Help me make this suck less, part II
April 17, 2012 3:28 PM   Subscribe

Just diagnosed with GERD, possible ulcer following 5 weeks of high-dose antibiotics for sinus issues. Seeking recs for anything that might help my beleaguered digestive system, information on getting tested for H. pylori. Gross details and looong narrative await within.

I had three weeks of Augmentin back in March, then sinus surgery, followed by another week of Augmentin. The day of my last Augmentin tablet, I got a 9-hour sinus bleed that lead me to the ER, sinus packing and another week of Augmentin, plus several days on antiemetic medication to help me handle having all the blood that I swallowed during the sinus bleed.

I had my first experience with severe heartburn before the surgery, during my the first round of antibiotics. I gobbled Tums, had some peppermint tea, soldiered through it and was better the next day.

Then the weekend before last, I got an even worse case of heartburn seemingly out of the blue. Tums didn't do much this time, and I didn't get better so off to the worksite clinic I went. They told me I have reflux and ordered OTC Prilosec. Took it for several days, no luck.

At my doctor's office yesterday, the nurse practioner gave me some Nexium tablets and told me about dietary restrictions, most of which I'd already found on AskMeFi and was following. Unfortunately, I got an anxiety attack, some hives and was grinding my teeth without realizing it while on the Nexium, so we're back to the Prilosec as of today.

I've been communicating with my doctor through e-mail and she ordered me to increase the Prilosec to two tabs/day and to add in regular Tums and Maalox for the next few days. I asked about getting tested for H. pylori, but she said that I have to fail three months therapy with the antacid/Prilosec combo to have the testing done. This makes very little sense to me. I've had "ulcers" in the past - no testing done, treatment with antacids, and always have had the problem return. I've asked for a GI referral but haven't gotten that, either.

Today I woke up, sat up in bed and had acid stuff come all the way up my throat, and have a killer sinus headache that I think might be connected. The reflux happens even when I'm sitting completely upright or standing up, which I didn't think was supposed to happen. I've lost nine pounds in the past two weeks, all of it unintentional. Are there magic words that I'm not using to get extra help from my doctor?

The whole sudden GERD after antibiotics thing seems like it might be a clue, too. However, my googling hasn't revealed anyone else who's had this happen. Am I alone in this?

I'm eating yogurt daily and am interested in adding probiotic suppliments. I've read in other questions about dietary enzymes suppliments but am not sure what to look for. Any advice will be sincerely appreciated.

As of now, I'm on the stomach medication merry-go-round, am following the dietary restrictions and am adding in the Maalox and Tums at regular intervals. Tonight I'm propping the head of the bed up rather than trying the wedge again, since I slipped down the wedge last night. I'm considering dropping my nightly pre-bedtime bath in favor of a shower as showers are more vertical, but I'll still have to bend to shave my legs, and every time I do bend, acid comes up my throat. I'm also considering dropping my ab workout for the time being, which makes me feel kind of sad since those exercises have been helping me out in other ways.

I'm under some stress that I can't do much about - business trip starts tomorrow, series of presentations to be done next week - which can't be helping. Working 11-hour days isn't doing me any favors, either, but again there's not a lot I can do about it right now. I can't even have a nice beer to take the edge off. Actually I could, but it probably wouldn't be worth it.

What might I be missing? Anything else that might help?
posted by terrierhead to Health & Fitness (10 answers total) 1 user marked this as a favorite
I had some GERD a few years ago (turned out to be caused by some other meds I was taking), and I remember my doc doing the h. pylori test without much hesitation. Also he ordered an ultrasound of my gall bladder (I think?).

You said you were seeing a doctor, but have you gone to see an internist or gastroenterologist, or just your GP? Your situation sounds severe, I would go see a specialist pronto.
posted by radioamy at 3:44 PM on April 17, 2012

Maalox and Tums make my reflex worse fwiw. I find eating well cooked meat the most helpful thing: crockpot or stir fry, pulled pork or meaty soups that kind of thing. Plus yogurt, bland white bread etc. No cold beverages & no veggies for a few days either.
posted by fshgrl at 4:05 PM on April 17, 2012

For future reference, peppermint is contraindicated for reflux as it can relax the sphincter between the stomach and the esophagus, making reflux worse.
posted by SweetTeaAndABiscuit at 4:12 PM on April 17, 2012 [3 favorites]

