Re: Heart burn after surgery: is it common?

[Guest guest]

Hi ,

I only got some heartburn after dining out and my pumpkin soup had heaps of

pepper in it. That was about 3 weeks after HM.

Did you get the fundo during your surgery? Having that is supposed to stop most

heartburn.

(Australia)

>

> I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

>

> According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

>

> For folks who have gone through the similar surgery, have you experienced the

same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

>

>

>

[Guest guest]

Hi ,

Yes fundoplication is performed but I still ended up having heart burns. I am

given anti-acid pills by surgeon to take for 3 weeks, so may he is expecting

that to happen. Hope I get better by time.

> >

> > I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

> >

> > According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

> >

> > For folks who have gone through the similar surgery, have you experienced

the same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

> >

> >

> >

>

[Guest guest]

yes i did get heartburn. i all better now. i didnt get the fundo though. couldnt

have it because of some prior surgery. although i did not get the fundo i do not

have gerd.

[Guest guest]

My doctor now advised me to take two pills of anti-acid every day instead of one

and also suggested Sulcrate. Let us see if it makes it any better.

>

> yes i did get heartburn. i all better now. i didnt get the fundo though.

couldnt have it because of some prior surgery. although i did not get the fundo

i do not have gerd.

>

>

[Guest guest]

Hi Notan,

Thanks for your reply.

For almost last two years since I started getting pain in my chest and food

pipe, I always struggled to find out whether that was a spasm or heartburn. When

I used to take PPI (sorry I should not say them as anti-acid, thanks for the

correction!), the pain is never gone completely. The way I used to workaround

the pain was that as soon as I eat apple, the pain used to go away almost

instantly.

Since my HM surgery last week, I still get a pain but somehow it is more burning

sensation. Eating apple does not help that much but at the same time I am not

eating full apple anyway because of the diet restrictions. I am taking two PPI

tablets (Pantoprazole sodium 40m) daily: one in the morning and one in the

evening. My heartburn is reduced somewhat since then but not substantially.

I am thinking of trying Gaviscon, I heard it removes the heartburn " quickly " . If

that can work then it can also prove that what I am having is heartburn, not

spasms. Otherwise, 24hr pH test may be the other option.

> >

> > My doctor now advised me to take two pills of anti-acid every day

> > instead of one and also suggested Sulcrate. Let us see if it makes it

> > any better.

> >

>

> Have you tried to determine if in fact it really is heartburn from acid

> and not an esophageal spasm? They can feel the same. Some people go for

> years thinking they have acid reflux when it is actually spasms or other

> esophageal NCCPs (Non-Cardiac Chest Pain). Spasms are not uncommon for a

> while after surgery and other treatments, but often doctors don't seem

> to know about the problem.

>

> To do your own test you need some antacid. The chalky stuff you can buy

> anywhere should work.

>

> Understand that the 24hr drug you are taking is not an antacid. It is

> most likely a PPI (Proton Pump Inhibitor). Sometimes people, doctors are

> people too, call them antacids but they are different. A PPI works by

> reducing (rarely completely stopping) the acid production at the proton

> pumps in your stomach. Antacids work by reacting with the acid that has

> already been produce to neutralize it, but do nothing to reduce

> production of acid. The Sulcrate coats the lining of your stomach to

> reduce the contact with the acid, it also does nothing to reduce

> production of, or neutralize, acid.

>

> If you have heartburn from acid then you are still producing to much

> acid but enough antacid should quickly neutralize the acid. Antacids

> work quick and then quickly quit working. So if you take some antacid

> and the heartburn quickly goes away but may come back later it was

> likely acid that caused the heartburn. If the antacid does not work then

> you have to suspect something like a spasm. For some people eating or

> drinking anything can cause a spasm to go away. In that case the antacid

> may make a spasm go away too. For many people though spasm can be hard

> to get rid of and antacid won't work. The point is that the test isn't

> perfect but often works.

>

> The real test would have to be done by your doctor. It is a 24hr pH

> test. Not a lot of fun.

