1 am rambling: nightime reflux/Carafate

[ouroborous 519]

So I've been having a problem with night time acid reflux lately. This is annoying because I didn't have this issue before, but it's now 1 am and I just woke up with a nasty apnea/reflux attack. My throat was sore and swollen plus I had all of the symptoms of an apnea attack (fast pulse, shaky, chilled, etc.) Those are fading, but now I have to figure out what to do about this.

My doc has prescribed sucralate (generic Carafate), 600 mg to be used "as needed" with acid. From what I understand, this drug works a little differently than PPI's -- it's a cytoprotective and helps the tissue of the throat and stomach avoid damage from GERD. The only problem I have is that these 600 mg pills are HUGE -- even cutting one in half would still produce something that violates the "no bigger than a pencil eraser" rule I have. So I've been crushing them; the problem there is that they turn into CEMENT once you crush them and put them into your mouth. Anyone got a solution to the huge pill/cement paste issue?

Also, does the "1 hour before meals" rule with Carafate apply to fluids, too? After having a pill, I really really want a drink of Water, but I don't know if I'm just washing the drug out of my system!

Finally, I wonder if sleeping on my wedge pillow will be a better solution for this night time reflux. I'm hoping it doesn't last and is more of a healing/losing weight thing; the pillow is uncomfortable but I'm willing to put up with it for a while if it helps.

[pnw218 14]

Huge is relative : ) I was taking all of my pills regularly by day 3 post op.

I was going to suggest elevating the top half of your body when sleeping. I only had a couple of instances of heartburn when at the end of a pregnancy and actually slept in the recliner.

Are you eating too close to bed time? If you need something, maybe try just a small glass of milk?? Unless that upsets your stomach as well.

[ouroborous 519]

I tried the wedge pillow, but it's really uncomfortable. I am not sure why, but the wedge really makes my back and neck sore.

After I choked down the Carafate (trust me, they're huge, almost an inch long, and fairly thick) I was finally able to sleep about an hour or hour and a half later. I'm going to talk to my doc about working to control my acid. I had a BM this morning that was mostly liquid and VERY acidic (I could feel it, trust me...) So obviously, my acid production is through the roof.

Does this level off and improve with time? One of the things I was hoping for from weight loss and WLS was better sleep; have I simply traded one heartbreak (obesity) for another (lifelong constant reflux and heartburn and waking up choking on acid)?

[wannalise 15]

Don't get too discouraged. Keep working closely with your doctor and you will find some comfort. I had to start taking my ppi both am and pm and it has helped very much. Good luck!

[Tiffykins 673]

Carafate sucks whole or crushed, I hate those pills. I'm sorry that your acid is on overdrive, and I hope you get some relief soon.

Can you have yogurt yet? Maybe the good bacteria in yogurt would help get things under control. I haven't ever dealt with acid since being sleeved. I had a couple of weird episodes early out that gave me this twinge after eating. Once I went on Prilosec once daily, it resolved. I have had a couple episodes of "breakthrough heartburn". I chomped down on a Pepcid complete and it was resolved. It happened because I chowed down on a bunch of jalepenos and this chipolte ranch dressing.

Can you crush up the Carafate and mix it in some sf pudding? I can't remember the dosing instructions such as if it should be before/after a meal, or without food. But, maybe you could mix it in a tablespoon of sf pudding, or yogurt to choke it down.

[ouroborous 519]

Are you eating too close to bed time? If you need something, maybe try just a small glass of milk?? Unless that upsets your stomach as well.

Oh, I forgot about this: yeah, I sometimes eat too late. I'm going to be trying to really rein that in (for a number of reasons, one of which is that it can torpedo my weight loss).

[ouroborous 519]

Carafate sucks whole or crushed, I hate those pills. I'm sorry that your acid is on overdrive, and I hope you get some relief soon.

Can you have yogurt yet? Maybe the good bacteria in yogurt would help get things under control. I haven't ever dealt with acid since being sleeved. I had a couple of weird episodes early out that gave me this twinge after eating. Once I went on Prilosec once daily, it resolved. I have had a couple episodes of "breakthrough heartburn". I chomped down on a Pepcid complete and it was resolved. It happened because I chowed down on a bunch of jalepenos and this chipolte ranch dressing.

Can you crush up the Carafate and mix it in some sf pudding? I can't remember the dosing instructions such as if it should be before/after a meal, or without food. But, maybe you could mix it in a tablespoon of sf pudding, or yogurt to choke it down.

Yeah I've been eating yogurt -- I don't think it's helping much.

I've been taking Omeprazole daily... I don't remember which PPI that's generic for, but I'm pretty sure it's a PPI. I've been taking 40 mg, but the doc hasn't been really clear on what dosage I SHOULD be taking. Since I still can't swallow the generic (time release) pills, I've been taking capsules opened up with some Water, in the morning.

