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Medical Forum / General / General / October 2007

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Acetaminophen for esophagitis?

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bobs - 15 Oct 2007 08:22 GMT
Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
NSAIDs).

In addition to proton pump inhibitors, can Acetaminophen be beneficial
for accelerating the recovery or would that be worse?
Acetaminophen has a significant anti-inflamatory effect on me, about
half of aspirin, without gastric side effects (but I don't know for the
esophagus).

TIA
trigonometry1972@gmail.com - 15 Oct 2007 19:32 GMT
> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
> NSAIDs).
[quoted text clipped - 6 lines]
>
> TIA

In my opinion this is a bad idea. Reflex/GERD is a chronic
condition and long term use of acetaminophen isn't good
for kidney function. And PPI meds aren't that good for
kidney health. PPI meds have caused kidney damage in
SOME patients.

I'll suggest you start to sleep on a highly inclined
bed. This will take some determination and
innovation on your part. The commonly suggest
amount of incline for bed is only 6 to 8 inches
at the head of the bed and this is far too little
for optimal relief in the context of nocturnal
reflux. And if you reflux, you reflux at night
when laying in bed as well. Nocturnal reflux
stays in the esophagus longer than daytime
reflux and hence causes the bulk of the damage
to the esophagus. You may not feel it
because you are asleep but it happens.
I use 18 inches (yes 18 inches) of incline on a bed platform
with a 8 inch foam pad. Innerspring mattresses
don't take kindly to being tilted and will
cause back pain. My bed platform tilts
the whole bed surface in one plane unlike
a hospital bed. This means I can sleep on
my side or my belly which is impossible on
a hospital bed. To prevent me and my bedding
and "mattress" from sliding off of the platform
put a foot board on the bed platform.
This works for me and I've spit up bright red
blood from reflux damage in years past.

Also discuss the use of digestive supplements
with an alternative medicine provider once
you have got the esophagitis healed up.

Another thing to consider is an operation
called a Nissen fundoplication. Try the heartburn
forum and get some comments there. Just
be careful as some fundos fail and it depends
on the surgeon being up to date on the best method.

I am not a big fan of PPI meds when taken over
the long term. But for controlling esophagitis
they are clearly useful. PPI meds can have
a range of adverse effects such as endocrine
disruption, bone weakening, pneumonia, abdominal
tenderness, kidney failure, confusion, impaired balance,
etc, IMO.

An MD will down play the risks of the meds
and sneer at the ideas from alternative medicine.
And be aware many have additional disease processes
in the GI tract such that what I suggest might
not work or have risks. I am not a Doc and this is only my opinion
and what I do for myself and no one else.
So talk to your Doc before you take your next breath.

"Dwight"

3 year and 3 months in remission from reflux/GERD due to sleeping on
a highly inclined bed to prevent night time reflux and due using a
digestive
supplement to INCREASE stomach acidity to prevent
daytime dyspepsia. My fundo failed over the course of
several years. I had my fundo over 10 years ago.
bobs - 16 Oct 2007 12:37 GMT
>> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
>> NSAIDs).
>
> In my opinion this is a bad idea. Reflex/GERD is a chronic
> condition and long term use of acetaminophen isn't good
> for kidney function.

Thanks but as I wrote my condition isn't chronic and isn't from reflux.

I just want to heal as fast as possible because I develop tolerance to
PPI after 5 days.
Peter - 17 Oct 2007 01:18 GMT
> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
> NSAIDs).
[quoted text clipped - 6 lines]
>
> TIA

Bobs...Acetaminophen (which works via the brain) is not an anti-inflammatory
(or has very little such properties - if any),  whereas NSAIDS are indeed
anti-inflammatories, since they work by blocking prostaglandins, and thus
screw up the stomach's mucosa, which relies on certain prostaglandins to
remain in a healthy condition.

How do you know acetaminophen has half the anti-inflammatory effect on you
(do you have some kind of magic detector for this) or do you mean that you
think it relieves your pain (for whatever you are taking it for) about half
as much as does aspirin.  The NSAIDS are classically used to treat
inflammatory conditions like arthritis.  May I ask what you were taking them
for, and how do you know you have esophagitis or gastritis (ie have you been
scoped by a gastro).