>

> Already you have a 24hr drug, which you have now doubled and a

> fundoplication, plus sulcrate. So even without any test, if all that

> doesn't stop the " heartburn " you should be thinking this could be

> something else. The good news is that spasms that start after, or

> increase after, surgery usually become less over time until they are

> less than before surgery. Over a longer time NCCPs of one kind or

> another, including spasms could start up or increase as thing change.

>

> notan

>

>

>

>

>

>

>

>

[Guest guest]

Hi ,

My 16 year old son had frequent heartburn/spasm right after his HM surgery and I

was quite worried.  His surgeon Dr. Dempsey told us that it should subside over

time.  If I remember correctly after 6 weeks it got less frequent and now it is

too rare.  His doctor asked him to 1st take 20 mg of omeprazole twice a day

(morning and 1hour before dinner), after heartburn became less frequent he took

only 20 mg a day.  It has been 5 months now.  I spoke to him and he said that

he could now try pepcid 40 mg and he strongly recommends that my son for his

rest of life take atleast 20 mg daily as it can reduce other problems.  You may

already know but drinking water helps get some relief during heartburns.

I wish you the best, I hope you get through this rough period and hoping after 6

weeks you feel much better like most people and after 3 months most feel normal.

Does anyone here know of any side effects to these acid reducer medicines?

Priti

________________________________

From: robert1242003 <robert1242003@...>

achalasia

Sent: Tuesday, December 27, 2011 4:16 AM

Subject: Heart burn after surgery: is it common?

 

I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

For folks who have gone through the similar surgery, have you experienced the

same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

[Guest guest]

Thanks Priti. I am glad to hear that your son is not suffering from

heartburn/spasm that much these days. I hope that my heartburn/spasm goes away

with time as well. I am going to buy Gaviscon and see if it helps when next

episode of heartburn/spasms kicks in.

>

> Hi ,

>

> My 16 year old son had frequent heartburn/spasm right after his HM surgery and

I was quite worried.  His surgeon Dr. Dempsey told us that it should subside

over time.  If I remember correctly after 6 weeks it got less frequent and now

it is too rare.  His doctor asked him to 1st take 20 mg of omeprazole twice a

day (morning and 1hour before dinner), after heartburn became less frequent he

took only 20 mg a day.  It has been 5 months now.  I spoke to him and he said

that he could now try pepcid 40 mg and he strongly recommends that my son for

his rest of life take atleast 20 mg daily as it can reduce other problems.  You

may already know but drinking water helps get some relief during heartburns.

>

> I wish you the best, I hope you get through this rough period and hoping after

6 weeks you feel much better like most people and after 3 months most feel

normal.

>

> Does anyone here know of any side effects to these acid reducer medicines?

>

> Priti

>

>

>

> ________________________________

> From: robert1242003 <robert1242003@...>

> achalasia

> Sent: Tuesday, December 27, 2011 4:16 AM

> Subject: Heart burn after surgery: is it common?

>

>

>  

> I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

>

> According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

>

> For folks who have gone through the similar surgery, have you experienced the

same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

>

>

>

>

>

>

>

[Guest guest]

Hi Priti and ,

You might consider trying peppermint tea. That's better than any antacid or PPI

I ever took, and a lot less expensive. I make a cup and leave it on my bedstand

at night if I feel like I might have problems later. If I feel an NCCP coming

on, I heat a mug of water in the microwave for 1 minute and then dip the tea

leaves in while eating Altoids. The Altoids hold it off long enough to heat the

tea, and then the tea calms everything down. This is for spasms and heartburn.

Helped before and after surgery. If it's bad, I'll also take an Aleve, which

relaxes muscles. I think every achalasia patient should have mint tea every meal

starting the day after surgery to keep the nerves calmed down and to calm the

stomach. I think someone told me that mint makes smooth muscle relax. I don't

know if that's true but it helped me. The doctors don't know what to do with

this pain, I think there is a misunderstanding because as someone pointed out in

a previous post it is a nerve issue, not so much muscle spasm or heartburn

(unless you have the diffuse esophageal spasm type of achalasia). The NCCP pain

may be caused by heartburn, but the actual pain itself, the " kneeling over and

laying in a fetus position while begging God to Stop " type of pain, is nerve

pain, IMHO. As always, what works for one person may not work for another.

