Tagged: GERD LPR SIBO PPI
- petermParticipantMay 15, 2018 at 8:34 amPost count: 5
have really been struggling with GI issues in the last month and am looking for help while I go through the medical process here in Canada. Here is my story. Sorry if it is long and detailed. I highlighted the parts where I feel there was a big turning point and my main concerns.
I’m a 43 year old male living in Canada and a year ago I was pretty fit, lighting weights and eating somewhat healthy. I was considered healthy by my doctors and I felt good. In late June 2017 I woke with very bad upper abdominal pain. I had fever, vomitting and nausea. Even a few specks of blood in my vomit. I went to emergency and they did some blood work, x-ray and an ultrasound but didn’t finy anything wrong. They sent me home with 2 weeks of pantoprazole. In about 24 hours I was on my feet again and mostly better but I was burping a lot. Like anytime after drinking water.
A couple of months later I noticed that I was getting small but concerning stomach aches (dull feeling) and still burping. I went to my doctor and he said it was likely acid reflux caused by something and to go on PPIs (40mg pantoprazole) for 6 months to see how it goes. He also tested me to for H. Pylori which came back negative
3 months after of trying to live my normal routing (a bit less eating and working out and reducing things like dairy) I had another pain attack. Not as severe as the first one but noticeable. I went back to my doctor and he suggested I get another ultrasound and tested for lactose and gluten intolerance. I came back with a diagnosis of lactose intolerance but was not celiac and ultrasound was fine.
A month and a half later I had another attack (likely from overeating since it was around the holidays) and went to the hospital. This one passed after about 16 hours. The doctor there told me to double my PPIs for 2 weeks and take restoralax (laxative that draws water to your bowels) for a month. I felt better for awhile. A month and a half later I finished my course of PPIs. I was feeling good and wanted to come off it.
He said I could try and didn’t think I needed to ween off the PPIs. The first 2 weeks went good. I was still avoiding dairy (occasionaly lactose free cheese and milk or a try with something with lactase pills) but I was eating more whole grains. And also my weakness, dark chocolate. A lot of burping came back so I went back to the doctor. We had me try 2 weeks on dexilant 60mg. I felt good for those 2 weeks but I also cleaned up my diet.
I tried without PPIs after that and was doing OK till I went on a vacation to NY. There I ended up eating more carbs (I was trying to avoid gluten in case I had non-celiac gluten sensitivity) and dabbled with a bit of pizza and ice cream. By the 3rd day I was getting burps again. My doctor prescribed me some dexilant (generic this time) and told me to take it if I had any problems. I took it for 2 days and stuck to a pretty simple diet of chicken, rice, salad and fruit for most of the rest of the trip. On the way back I started getting little bubbling type pains in my gut. Often lower left but sometimes in other areas.
When I returned I noticed that ginger helped so I was regularly consuming ginger anytime the pains popped up. I was feeling pretty good and tried going to the gym a little more. On one trip I tried doing some light bench presses and felt a uncomfortable feeling of gurgling just before my chest. I then stopped everything. For the next week I felt a little uneasy in the abdomen and went back to my doctor. He put me back on the dexilant (generic 60mg) and said all the problems were because I stopped the meds. He also send me for tests for kidney function which came back ok.
**A few days later (about 3-4 weeks ago) I had another pain attack. This one was not as severe but lasted several days.** Since then I have been on a rollercoaster of mostly downwards health. I have tried really cleaning up my diet which I am not sure helps. I am mostly on bananas, chicken, spinach, coconut yogurt, berries and carrots. Symptoms in order that they started to appear/worsen have been:
– light pains popping up randomly in my lower abdominal
– discomfort in my lower abdominals when sitting.
– a feeling of acid reflux shortly after cutting out most carbs. (Also seemingly after crossing my arms across my chest one day)
– light upper abdominal pains that appear rapidly for short periods. Anywhere from both sides under the ribs to middle of chest or slightly lower.
– occasional light headedness. Usually goes away shorty after eating.
– Going from discomfort when lying on my back or right (could only sleep on my left for months) to pain when leaning back. This lasted for a few days. It has subsided a lot after avoiding drinking fluids 2 hours before bed and sleeping elevated with a wedge.
– a light cough and globus feeling. (after I switched back from dexilant to pantoprazole.
– lower energy and depression
– this morning I woke up with a bitter taste in my mouth. (note I just tried reducing my PPIs to once a day the day before)
In the last month I have tried:
– being much more strict with my diet though I am still experimenting with what may trigger things.
– sleeping elevated
– After significant chest pain a week ago when accidentally rolling onto my back in the morning I went to emergency. They checked my heart and lungs (blood and xray) and said it was OK. The doctor then switched me to pantoprazole twice a day.
– adding things like throat coat tea and vitamin B12.
– I also just had a CT and am waiting to discuss results with my doctor next week.
– reducing my pantoprazole to once a day.
What I currently feel:
– minor lump in my throat and light cough. Seems to get much worse later in the day. Not sure if it coincides with when I take my pantoprazole. I am taking it right before dinner so I still have some acid reduction during night tine.