Pete
bobs - 17 Oct 2007 13:06 GMT
>> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
>> NSAIDs).
[quoted text clipped - 3 lines]
> think it relieves your pain (for whatever you are taking it for) about half
> as much as does aspirin.  

I have had some inflamations. E.g. I have some prostatitis and sometimes
I used acetaminophen and it relieved such inflamation half of aspirin.

Probably the amount of anti-inflamatory power of acetaminophen depends
on the person, but it's not zero. For me it's significant.

> The NSAIDS are classically used to treat
> inflammatory conditions like arthritis.  May I ask what you were taking them
> for,

A bad cold. I used aspirin + ketoprofen, a bad mistake. Next time, I
won't mix these!

> and how do you know you have esophagitis or gastritis (ie have you been
> scoped by a gastro).

I had gastritis which went away with 2 days PPI, and I have symptoms of
esophagitis which is relieved by PPI.
TheGuffster - 17 Oct 2007 13:33 GMT
> >> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
> >> NSAIDs).
[quoted text clipped - 22 lines]
> I had gastritis which went away with 2 days PPI, and I have symptoms of
> esophagitis which is relieved by PPI.

Raise the head of your bed to at least 15 degrees when you lay down or
sleep, that will prevent any acid reflux. The acetaminophen shouldn't
make the condition any worse(though it isn't generally an anti
inflammatory, you could just be having an idiosyncratic response), if
it helps you then use it, just don't take any more than the
recommended dosage. If you want to take an NSAID instead look for the
enteric coated nsaids.

These are basic things your doctor or nurse should have told you, have
you seen a doctor?
bobs - 19 Oct 2007 17:16 GMT
> Raise the head of your bed to at least 15 degrees when you lay down or
> sleep, that will prevent any acid reflux.

Great man you saved my life!
That inclined bed is wonderful. But I didn't raise it 15 degrees, just
4cm, it was enough for the acid to move towards the bottom of the stomach.

And I had some strange problems at 15 degrees: I woke up with almost
another gastritis or maybe it was a duodenitis, I don't know... seemed
like either the acid stopped in a location which was partly eroded
already, or the stomach was going on producing acid on such extreme
inclination.

4cm inclination at night is already excellent, my symptoms are way
relieved in this position.

> These are basic things your doctor or nurse should have told you, have
> you seen a doctor?

Yes and he didn't tell me this. Is the trick very famous?
TheGuffster - 19 Oct 2007 18:14 GMT
> > Raise the head of your bed to at least 15 degrees when you lay down or
> > sleep, that will prevent any acid reflux.
[quoted text clipped - 16 lines]
>
> Yes and he didn't tell me this. Is the trick very famous?

Yes, it's the very first thing you are supposed to tell someone to do.
Raise the head of the bed.
Peter - 17 Oct 2007 19:17 GMT
>>> Hi all, I have an esophagitis from NSAIDs (or from a gastritis from
>>> NSAIDs).
[quoted text clipped - 22 lines]
> I had gastritis which went away with 2 days PPI, and I have symptoms
> of esophagitis which is relieved by PPI.

Bobs...you didn't answer my question.  How do you know you have gastritis or
esophagitis without being scoped.
bobs - 19 Oct 2007 16:47 GMT
>>> and how do you know you have esophagitis or gastritis (ie have you
>>> been scoped by a gastro).
[quoted text clipped - 4 lines]
> Bobs...you didn't answer my question.  How do you know you have gastritis or
> esophagitis without being scoped.

What I wrote above, then the opinion of a MD (a Cardiologist currently
working as GP), and the fact that all begun with NSAIDs. It's more than
enough IMHO.
Peter - 19 Oct 2007 19:54 GMT
>>>> and how do you know you have esophagitis or gastritis (ie have you
>>>> been scoped by a gastro).
[quoted text clipped - 8 lines]
> working as GP), and the fact that all begun with NSAIDs. It's more
> than enough IMHO.

Naw...its just a guess without an EGD.  They are assuming you had some mild
gastritis or esophagitis but it can't be confirmed without an EGD.  They are
basing it on your symptoms, and if it got better after a couple of days on
PPI's then its not a big deal unless it keeps coming back after you go off
the PPI's.  Then you may want to be scoped.

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