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Medical Forum / Diseases and Disorders / Sinusitis / December 2006At the risk of retreading old ground....GERD
Interested in this...in the last few weeks my breathing (in my chest) has deteriorated a lot...this was also the first symptom I noticed in the days prior to my sinuses becoming a problem, ie when I was totally healthy... Probably circumstantial evidence and I know it's easy to pick out factors which suggest one thing or another, but I know the first day I noticed these breathing problems in a big way I just drank a huge milkshake...innocently. In the past few months I wondered was I allergic or reacting to the dairy, but now that I've had those breathing symptoms again (as opposed to just fatigue/pain/inflammation in nose) and had a chance to analyse them...I'm wondering is it a sort of heartburn making breathing difficult? I know if I drink alcohol, even in the months where my breathing hadn't been so bad, the next day I would find my stomach all clenched and churning....and I'd be constipated. I mean the more I think about this the more likely it seems that GERD (exacerbated by my pnd being much worse in this cold weather) is doing this to me, on Saturday evening I ate dinner later than usual cos of work and sure enough, by midnight stomach was churning, like an anxiety attack but I have no reason to be anxious and never had anxiety problems before becoming sick 18 months ago. Also my ENT tried a course of doxycycline which I began about 3-4 weeks ago, taking that almost exactly coincided with my breathing and general health deteriorating...is it possible an antibiotic like this worsens GERD? I am starting to think while I kept wondering about allergies and problems in my bedroom (cos my breathing is worst of all when in bed), the actual problem is caused by lying down...and the clear allergy tests are correct Am I overegging the case here? It just suddenly seems so plausible and a good reason why everyone has been barking up the wrong tree with allergies etc...I'm even wondering if since I never noticed major sinus problems until 2-3 weeks after this initial breathing problem (and the milkshake!) that GERD has caused the whole thing....tho that would be a little too perfect... I've read in the archive that GERD means a problem with the oesaphagas, is this always the case? Is it worth giving some antacids a try, eg Pepcid (I'm in Ireland, not sure if some of the drugs mentioned in the archive are on sale here) Also what success with elevating the bed a little? Dietary changes are obvious I guess, no eating at night, already have very little chocolate and alcohol, occasionally fatty foods tho mostly I eat meat/vegetables/potato....I think first things first I want to finish this doxycycline which has done nothing and may have just made me feel worse.... > Also my ENT tried a course of doxycycline which I began about 3-4 weeks > ago, taking that almost exactly coincided with my breathing and general > health deteriorating...is it possible an antibiotic like this worsens > GERD? YES!! In fact, it commonly causes esophagitis. Most doctors fail to emphasize that you must take it with non dairy food (calcium inhibits absorption) and not lie down or recline for at least 60-90 minutes afterward. Susan that makes total sense...on saturday i had dinner about 10...then took the doxycycline cos i figure these things are better on a full stomach (possibly idiotic on my part or a belief with no founding) i went to bed about midnight and stomach was going crazy....l had to get up and take a xanax to get to sleep....which I don't do often...I was prescribed them for anxiety but never have really felt anxiety was something I suffer from. tho to be fair the doc sort of gave them as a try it and see type thing...and they have helped a little when i can't sleep > x-no-archive: yes > [quoted text clipped - 9 lines] > > Susan I have Gerds also. The nights are the worst when I get an attack. Mine starts with a cough when I lay down at night. I take Prilosec for a few days (3), until this clears up. I take it as needed. My head is elevated at night, low acid diet. I do not lay down for 2 hours after dinner. Recently I have been walking slowly around the house for 10 minutes and this helps me a lot. We eat early but it is dark now around 5 pm. shirleyann On 12/11/06 8:10 AM, in article 1165853452.715307.322720@n67g2000cwd.googlegroups.com, "mr_lamouche" <RonanFitzgerald@gmail.com> wrote: > that makes total sense...on saturday i had dinner about 10...then took > the doxycycline cos i figure these