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Reflux and HCM


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Lisa Salberg Find out more about Lisa Salberg
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  • shirleymahoney
    I do too Reenie and Lisa

    I will wake up in middle of the night with the nausea and i was given prilosec years ago when it first came out and i didn't like the salty taste it gave me and quit it i was told i had nodular Gastritis i had an upper GI and it showed thosands of nodules in my esophacus and i do have problems swallowing on a daily bases, so you can include me in on the reflux also


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  • Reenie
    My husband also has trouble with acid. He took Tums for years, even before diagnosis, then he finally moved on to Ranitidine. That only worked for a while and now he's on Aciphex. It seems to do the trick for him. He not only had acid heartburn symptoms, but before he started the Aciphex he had some severe abdominal cramping. We thought he might even be developing an ulcer. It's all better now.


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  • Lisa Salberg
    Let me explain further - About 2 years ago I was really sick, chest infection, throat, ears, sinus I was on my back and felt horrible. I thought I had pneumonia again but no - I was in the ER for difficulty breathing it was really bad.

    I went to a new doc, pulmonary guy - he gave me nexium without much explanation. I took it for a month and stopped. I returned for a recheck and he said you may want to go back on the nexium - but did not say why. I headed off to an ENT - he took one look at me and said WOW you need Nexium for about a year! I had never had any typical symptoms of reflux, so I was a hard sell - then I thought about little things like the feeling I was going to 'be sick' in my sleep - leaning over to tie my shoes and feeling like I was going to vomit. I had no pain at all.

    I also reevaluated my diet and changed many things (however I can not give up my tea or chocolate - I have my limits )

    Then last week I spoke to someone who also has HCM and reflux. He was telling me about his gastro guy and that his chest pain was directly connected to his reflux and after a lowering of meds and change of diet/habits the reflux was improved as were his symptoms of chest pain.

    This call - and a conversation with a good friend who's child has severe reflux lead me to do a little digging - and WALLA a simple connection was found.

    I will be speaking to some of our advisor's shortly about this issue and see if we can create a better guide to understanding HCM and Reflux!

    Peace to all!

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  • Abbygirl2
    I would love to blaim my heartburn on B-Blockers but I can not. I began getting heartburn with my first pregnancy and it never went away. (That was 8 yrs or so before beginning Atenolol.) It did however worsen with the addition of the Atenolol.
    I had tried different prescription meds. Nothing helped except Tums, which I relied on daily. Then 9 months ago or so, my Dr gave me Nexium, I haven't taken a Tums(or any other antacid) since. Hmm, I sound like a commercial.
    I am cautious though because I was on Propulcid/Prepulcid when it was discontinued due to serious heart disturbances, so now every medication makes me nervous.

    Anyway, super topic of discussion.
    Thanks yet again Lisa.


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  • mtlieb

    I hadn't realized that there's a direct connection between beta and calcium channel blockers and acid reflux... thanks for the info.

    It makes sense that a large percentage of HCM'ers also have GI problems, and i think it's quite simple really. The heart works overtime during the digestive process, and if our hearts don't pump as effectively as a normal heart it stands to reason that our digestive tracts would be impaired to some degree. We've all experienced that increase in HCM symptoms after a large meal, right?

    Proper digestion relies quite a bit on gravity and movement as well, and most symptomatic HCM'ers simply can't be as physically active as the average Joe. When symptoms are really bad there are days when we can spend more time horizontal than we do upright. That's not good for digestion... acid backs up, etc. There's also the weight issue to consider. Aside from all the usual factors, HCM'ers tend to have a harder time managing weight because of meds, restricted activity, and metabolism.

    Frankly, i'm surprised all of us don't have acid refux.

    Interesting topic!


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  • Largehearted
    Thanks Lisa.

    This helps me understand my symptoms better. While I don't have all those symptoms, I do have enough that it makes me wonder if the heart meds play a role.


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  • Lisa Salberg
    started a topic Reflux and HCM

    Reflux and HCM

    I have noticed that a very large percentage of those with HCM have reflux - this made me wonder about a connection. Well it seems as though there is a very obvious answer. Both beta blockers and calcium channel blockers can actual cause or aggravate reflux - as most people with HCM are on one or both of these meds... it is no wonder that many have reflux.
    This is a nice outline that I found on line that discusses reflux AKA GERD.

    1) Most people experience heartburn at some time in their lives.
    a) Heartburn is most often caused by gastroesophageal reflux, or leakage of stomach
    acid backwards into the esophagus (“food tube” from mouth to stomach).
    b) A small amount of gastroesophageal reflux is normal, but repeated reflux of large
    amounts of acid is not. This is gastroesophageal reflux disease (GERD).
    2) About 7% of Americans have daily heartburn. Many of these have GERD.
    3) Symptoms of GERD (you don’t have to have all of them):
    a) Heartburn
    b) Acid taste in the mouth
    c) Abdominal bloating
    d) Difficulty swallowing
    e) Chronic cough
    f) Wheezing
    g) Hoarseness
    h) Chest pain
    4) The lower esophageal sphincter (LES) is a ring of muscle around the bottom of the
    esophagus, just before it enters the stomach. The LES loosens up to allow food to
    pass into the stomach, and tightens to prevent acid from refluxing back up. In GERD,
    the LES often doesn’t stay closed when it should.
    5) Some things make GERD worse:
    a) Alcohol
    b) Caffeine
    c) Cigarettes
    d) Obesity
    e) Eating before bedtime
    f) Chocolate
    g) Peppermint
    h) Acidic foods, such as tomato-based foods, citrus, etc.
    i) Hiatus (or hiatal) hernia (the junction between the esophagus and stomach slides
    up out of the abdomen and into the lower chest).
    j) Certain medications
    i) Calcium channel blockers
    ii) Beta-blockers
    iii) Nitroglycerin
    iv) Theophylline
    v) Progesterone
    6) Complications
    a) Esophagitis – inflammation of the esophagitis. Occurs in about ˝ of people with
    b) Barrett’s esophagus – the esophagus gets so irritated for so long that it changes its
    lining in an attempt to protect itself. In a small percentage of patients, this can
    become serious (chronic irritation, cancer).
    c) Asthma
    d) Pneumonia
    e) Vocal cord irritation and hoarseness or voice changes
    7) Treatment
    a) Lifestyle changes
    i) Lose weight if overweight
    ii) Avoid alcohol, caffeine, chocolate, tomatoes, citrus products, especially
    within a few hours before bedtime.
    iii) Avoid large meals
    iv) Elevate head of bed. Use bricks under bedposts; do not use extra pillows.
    v) Do not lay down or go to bed within 3 hours after a meal.
    b) Medications
    i) Antacids – Maalox, Mylanta, Tums, Gaviscon, etc. These are often enough
    for milder symptoms, and can be added to other medications below.
    ii) H2 blockers – Tagamet, Zantac, Pepcid, Axid. They decrease the amount of
    acid made by the stomach.
    iii) Proton pump inhibitors – Prilosec, Nexium, Prevacid, Aciphex, Protonix.
    The most powerful medicines for decreasing stomach acid.
    (1) People on these medicines for more than a few months may have difficulty
    coming off them because of a “rebound” phenomenon. However, some
    people with severe GERD need to stay on them.
    (2) Vitamin B12 absorption may decrease with prolonged treatment with
    these medicines. This is usually not a problem.
    iv) Reglan. Tightens up the LES, and allows stomach to empty sooner. May be
    used as an adjunct to other medicines.
    c) Surgery. Reserved for the most severe cases.