– a slight burning feeling in my stomach every so often during the day. It doesn’t seem to go high up enough to feel like heart burn or burn my throat.
– slight lower abdominal pains and the burning pains in my stomach when doing something like riding a stationary bike for awhile.
-** low energy. Even though I don’t have very bad pains I feel low energy, can’t be happy and feel anti-social. I feel like this is because my lifestyle suddenly came to a dead stop a month ago and I don’t know if I can ever go back to it, even in a smaller capacity. Everytime a little pain in my abdomen pops up it completely ruins my mood. With all the pains and issues I had since last June, it hardly affected my mood until the several day pain episode that happened a few weeks ago.**
I am looking for any advice that may nudge me in the right direction as I haven’t been able to get much direction from doctors yet. I have not been able to get referred to a GI doctor yet.
I feel like i may have:
– hiatal hernia (from weightlifting) but my doctor seems to constantly think it is a low possibility and never tests for it
– SIBO, H. Pylori and/or gastritis from PPIs messing with my digestive system
– Some kind of vitamin, nutrient deficiency from the reduced diet.
Thanks for any advice you may have.
PeterNorm RobillardKeymasterMay 15, 2018 at 8:36 amPost count: 441
I can relate to your challenges. Have you read Fast Tract Digestion Heartburn? Do you have the Fast Tract Diet mobile app? If not, I suggest you start there and perhaps consider our consultation program.petermParticipantMay 16, 2018 at 7:09 amPost count: 5
Thanks for responding.
I have Fast Tract Digestion Heartburn on order but it won’t arrive till early June. I wasn’t able to find anywhere locally or in Canada that could get it to me faster.
I purchased and downloaded the app and it is a handy start but I feel like I need the book and recipes for more guidance.
In particular I noticed some low FP foods and ingredients in recipes are common reflux triggers. I am wondering if there are specific recipes for avoiding heartburn in general or if the diet is primarily based on keeping the FP low to avoid gas etc..
I will look into the consultation program as well.george8181ParticipantMay 27, 2018 at 6:04 amPost count: 1
Have you got the book yet and started the diet? Really interested to hear how you go as my husband has similar issues and started the diet today. Praying it works because I don’t want him on PPIspetermParticipantJune 12, 2018 at 1:50 pmPost count: 5
How has the diet been working for your husband? I have not started it yet as I just got the book delivered in the mail a few days ago. I have read through it and am excited to try it but I have a few things I want to finish going through before changing things up again.
Since I posted I am feeling better but still far from normal. Here is an account of what happened and what changed in case you are interested in my journey so far: (not I still do not have an official diagnosis from any medical professional)
– My abdominal CT came back clean. Both my doctor and the GI doctor (more on this later) didn’t see anything. He also suggested trying some pancreatic enzymes to see if that helps.
– switched back to dexilant 60mg once a day. I take it around 5:30PM so I have good protection at night.
– I started talking vitamin D and Calcium and Magnesium supplements. I feel something there really helped with depression or making my mood better. (not 100% but quite a bit better). I also switched to a more potent (30 billion from 5 billion) probiotic.
– A stool test for bowel inflammation came back a bit high. High enough for my doctor to finally refer me to a GI but the GI said that at that level they don’t do anything.
– I went to see a Naturopathic Doctor. She said that she often sees this and my stomach and intestinal linings needs to heal and when they do my food sensitivies should reduce. She gave me some supplements for protecting (villicote) and healing (intestamine) by stomach lining and some more complete enzymes to try. She also replaced my vitamin D, calcium and mag with a liquid form cause she said I will absorb it better.
She also adjusted my diet a bit. I was already basically only on chicken, ground turkey, eggs, fish, spinach, rice, sweet potatoes, squash, bananas and melons. She put me on a hypoallergenic/elimination diet for 4 weeks (I am on week 3 now). The biggest adjustment was removing eggs but otherwise it stayed the same.
– I ordered a MedCline pillow and returned my wedge. It is much more comfortable but I still wake up every night.
– a couple of days after seeing the naturopath I started feeling better. I am not sure if it is because of her treatment or things were starting to calm down internally. I suspect a combination of things.
– I continued seeing my accupuncturist. I think it helps with some symptoms and is a little stress relieving.
– was lucky and able to get to see a GI doctor relatively quickly (1 week ago today). He said he things I ate something that made my digestive system go crazy and that things could improve over time (months) with treatment but he wants to do some more tests to confirm or rule out things. He mentioned something similar happened to him but he had diarrhea instead of cramping pains but he also could not lie down or bend over without pain. He also had burping as a symptom of his reflux.
I told him I am concerned about LRP/reflux and being on PPIs long term so he is going to do an endoscopy next. That is scheduled a month from now. As I mentioned he wasn’t too concerned with my calprotectin levels and he said my CT looked really good so he didn’t see the need for a colonoscopy at this point.
The bad part about the visit is that he recommended I add 2 things. Benefibre a couple of times a day which I wasn’t sure about since I was pretty regular. And Elavil (anti-depressent) to calm down the nerves in my gut. I was pretty apprehensive about the drugs but tried them but I am now weening off of them. More on this later.