Please let me know if you try this and if it works. I had aweful pain after

surgery and no amount of pain killer or antacids would help. Finally after 4

days we thought to go to the Starbucks and get a little mint tea, after that I

was fine, or at least functional. They should just put mints on the bedspreads

and put mint tea in all the meals of hospital patients. I'm not kidding - they

gave me Orange Pekot tea in the hospital, which was acidic, and causes

heartburn!

pletchsr@...

>

> Hi ,

>

> My 16 year old son had frequent heartburn/spasm right after his HM surgery and

I was quite worried.  His surgeon Dr. Dempsey told us that it should subside

over time.  If I remember correctly after 6 weeks it got less frequent and now

it is too rare.  His doctor asked him to 1st take 20 mg of omeprazole twice a

day (morning and 1hour before dinner), after heartburn became less frequent he

took only 20 mg a day.  It has been 5 months now.  I spoke to him and he said

that he could now try pepcid 40 mg and he strongly recommends that my son for

his rest of life take atleast 20 mg daily as it can reduce other problems.  You

may already know but drinking water helps get some relief during heartburns.

>

> I wish you the best, I hope you get through this rough period and hoping after

6 weeks you feel much better like most people and after 3 months most feel

normal.

>

> Does anyone here know of any side effects to these acid reducer medicines?

>

> Priti

>

>

>

> ________________________________

> From: robert1242003 <robert1242003@...>

> achalasia

> Sent: Tuesday, December 27, 2011 4:16 AM

> Subject: Heart burn after surgery: is it common?

>

>

>  

> I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

>

> According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

>

> For folks who have gone through the similar surgery, have you experienced the

same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

>

>

>

>

>

>

>

[Guest guest]

Priti wrote:

>

> Does anyone here know of any side effects to these acid reducer medicines?

There are a number of possible side effects. Some are more possible than

others. There is a lot of confusion on this topic. I see you used the

term " acid reducer " and that is a good way to think of them. A lot of

the fears some people have would be more understandable if acid

production was completely stopped but it is usually just reduced.

Stomach acid is important for digestion. You wouldn't want to completely

stop it if you didn't have to. Some of the nutrients in food need acid

to break the food down so that the nutrients can be absorbed. It seems

that normally people can get enough nutrients even when on acid

reducers. Some people though, have problems absorbing some nutrients

even without being on these medications. There are others that probably

are just getting by without the medications and when you put them on one

of the reducers they have a problem. As we age we can lose some of our

ability to absorb some nutrients, but there could be a problem at any

age. You want to keep an eye out for problems that could be due to a

deficiency of a nutrient, but don't go nuts on this.

Acid in the stomach also helps to kill germs that get into the stomach.

These germs may have come with food and drink or other sources. The

changes at the stomach may have changes that effect germs all the way

through the colon. Normally people on these medications don't have a

problem with this. There probably are some situations where it makes a

difference but most of us will not have a problem. There has been

research on this topic. One area of interest is community-acquired

pneumonia (CAP). There are studies that suggest that in the first few

days after starting a PPI there is a small increase in the risk of

getting CAP, but with long-term use after those first few days there is

no increase in the risk. Some studies also indicate that there could be

an increase risk for Clostridium difficile Infection with PPI use. That

risk has been estimated to be twice normal. Typically, one would be

older, in a hospital, rehab or nursing home and taking antibiotics to

get this infections. Otherwise the risk is small. You can double the

risk of winning a big lottery by buying twice as many tickets but you

still don't win. Most of us won't win a big lottery no matter how may

tickets we buy and we won't have these problems, unless we are old

and/or in a hospital and taking antibiotics. Even so, good hygiene can't

hurt.

One of the biggest areas of concern has been the risk of osteoporosis

and bone fractures. There were enough studies that seemed to show some

association (note that word) between PPI use and osteoporosis and

fractures that the FDA issued a statement to inform doctors about the

possible link. Even with the statement the FDA indicated that the

studies had problems including contradictory findings. Also, the studies

point to association not causation. It could be that people who are

going to have these bone problems even without PPIs have reason to get

on PPIs and that the PPIs didn't in anyway cause the bone problems. Only

better studies will tell.