things are better on a full stomach [quoted text clipped - 18 lines] >> >> Susan Eating at 10 and then going right to bed encourages acid reflux, esp if you take chocolate and mint. On 12/11/06 6:26 AM, in article 4u585aF16ch3dU1@mid.individual.net, "Susan" <nevermind@nomail.com> wrote: > x-no-archive: yes > [quoted text clipped - 9 lines] > > Susan Interesting comments. I did an original study on Doxycycline. With 64 patients I couldn't find a single side effect esp nausea or burning. I know of none of these suggestions. > Interesting comments. I did an original study on Doxycycline. With 64 > patients I couldn't find a single side effect esp nausea or burning. I know > of none of these suggestions. Interesting observations. In over a decade using doxy and Doryx, and in contact with many of those also taking doxycycline, I've rarely encountered one who didn't have such symptoms. I certainly did, so did my MIL. I wonder why your results ran so counter to all the anecdotes and drug study information I've encountered, along with my own experience? I also experienced pseudotumor cerebri, a not terribly uncommon doxycycline side effect. Extreme photosensitivity is also quite common with doxy. I've had it, my child has, and many others I know of have experienced it. Susan Doxy induced esophagitis: http://www.mypacs.net/cases/DOXYCYCLINE-INDUCED-ESOPHAGITIS-173438.html http://www.blackwell-synergy.com/doi/abs/10.1111/j.1442-2050.2004.00384.x http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 5701316&dopt=Abstract Went to a new ENT who is also a chest physician today....he was far more up to date on sinuses than my previous ENT and suggested GERD before I did...he's prescribed an antacid of some kind for a month and suggested I try going off wheat or something too, tho I have no allergies he said he feels something could be triggering both the sinus problems and the reflux..food sensitivity he suggested... He also had heard of the Hydropulse which for a Dr in Ireland is rare...most importantly of all tho it's the first specialist I've seen who gave me as much time as possible to discuss the illness, and seems genuinely determined to keep trying things until I feel better... Feeling so much more optimistic after today...makes me wonder why I paid 2000 for an op to a guy who'd barely give you 10 minutes in an appointment > x-no-archive: yes > [quoted text clipped - 5 lines] > > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 5701316&dopt=Abstract > Went to a new ENT who is also a chest physician today....he was far > more up to date on sinuses than my previous ENT and suggested GERD > before I did...he's prescribed an antacid of some kind for a month and > suggested I try going off wheat or something too, tho I have no > allergies he said he feels something could be triggering both the sinus > problems and the reflux..food sensitivity he suggested... Wow, that almost never happens, that doctor is a KEEPER! It's true, anecdotally, that those who go off of starches (not just wheat) and eat lower carb are often cured of their GERD and IBS overnight, I've heard it so many times. In fact, it's also reported invariably by asthmatics that they hardly ever need to use inhalers for rescue or maintenance on low carb. Because I had adrenal sufficiency last summer (and now have apparent Cushing's syndrome due to use of low dose topical steroids), I've been reading a lot about it. Insulin, which the body secretes extremely high amounts of when you eat high carb, promotes inflammation, in part by inhibiting your adrenal function. Inhibited adrenals mean you have less ability to reduce inflammation naturally. If you get treated with steroids, you're further adrenally suppressed, which ultimately makes the inflammatory condition worse over time, not better. > He also had heard of the Hydropulse which for a Dr in Ireland is > rare...most importantly of all tho it's the first specialist I've seen [quoted text clipped - 4 lines] > paid 2000 for an op to a guy who'd barely give you 10 minutes in an > appointment You found a very curious and interested doctor who's better equipped to help you than anyone here. Susan On 12/13/06 5:03 PM, in article 1166058185.779092.267130@f1g2000cwa.googlegroups.com, "mr_lamouche" <RonanFitzgerald@gmail.com> wrote: > Went to a new ENT who is also a chest physician today....he was far > more up to date on sinuses than my previous ENT and suggested GERD [quoted text clipped - 22 lines] >> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uid >> s=15701316&dopt=Abstract I presume your doctor who put you on GERD medications