– I am in the process of getting a new family doctor because mine is dropping patients due to working more at the hospital now. I am fine with that since I didn’t think we were a good fit for each other. I am meeting a doctor I am hopeful about this week who seems quite experienced and has a spouse that is a GI doctor I believe.
So my current main symptoms issues are these:
– There is still something going on with the whole reflux/LPR thing but I am trying to sort out what is what as I wait for the endoscope and likely more consultation.
1) Near the 22 hour mark after taking my daily PPI I seem to notice a slight burning feeling in my stomach. I thought it was whatever I was eating but it doesn’t seem to matter. I suspect it has something to do with the PPIs wearing off enough that my stomach starts producing more acid. I don’t know if it is overproducing or not though so I am scared to wean off the PPIs at this point since I still have some symptoms.
2) I get a slight feeling of having a harder time breathing and a slight cough (like a light dry cough a few times an hour). This also only seems to start later in the day. I wake up typically feeling OK. Again I am suspecting that this may have something to do with the PPI wearing off enough that acid reflux is irritating my esophagus and doesn’t calm down till after I sleep. Last night I had bad sleep and woke up with a bit of a feeling of air trapped in my chest and I seem to have the slight cough already (before noon)..
3) Something is irritating my throat. At first I thought it was reflux for sure but now I am not so sure. At one point I added some more “safe” (according to the hypoallergenic diet guide) foods such as gluten free oats, blueberries, apples, honey, etc.. to my diet. Before that my throat seemed mostly OK but about a week ago it got really irritated, I started getting a funny (almost metallic) taste in my mouth and a bit of congestion. I pared back the foods I added, switched back to a tablet form for vitamin D, Calcium + Magnesium cause the liquid now seemed to irritate my thoat, and went to vitamin B12 only twice a day and a couple of days later my throat felt a lot better. I suspect it was apples. However, I still noticed it would get irritated a little, so more recently I stopped eating bananas and now I don’t seem to have the throat irritation anymore.. Still the cough though.
– I am not able to sleep through the night. Even with my much more comfortable Medcline pillow. I don’t know what is waking me up now. In the early days it seem to be either pain or being physically uncomfortable with the way I was sleeping. Now I don’t know as when I wake I typically don’t feel any pain or discomfort. I am hoping it is not sleep apnea but I heard that commonly goes with LPR.
Side note about the Elavil. One side effect is that it is supposed to make you sleepy and drowsy. It did for the first day and I almost slept the entire night but every day after that it was back to the same but some nights I had an elevated heart rate that was kind of scary. The pharmacist I asked said it is from my blood pressure dropping cause of the drugs and once in awhile my heart has to pump faster to get things going again. I didn’t like that at all and on top of my it seemingly only to help with stomach pains/spasms which were becoming less of an issue at this point anyways, it didn’t seem to be worth the risks. My GI doc dropped the dosage (from 25mg to 10mg) but I still had the faster heart rate problem but less drowsiness. In any case, I am weening off of it and will stop it today or tomorrow. (on split pill right now so only 5mg). My advice would be don’t take it unless you have severe symptoms. It might have helped a month ago but not now. Also since another side effect is constipation and slowing everything down in your digestive system, it seemed counter productive for me. I don’t have diarrhea but I suspecting some slow emptying problems.
– other abdominal pains are still there but pretty light and less frequent it seems. In any case, they don’t worry me as much now. Likely because they seem to be getting better and I haven’t had any significant flare ups (knock on wood)
– Chest/rib pains are still bothering me. I can’t seem to do anything with a lot of arm movement or things with much impact without these pains flaring up. They aren’t really bad at this point but they are there every day. I use a heat pad on the area whenever it comes up. It is usually in my chest area but sometimes on my sides or lower ribs. Anxiety may also be a bit of a trigger for this.
– I developed some light back pain which I attribute to muscle loss and posture and more disturbingly some rectal pains which at first felt like pressure but now it is sort of like a sore tailbone feeling. I think it is muscle related (like ani levator syndrome) because it is relieved when doing certain stretches or sitting). It mostly kicks up when I am at home cooking or washing dishes. Maybe too tense when I am standing. I had been reading some John Sarno and he mentioned that TMS sometimes kicks in when doing certain activities so maybe there is something there.. Cause when I am standing around at work or other places it doesn’t seem to happen. Mostly at home..
So to wrap up a very long post here is what I would recommend to date:
– listen to your body and try to make adjustments. Things like deep breathing, meditation, stretching etc.. relieve pains and anxiety. Foods of course seem to have a lot of impact when your digestive system isn’t right so either track it carefully or slowly add foods one at a time and give time to notice effects.
– challenge any drugs that doctor want to prescribe so you can make the right decisions. Are they integral for your healing or just for symptom management. Is it worth the trade off?
– Stay positive and try to enjoy the good things around you like your family etc.. Minimize the time you search on the internet for answers. I find this hard but now I mostly look for things that will help me (eg. diet advice etc..) or good news stories. Getting sucked into reading all the potential things you could have and depressing stories won’t help your anxiety and that will make things worse.
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