PPIs can increase the number of stomach polyps but the polyps don't seem

to be a problem or lead to cancer.

Here is a review of the evidence:

Safety of the long-term use of proton pump inhibitors

World J Gastroenterol. 2010 May 21

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874135

" ...in summary, the PPIs are a safe class of medications to use

long-term in persons in whom there is a clear need for the maintenance

of extensive acid inhibition. "

Also an abstract:

Long-term acid inhibition: benefits and harms.

Dig Dis. 2011

http://www.ncbi.nlm.nih.gov/pubmed/22095013

" At the moment we cannot conclude that long-term PPI use causes anemia,

osteoporosis and bone fractures, increases the risk for pulmonary or

enteric infections, has an effect on GUT mucosa, polyp or tumor

formation, or that PPI use increases the risk of cardiovascular events

in patients on PPIs and clopidogrel. "

notan

[Guest guest]

Notan, you are so right. i had spasms 14 years ago. i would be out for my early

early morning run/walk and i would have the most awful pain. thinking it was

heartburn i would take a bottle of H20 with... i had it for years and finally

when i was firmly found with A.. it was then when the Dr said , nope it is

spasms... still have them too. H20 helps me sometimes. 

[Guest guest]

Hi ,

I bought Gaviscon yesterday and " waiting " for the next occurrence of heartburn.

I will try to see if it works or not.

I tried water before but it makes it worse for some reason. The other day, when

I drank full glass of water it ended up causing the heartburn right away. So

water is no go. Cold milk works but only some times though.

Thanks,

> >

> > Hi ,

> >

> > My 16 year old son had frequent heartburn/spasm right after his HM surgery

and I was quite worried.  His surgeon Dr. Dempsey told us that it should

subside over time.  If I remember correctly after 6 weeks it got less

frequent and now it is too rare.  His doctor asked him to 1st take 20 mg of

omeprazole twice a day (morning and 1hour before dinner), after heartburn became

less frequent he took only 20 mg a day.  It has been 5 months now.  I

spoke to him and he said that he could now try pepcid 40 mg and he strongly

recommends that my son for his rest of life take atleast 20 mg daily as it can

reduce other problems.  You may already know but drinking water helps get

some relief during heartburns.

> >

> > I wish you the best, I hope you get through this rough period and hoping

after 6 weeks you feel much better like most people and after 3 months most feel

normal.

> >

> > Does anyone here know of any side effects to these acid reducer medicines?

> >

> > Priti

> >

> >

> >

> > ________________________________

> > From: robert1242003 <robert1242003@>

> > achalasia

> > Sent: Tuesday, December 27, 2011 4:16 AM

> > Subject: Heart burn after surgery: is it common?

> >

> >

> >  

> > I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

> >

> > According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

> >

> > For folks who have gone through the similar surgery, have you experienced

the same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Hi , I will definitely give it a try to peppermint tea. Thanks for

sharing the tip.

> >

> > Hi ,

> >

> > My 16 year old son had frequent heartburn/spasm right after his HM surgery

and I was quite worried.  His surgeon Dr. Dempsey told us that it should

subside over time.  If I remember correctly after 6 weeks it got less frequent

and now it is too rare.  His doctor asked him to 1st take 20 mg of omeprazole

twice a day (morning and 1hour before dinner), after heartburn became less

frequent he took only 20 mg a day.  It has been 5 months now.  I spoke to him

and he said that he could now try pepcid 40 mg and he strongly recommends that

my son for his rest of life take atleast 20 mg daily as it can reduce other

problems.  You may already know but drinking water helps get some relief during

heartburns.

> >

> > I wish you the best, I hope you get through this rough period and hoping

after 6 weeks you feel much better like most people and after 3 months most feel

normal.

> >

> > Does anyone here know of any side effects to these acid reducer medicines?

> >

> > Priti

> >

> >

> >

> > ________________________________

> > From: robert1242003 <robert1242003@>

> > achalasia

> > Sent: Tuesday, December 27, 2011 4:16 AM

> > Subject: Heart burn after surgery: is it common?