I can choke down the Carafate (it's actually sucralate -- generic Carafate), even though it's sort of gross and annoying. The more annoying part is that the timing is so picky. You have to take it an hour or more before a meal, or 3 hours after. You can't take it within 3 hours of omeprazole. Juggling all of the pills I'm taking just to keep my acid reflux under control is a real bummer, but otherwise I wake up choking on acid, and every single meal produces reflux.

I REALLY hope this isn't a "forever" thing, or I'm going to be VERY bummed out.

[wannalise 15]

Its priolsec. And I hope this is not a forever thing too. Acid reflux is awful, but it beats diabetes, heart disease, and cancer. Good luck friend!

[deletedsally 8]

If it's any encouragement, my surgeon said that for the first 3 months after this surgery, almost everyone has reflux. He seemed to think that it tends to be less of a problem as you get further out. Also, GERD is almost always worse when people are overweight. My guess would be that as you continue to lose and your body continues to heal, that this will be less and less of a problem.

[lmmore 0]

You mentioned you are taking a generic. Try asking the pharmacist if there is another brand that has a smaller pill. I have done this before. Your insurance should pay if, as in this case, you cannot medically take the pill you are prescribed. It's worth a try. And don't bother asking the doctor, they dont' usually know. My doctor is the one that recommended me going to the pharmacist to begin with.

[deletedsally 8]

Carafate also comes in an liquid.< /p>

[Tiffykins 673]

Yeah I've been eating yogurt -- I don't think it's helping much.

I've been taking Omeprazole daily... I don't remember which PPI that's generic for, but I'm pretty sure it's a PPI. I've been taking 40 mg, but the doc hasn't been really clear on what dosage I SHOULD be taking. Since I still can't swallow the generic (time release) pills, I've been taking capsules opened up with some Water, in the morning.

I can choke down the Carafate (it's actually sucralate -- generic Carafate), even though it's sort of gross and annoying. The more annoying part is that the timing is so picky. You have to take it an hour or more before a meal, or 3 hours after. You can't take it within 3 hours of omeprazole. Juggling all of the pills I'm taking just to keep my acid reflux under control is a real bummer, but otherwise I wake up choking on acid, and every single meal produces reflux.

I REALLY hope this isn't a "forever" thing, or I'm going to be VERY bummed out.

Inside the little capsules of the generic Prilosec (omeprazole), those little balls are not supposed to be crushed or chewed per my pharmacist. He said that it decreases the efficacy of the drug. They can be opened, and swallowed but not crushed or chewed. I just mentioned that because I wanted to crush mine up before I attempted the entire swallowing thing. My little RX insert advises to take the meds then wait a minimum of 30 minutes before consuming any food or to take it 3 hours after eating. I just pulled out my RX insert (I save all of them in a specific med drawer in my kitchen), and it also states that it can take 7-14 days for the omeprazole to give relief. I wait a solid hour before eating after taking my Omeprazole 20mg once daily. I take it first thing in the morning, and then eat my first meal an hour later. They do make a carafate suspension that may be more tolerable and have better effect due to it being in liquid form.

I plan on weaning off slowly as I've been on it for about 10 months. But, I'm going to go to one pill every other day, then one every 2 days and so on. I plan on having an H2 blocker like Zantac or Pepcid on hand to control any breakthrough reflux. I didn't have reflux before surgery, and I'm not willing to have it post-op.

I'm not sure if you've read about that med called Zegerid. It's Prilosec and sodium bicarbonate combined to help with reflux. Of course, there are issues with all of the PPIs, but if you aren't getting relief now, maybe your doc can switch things up.

[ouroborous 519]

Thanks for all the good ideas and well wishes, folks.

Hopefully some combination of the omeprazole, carafate, and changing my eating habits (along with losing more weight) will make this more manageable. Right now it's a pain (literally!).

[ouroborous 519]

Wow, I am really just not feeling well. This is getting scary. I'm having serious buyer's remorse about my sleeve right now... The first week of recovery was so EASY, and then BAM-- massive, constant acid reflux.

At least I was able to choke down a Carafate. That should at least help protect my stomach and throat from the acid.

It feels like my stomach just isn't emptying; I feel like I constantly want to burp, and yet every time I burp I bring up acid. The acid makes me cough and "ahem" a lot, and it makes me feel like my throat is swelling up and that's scary (I breathe with that pipe, you know).

I went for a walk and that helped a tiny bit, but when I'm at work I just can't go for a 15 minute walk every hour.

I just don't know what to do.

Oy.

[deletedsally 8]

I'm sorry you are having a rougn time. I hope your doctor will be able to figure out what's causing the problem and get you some relief--soon! Has there been any change in your diet, medication, supplements, or type of Protein Powder that could account for the difference in the way you feel?