Antibiotics mess with your GI system in multiple ways. One way is through the killing of various bacteria. Recovery is not simple. You mention probiotics, but to put the whole issue in perspective, it is helpful to understand the difference between prObiotics and prEbiotics. For healthy gut flora, you need both. Remember to introduce any dietary changes, such as addition of pr(o)(e)biotics, very gradually - suddenly consuming large amounts of either is not good.
posted by VikingSword at 4:19 PM on April 17, 2012 [2 favorites]

Nexium is almost identical to Prilosec and functions in exactly the same way with exactly the same efficacy, so don't worry about that door closing. It is no accident that it came out just around the time that Prilosec was going off patent.
posted by Coventry at 4:28 PM on April 17, 2012

1. Enzymes: Enzymedica. Great brand of enzymes! I take Digest Gold but it's very strong, start with something weaker then work your way up if needed. My reflux used to be daily and excruciating, now it's very rare and pretty mild.

2. Probiotics: BioKult is excellent and so are Jarrow brand. yes, they are more expensive then what you find at any supermarket, but you get what you pay for. I heard that the more variety of cultures, the better. However, the most important part is to be consistent.

Homemade Kefir! The cultures in commercial brands of yogurt can sometimes be dead by the time they reach the consumer. Plus yogurt only has one or two cultures, and same goes for commercial kefir. Homemade Kefir can have 30-35 different kinds of cultures. Go to Cultures for Health (or buy their brand from amazon) and buy kefir grains (NOT starter powder! you want the grains which aren't actually grains). Follow the instructions and voila: excellent probiotic awesomeness. And kefir is a lot easier to make than yogurt. And can be done while on trips.

I buy all of these online (amazon, iherb, vitacost, etc). Tends to be cheaper and I have no time to look for them in stores.

Eating some pineapple or papaya every time you eat meat tends to help with the digestion, too.

About the sinus pain:
Ask to get checked for gluten sensitivity. (I never thought my sinus issues were gluten related, oh man was I wrong!) Then go on a rotation diet and keep a food journal. Meaning write down everything you eat/drink and how you feel, even psychological symptoms, keep rotating the foods until you figure out what aggravates it, what doesn't. It's cumbersome but worth it. Mind you, some foods take a few hours for the reaction to kick in.

Get yourself to a GI!

It could definitely be H pylori or Candida.

Nexium/prilosec may be great for some people, but it won't address the cause of the issue, hence why so many people stay on it for years instead of the 2 weeks' use that is FDA approved. And don't be discouraged if the doctors just attribute it to stress. Stress doesn't help, but it's unlikely to be the sole cause of it.

No, you're not alone. Anti-biotics -> reflux. I've spent a lot of time online looking for answers, there are plenty of us out there for sure.
Got any questions, feel free to memail me.
posted by Neekee at 5:05 PM on April 17, 2012

The effects of Maalox, Tums AND stomach meds can cancel the effects of each other out in your system. Plus, all that shit actually hurts your stomach.

Just take the stomach meds. I found myself in the hospital 3 years ago after an infection and steroids/meds combined to create an insane case of thrush in my throat, which then irritated itself so bad that I was choking on strips of my own esophagus from the reflux.

So, y'know, been there.

I just posted this in another thread this week and you might find it helpful, too.
posted by Unicorn on the cob at 7:01 PM on April 17, 2012

Doesn't hurt to play around with diet. For example, low-carb has been shown to be helpful in some circumstances. Grains set me off, personally.
posted by Earl the Polliwog at 7:04 PM on April 17, 2012

I tested negative for H pylori or anything other than plain-old GERD with more severe symptoms than yours. Constant medication and/or fairly extensive lifestyle modifications seem to be the only treatments that help at all. It's possible that this really is GERD that you're experiencing.

That said, you are receiving inadequate medical care considering your extreme weight loss and discomfort. Do you have access to an urgent care center (not the same as an ER), or is there a way to get in to see a specialist soon? Did you talk to a doctor about your medical issues, or did you discuss them exclusively with a nurse practitioner?
posted by croutonsupafreak at 10:46 PM on April 17, 2012

I second the suggestion it's likely H. pylori or Candida. In either case, low-carb with prebiotics, probiotics (try ThreeLac or FiveLac from Amazon, a simple shot of tasty powder-form active probiotics), and papaya enzyme after every meal or snack would be a really good, simple plan that could be very helpful.

Go slowly when adding the prebiotics and probiotics, as you may experience a miserable flu-type illness as bad bacteria die off if you go quickly. If you do the ThreeLac or FiveLac, start with just one packet a day and work up gradually to five or so until you feel like seeing how you do without them. When I started this, I felt better within just a few days.
posted by notashroom at 7:20 PM on April 18, 2012

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