> >

> >

> >  

> > I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

> >

> > According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

> >

> > For folks who have gone through the similar surgery, have you experienced

the same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

That's good to know. I will give it a try. Thanks for sharing the info.

> >

> > Hi ,

> >

> > My 16 year old son had frequent heartburn/spasm right after his HM surgery

and I was quite worried.  His surgeon Dr. Dempsey told us that it should

subside over time.  If I remember correctly after 6 weeks it got less

frequent and now it is too rare.  His doctor asked him to 1st take 20 mg of

omeprazole twice a day (morning and 1hour before dinner), after heartburn became

less frequent he took only 20 mg a day.  It has been 5 months now.  I

spoke to him and he said that he could now try pepcid 40 mg and he strongly

recommends that my son for his rest of life take atleast 20 mg daily as it can

reduce other problems.  You may already know but drinking water helps get

some relief during heartburns.

> >

> > I wish you the best, I hope you get through this rough period and hoping

after 6 weeks you feel much better like most people and after 3 months most feel

normal.

> >

> > Does anyone here know of any side effects to these acid reducer medicines?

> >

> > Priti

> >

> >

> >

> > ________________________________

> > From: robert1242003 <robert1242003@>

> > achalasia

> > Sent: Tuesday, December 27, 2011 4:16 AM

> > Subject: Heart burn after surgery: is it common?

> >

> >

> >  

> > I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

> >

> > According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

> >

> > For folks who have gone through the similar surgery, have you experienced

the same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Before the surgery, I used to have spasms/heartburn in the morning as soon as I

start running on the treadmill. Mornings were always worse. If I go to the gym

in the evening and do the same exercise, I never had any pain.

I always kept apple with me, as soon as I have the pain if I eat apple right

away, it used to go away instantly. If I eat apple before starting the exercise,

I never had problem as well. Apple was always a big help for me.

>

> Notan, you are so right. i had spasms 14 years ago. i would be out for my

early early morning run/walk and i would have the most awful pain. thinking it

was heartburn i would take a bottle of H20 with... i had it for years and

finally when i was firmly found with A.. it was then when the Dr said , nope it

is spasms... still have them too. H20 helps me sometimes. 

>

>

[Guest guest]

I personally had acid reflux for about 5 years diagnosed, I probably had it

longet than that. But never got heartburn once in my life until last December.

My doctor said I will be on medication the rest of my life as well. Before my

last dilation I was eating Tums like candy but water seems to help me more than

anything!

 

Kim A

________________________________

From: Preeti Mahajan <priti19.mahajan@...>

" achalasia " <achalasia >

Sent: Thursday, December 29, 2011 8:30 PM

Subject: Re: Heart burn after surgery: is it common?

 

Hi ,

My 16 year old son had frequent heartburn/spasm right after his HM surgery and I

was quite worried.  His surgeon Dr. Dempsey told us that it should subside over

time.  If I remember correctly after 6 weeks it got less frequent and now it is

too rare.  His doctor asked him to 1st take 20 mg of omeprazole twice a day

(morning and 1hour before dinner), after heartburn became less frequent he took

only 20 mg a day.  It has been 5 months now.  I spoke to him and he said that

he could now try pepcid 40 mg and he strongly recommends that my son for his

rest of life take atleast 20 mg daily as it can reduce other problems.  You may

already know but drinking water helps get some relief during heartburns.

I wish you the best, I hope you get through this rough period and hoping after 6

weeks you feel much better like most people and after 3 months most feel normal.

Does anyone here know of any side effects to these acid reducer medicines?

Priti

________________________________

From: robert1242003 <robert1242003@...>

achalasia

Sent: Tuesday, December 27, 2011 4:16 AM

Subject: Heart burn after surgery: is it common?

 

I had my HM surgery with wrap done 4 days ago. For the 1st 24 hrs after the

surgery, I was on IV and didn't experience any heart burn. But since then, I

started eating mushy foods but I am experiencing quite a bit of heart burn. The

heart burn starts if I even cough or sneeze.

