them. So don’t get too discouraged if these drugs seem ineffective; you may just need to take bigger doses.
(OTOH, don’t blame me if you end up overdosing. Use common sense here.)
Thanks! Just figured I would relate my own experiences for the benefit of others (with the understanding of course that IANAD).
I was on 40mg of omep (20 is the OTC dose). The doc told me I cold take a second 40mg pill in the afternoon if I wanted too. The problem I found is that the stepping up from 20 to 40 causes certain GI issues (let’s just group it all under ‘the runs’ and leave it at that, but it did stop after about a week*) so going from 40 to 80 didn’t sound that appealing. With Nexium (OTH) and Protonix she told me I could take it twice a day as well. I don’t think she’s underdosing me, but I’d rather find a med that works that take more of one that only kind of works. Don’t get me wrong, if something worked great for a few hours and then kinda tapered off, I’d take it again in the afternoon, and I tried that with Nexium, but it still wasn’t working and waking up in the morning to run to the toilet was getting old.
As of right now, she’s got me on Protonix, she called in the script for twice a day, but told me to step it up to that if once day isn’t cutting it. We’ll see how I feel in a week or two and go from there.
*While my GI issues stopped after about a week when I moved from 20 to 40mg of omeprazole, they didn’t stop the entire time I was on (once a day, OTC Nexium). I think, but don’t remember, what happened with Dexilant and I’ll find out soon how Protonix treats me.
Okay, that sounds better. So your doctor is giving you leeway to experiment with higher doses. So by all means play around with that angle. I know from experience that if you go high enough with the doses, the drugs do eventually work. They can be quite effective. Naturally your GI issues have to be considered (I didn’t have such issues). But presumably you can find a med that won’t have that side effect.
I was just reading through the thread and I want to make one more pitch for the efficacy and use of H2 blockers.
H2 blockers are medium-term: They kick in within a period of 45 minutes or so and work for 4-6 hours.
A great use of H2 blockers: Crank down a few of them an hour or two before bedtime. They’ll kick in as you go to sleep, and they’ll keep your stomach trouble-free through the night. As any GERD-sufferer knows, night can be the worst time. You go to bed with a full stomach, and halfway through the night your stomach empties and then fills with acid left over from the digestion process. So H2 blockers really shine at night: They’re timed to be perfect for that use. The main thing is to figure out the correct dosage. You may need to go high-dose with them.
In other words, you can go low-dose with PPIs for long-term use, figuring that your stomach doesn’t trouble you much during the day. And then you can supplement with H2 blockers at bedtime for an extra boost of protection to get you through the nights.
I know H2 blockers don’t seem to have much effect at normal OTC doses. But if you double or triple the dose, they can really cut down acid production for the rest of that day or through a night. Also, as I said, they won’t clear out any current acid–that’s a job for antacids. But take H2 blockers at the correct dosage, and you’ll get excellent relief over the medium-term (1 hour to 6 hours).