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Reflux (Heartburn) Prevention and Treatments

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Lifestyle Changes
Reflux and Diet
Reflux and GERD Treatments
Surgery
Reflux Prevention Forum Discussions

Overview of GERD Prevention and Treatments

Heartburn (reflux) is very common in the general population. It can often be managed well with lifestyle changes, such as changing eating habits, sleeping differently, and increasing your activities. When lifestyle changes alone don't work, more agreesive preventive measures such as medications or even surgery (in severe cases) may be required.
Heartburn (reflux) is quite common in people with systemic scleroderma; therefore, preventing reflux, or at least, reducing its severity is very important in preventing esophegeal damage. (Also see: Scleroderma Gastrointestinal Involvement, What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis)
What is a reasonable approach to the management of GERD? There are several ways to approach the evaluation and management of GERD. The approach depends primarily on the frequency and severity of symptoms, the adequacy of the response to treatment, and the presence of complications. MedicineNet.

Lifestyle Changes

Heartburn Drugs Pose Risks: 12 Natural Symptom Relievers. A series of new studies, published Monday in the Archives of Internal Medicine, found that daily use of these drugs, which suppress the production of stomach acid, increases the risk of infection with an intestinal bacteria and increases the risk of fractures in postmenopausal women. Deborah Kotz. US News. May 2009.
10 Lifestyle Changes That Can Prevent Heartburn About.com (Heartburn/GERD)
Hold the Heartburn: Heartburn Log. Tracking your triggers can help manage heartburn effectively and naturally. WebMD.
10 Steps to Lesson Nighttime Heartburn. If staying up all night isn't the option you are prepared to take for handling your nighttime heartburn, the following suggestions should help you. About.com
Heartburn: To relieve nighttime reflux, sleep on your left side. reported MSNBC on 5/22/98:  "If all reflux sufferers followed this advice, we'd see a lot less nighttime reflux," says Dr. Don Castell of the American Gastroenterological Association.
Wikipedia image of Stomach Position
Wikipedia Image
Why does sleeping on your left side reduce night reflux? Check out the position of the stomach and the opening into the esophagus. When you sleep on your left side, gravity helps to keep the contents in the stomach. Roll over on your right side and those contents could flow into the esophagus, especially if you have problems with your esophageal sphincter (valve between stomach and esophagus) or a hiatal hernia.

Reflux and Diet

Black Raspberries Protect Against Cancer: New Study Finds Black Raspberries Help Barrett's Esophagus Patients. A new study showed that black raspberries helped many patients reverse the negative impact of reflux acid. Nearly 4 in 10 saw a boost in a protective enzyme and 6 in 10 saw a decline in oxidative stress, which can cause cell damage. Medical News Today. 02/15/09. (Also see: Barrett's Esophagus)
Good Foods, Bad Foods, Recipes, Menus. Charts to show you what you can eat and what you shouldn't. Heartburn-free recipes. There are also links to menus with heartburn-friendly foods. About.com.
Use Beano before eating foods that are troublesome.

Treatments for Reflux and GERD

Methotrexate and heartburn drugs alert. Using both drugs at the same time many increase the amount of methotrexate in the blood leading to side-effects, including kidney failure, low red blood cell count, inflammation of the digestive tract, irregular heartbeat, muscle pain, infections and diarrhea. CBC News. 10/19/12. (Also see: Methotrexate)
Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis. Use of a proton pump inhibitor or histamine2 receptor antagonist may be associated with an increased risk of both community- and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk. Chun-Sick Eom, MD MPH, Canadian Medical Association Journal, February 22, 2011.
FDA Warns of Fracture Risk From Acid Reflux Drugs. Popular PPI antacids -- Aciphex, Dexilant, Nexium, Prevacid, Prilosec, Protonix, Vimovo, and Zegerid -- raise the risk of bone fracture, especially when used for a year or more or at high doses, the FDA warns. Danial J. DeNoon. WebMD Health News. May 25, 2010 (Also see: FDA Warnings)
Lansoprazole (Prevacid ) Can Cause Chronic Diarrhea Unresponsive To Conventional Medication. Lansoprazole is a proton pump inhibitor which powerfully suppresses gastric acid production and is widely prescribed for chronic use in gastroesophageal reflux disease (GERD). Lansoprazole uncommonly causes chronic watery diarrhea unresponsive to conventional medication as a symptom of collagenous colitis. Medical News Today. 05/14/09.
Plavix, heartburn drugs combined raise heart risk. People who suffer a heart attack nearly double the risk of having another if they are taking the widely used blood thinner Plavix together with a heartburn drug like Prilosec. Will Dunham. Reuters. 03/03/09.
Magnetic Device Studied As Treatment For Heartburn And Acid Reflux. For those seeking a non-prescription alternative, a magnetic device, currently being evaluated at UC San Diego Medical Center, may provide a long-term solution. Medical News Today. 02/24/09.
FDA Approves KAPIDEX (dexlansoprazole) Delayed-Release Capsules For The Treatment Of GERD. The U.S. Food and Drug Administration (FDA) approved KAPIDEX™ (dexlansoprazole) delayed release capsules for the once-daily, oral treatment of heartburn associated with symptomatic non-erosive Gastroesophageal Reflux Disease (GERD), the healing of erosive esophagitis (EE) and the maintenance of healed EE. Medical News Today 02/03/09 (Also see: Barrett's Esophagus)
G.I. Cocktail. Ask your doctor about this! It's a mixture of Maalox, Donnatol, and Xylocaine which can quell severe heartburn/reflux right away. Many SD patients give it rave reviews.

Surgery

In severe cases of heartburn, where medication does not help or there are complications, surgery may be done.
GERD Surgery: Nissen Fundoplication. In this procedure, the surgeon wraps the top of the stomach around the lower esophagus. This reinforces the lower esophageal sphincter, making it less likely that acid will back up in the esophagus. Mayo Clinic.
Nissen Fundoplication Surgery Personal Stories
Jon F: Gastroesophageal Reflux Disease (GERD) I believe my vagus nerve was damaged in some way during the Nissen fundoplication surgery or as a result of it...
Moomary: Diffuse Scleroderma The endoscopy showed that my esophagus does not close at all when I swallow. The surgeon suggested that he could do a Nissen Fundoplication...
Rosie: Limited Systemic Sclerosis (Australia) Some of my symptoms may not be due to limited scleroderma, however most of these symptoms have appeared since my diagnosis...

Sclero Forum Discussions

Has anyone noticed reflux intensifying at night and making sleep difficult? I have become nocturnal...
For those with reflux issues, a recommendation. About 1 1/2 months ago, my wife scheduled an appointment with a Nutritionist...
Toupet Fundoplication, Surgery to relieve acid reflux. I went through a surgical procedure, Toupet Fundoplication to relieve my acid reflux problems.. This is a partial wrap...
 
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