According to my family doctor, I may have some wounds from the surgery in my

stomach or esophagus and thus when stomach acid gets into contact with these

wounds, I am getting heart burn. According to him, the heart burn should go away

after few weeks once the wounds are fully healed.

For folks who have gone through the similar surgery, have you experienced the

same heart burn after the surgery? If yes then for how long you used to have

them before you get fully recovered?

[Guest guest]

Someone also told me that coconut water is good for digestion and acidity.  Is

that true?  Would anyone know?

Not coconut milt, only coconut water,

________________________________

From: notan ostrich <notan_ostrich@...>

achalasia

Sent: Friday, December 30, 2011 12:58 PM

Subject: Re: Heart burn after surgery: is it common?

 

Priti wrote:

>

> Does anyone here know of any side effects to these acid reducer medicines?

There are a number of possible side effects. Some are more possible than

others. There is a lot of confusion on this topic. I see you used the

term " acid reducer " and that is a good way to think of them. A lot of

the fears some people have would be more understandable if acid

production was completely stopped but it is usually just reduced.

Stomach acid is important for digestion. You wouldn't want to completely

stop it if you didn't have to. Some of the nutrients in food need acid

to break the food down so that the nutrients can be absorbed. It seems

that normally people can get enough nutrients even when on acid

reducers. Some people though, have problems absorbing some nutrients

even without being on these medications. There are others that probably

are just getting by without the medications and when you put them on one

of the reducers they have a problem. As we age we can lose some of our

ability to absorb some nutrients, but there could be a problem at any

age. You want to keep an eye out for problems that could be due to a

deficiency of a nutrient, but don't go nuts on this.

Acid in the stomach also helps to kill germs that get into the stomach.

These germs may have come with food and drink or other sources. The

changes at the stomach may have changes that effect germs all the way

through the colon. Normally people on these medications don't have a

problem with this. There probably are some situations where it makes a

difference but most of us will not have a problem. There has been

research on this topic. One area of interest is community-acquired

pneumonia (CAP). There are studies that suggest that in the first few

days after starting a PPI there is a small increase in the risk of

getting CAP, but with long-term use after those first few days there is

no increase in the risk. Some studies also indicate that there could be

an increase risk for Clostridium difficile Infection with PPI use. That

risk has been estimated to be twice normal. Typically, one would be

older, in a hospital, rehab or nursing home and taking antibiotics to

get this infections. Otherwise the risk is small. You can double the

risk of winning a big lottery by buying twice as many tickets but you

still don't win. Most of us won't win a big lottery no matter how may

tickets we buy and we won't have these problems, unless we are old

and/or in a hospital and taking antibiotics. Even so, good hygiene can't

hurt.

One of the biggest areas of concern has been the risk of osteoporosis

and bone fractures. There were enough studies that seemed to show some

association (note that word) between PPI use and osteoporosis and

fractures that the FDA issued a statement to inform doctors about the

possible link. Even with the statement the FDA indicated that the

studies had problems including contradictory findings. Also, the studies

point to association not causation. It could be that people who are

going to have these bone problems even without PPIs have reason to get

on PPIs and that the PPIs didn't in anyway cause the bone problems. Only

better studies will tell.

PPIs can increase the number of stomach polyps but the polyps don't seem

to be a problem or lead to cancer.

Here is a review of the evidence:

Safety of the long-term use of proton pump inhibitors

World J Gastroenterol. 2010 May 21

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874135

" ...in summary, the PPIs are a safe class of medications to use

long-term in persons in whom there is a clear need for the maintenance

of extensive acid inhibition. "

Also an abstract:

Long-term acid inhibition: benefits and harms.

Dig Dis. 2011

http://www.ncbi.nlm.nih.gov/pubmed/22095013

" At the moment we cannot conclude that long-term PPI use causes anemia,

osteoporosis and bone fractures, increases the risk for pulmonary or

enteric infections, has an effect on GUT mucosa, polyp or tumor

formation, or that PPI use increases the risk of cardiovascular events

in patients on PPIs and clopidogrel. "

notan

[Guest guest]

Yes, coconut water is excellent for digestion and hydration. Much better than

gatorade or any sports drink - it's high in potassium and much lower in sodium

and sugar. It's pricey, but I keep it handy for those periods when getting

fluids down is a problem - it helps with hydration.  Costco carries it by the

case for around $15.

Kim

________________________________

From: Preeti Mahajan <priti19.mahajan@...>

" achalasia " <achalasia >

Sent: Tuesday, January 3, 2012 9:14 PM

Subject: Re: Heart burn after surgery: is it common?

 

Someone also told me that coconut water is good for digestion and acidity.  Is

that true?  Would anyone know?

Not coconut milt, only coconut water,

________________________________

From: notan ostrich <notan_ostrich@...>

achalasia

Sent: Friday, December 30, 2011 12:58 PM

Subject: Re: Heart burn after surgery: is it common?

 

Priti wrote:

>

> Does anyone here know of any side effects to these acid reducer medicines?

There are a number of possible side effects. Some are more possible than

others. There is a lot of confusion on this topic. I see you used the

term " acid reducer " and that is a good way to think of them. A lot of

the fears some people have would be more understandable if acid

production was completely stopped but it is usually just reduced.

Stomach acid is important for digestion. You wouldn't want to completely

stop it if you didn't have to. Some of the nutrients in food need acid

to break the food down so that the nutrients can be absorbed. It seems

that normally people can get enough nutrients even when on acid

reducers. Some people though, have problems absorbing some nutrients

even without being on these medications. There are others that probably

are just getting by without the medications and when you put them on one

of the reducers they have a problem. As we age we can lose some of our

ability to absorb some nutrients, but there could be a problem at any

age. You want to keep an eye out for problems that could be due to a

deficiency of a nutrient, but don't go nuts on this.

Acid in the stomach also helps to kill germs that get into the stomach.

These germs may have come with food and drink or other sources. The

changes at the stomach may have changes that effect germs all the way

through the colon. Normally people on these medications don't have a

problem with this. There probably are some situations where it makes a

difference but most of us will not have a problem. There has been

research on this topic. One area of interest is community-acquired

pneumonia (CAP). There are studies that suggest that in the first few

days after starting a PPI there is a small increase in the risk of

getting CAP, but with long-term use after those first few days there is

no increase in the risk. Some studies also indicate that there could be

an increase risk for Clostridium difficile Infection with PPI use. That

risk has been estimated to be twice normal. Typically, one would be

older, in a hospital, rehab or nursing home and taking antibiotics to

get this infections. Otherwise the risk is small. You can double the

risk of winning a big lottery by buying twice as many tickets but you

still don't win. Most of us won't win a big lottery no matter how may

tickets we buy and we won't have these problems, unless we are old

and/or in a hospital and taking antibiotics. Even so, good hygiene can't

hurt.

One of the biggest areas of concern has been the risk of osteoporosis

and bone fractures. There were enough studies that seemed to show some

association (note that word) between PPI use and osteoporosis and

fractures that the FDA issued a statement to inform doctors about the

possible link. Even with the statement the FDA indicated that the

studies had problems including contradictory findings. Also, the studies

point to association not causation. It could be that people who are

going to have these bone problems even without PPIs have reason to get

on PPIs and that the PPIs didn't in anyway cause the bone problems. Only

better studies will tell.

PPIs can increase the number of stomach polyps but the polyps don't seem

to be a problem or lead to cancer.

Here is a review of the evidence:

Safety of the long-term use of proton pump inhibitors

World J Gastroenterol. 2010 May 21

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874135

" ...in summary, the PPIs are a safe class of medications to use

long-term in persons in whom there is a clear need for the maintenance

of extensive acid inhibition. "

Also an abstract:

Long-term acid inhibition: benefits and harms.

Dig Dis. 2011

http://www.ncbi.nlm.nih.gov/pubmed/22095013

" At the moment we cannot conclude that long-term PPI use causes anemia,

osteoporosis and bone fractures, increases the risk for pulmonary or

enteric infections, has an effect on GUT mucosa, polyp or tumor

formation, or that PPI use increases the risk of cardiovascular events

in patients on PPIs and clopidogrel. "

notan