also explained that you need to follow the GERD routine A. nothing to eat/drink except water after 8 PM B elevate head of bed C no caffeine, pepermint D evening meal should NOT be full, big one. Many failures of GERD therapy are due to not following these and other procedures. The 220 Volt Hydro Pulse Nasal/Sinus Irrigator is available in UK at Just Buy Online Ltd T/a Just Natural Stuff 45d Victoria Road Surbiton, Surrey UK KT6 4JL http://www.justnaturalstuff.co.uk/ Just to clarify: the new physician is a pulmonologist (chest physician) and an ENT (surgeon)? It sounds like he listened, is willing to treat you medically and it's great you found him. Regarding doxycycline: I've seen tetracycline--which has to be taken on an empty stomach, cause severe erosive esophagitis--patients take it with a sip of water, it gets stuck in the esophagus and causes severe irritation. Doxycyline, because you take it with food, is less likely to cause esophagitis, but it's possible. I once took it on an empty stomach, and the nausea was horrible. My daughter took it without enough food and vomited for two hours. It was impressive. So, it could definitely lead to exacerbations of GERD. I've been to few lectures on GERD lately, and the elevating the head of the bed wasn't felt to be that helpful. Weight loss, even a small amount, was very helpful in decreasing the pressure on the stomach to reflux up into the esophagus. My daughter's ENT advised her to adopt a low inflammation diet a year ago: low trans-fatty acids, lower carbs. Her horse was just diagnosed with incipient Cushing's disease--very common in older horses--and the treatment is a low carb diet, with additions of chromium/magnesium and cinnamon. Omega-3/6 are helpful as well. Granted, horses aren't people, but they do get some similar syndromes. Good luck with the new doctor. Too bad about the expensive consult that preceeded him. Judy > Went to a new ENT who is also a chest physician today....he was far > more up to date on sinuses than my previous ENT and suggested GERD [quoted text clipped - 21 lines] > > > > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 5701316&dopt=Abstract > Just to clarify: the new physician is a pulmonologist (chest physician) > and an ENT (surgeon)? It sounds like he listened, is willing to treat [quoted text clipped - 18 lines] > well. Granted, horses aren't people, but they do get some similar > syndromes. Geez, Judy, the horse and I have more in common than the other people here and I do! :-) I take all of those, and have cut out the pantethine that stimulates adrenals. Susan Susan, The information on cinnamon was really interesting. He's cautiously stayiing on his glucosamine, at a low dose, because he's so arthritic without it. My husband switched from diet soda to iced tea--some roobois with spices. He has metabolic syndrome, and his fastiing blood sugar improved dramatically--probably a combination of anti-oxidants and the cinnamon. For horses, the recommended dose is 1 tsp/250 lb/day. I guestimate him at 1000 lb or a little above when I calculate his doses for chromium and magnesium--which made a huge difference for him very quickly. To get the carbs out of hay, you soak it. Judy > x-no-archive: yes > [quoted text clipped - 28 lines] > > Susan > Susan, > The information on cinnamon was really interesting. He's cautiously > stayiing on his glucosamine, at a low dose, because he's so arthritic > without it. You mean the horse? I've seen studies and comments about cinnamon lowering bg and improving insulin sensitivity, but no luck with any real life DMs I know. How about MSM for the arthritis, too? OTOH, silymarin (milk thistle) and alpha lipoic acid work brilliantly for this. Right now, alpha lipoic is reducing the facial redness and swelling I'm experiencing from Cushing's syndrome. Silymarin is lowering my bg, which cortisol has been pushing higeer, even with extreme low carb. > My husband switched from diet soda to iced tea--some roobois with > spices. He has metabolic syndrome, and his fastiing blood sugar > improved dramatically--probably a combination of anti-oxidants and the > cinnamon. Judy, have you seen the research about fbg missing the diagnosis of MOST older diabetics? Or that many DM complications occur during what's classified as IGT? My endo says I've likely been DM for 10-15 years, yet my fbg has never been above 109. The Rancho Bernardo study found that post prandial numbers dx'ed many more diabetics. In fact, 70% of women were missed by the FBG. If it had been a 1 hour instead of two hour PP, it would've likely been 100% missed by fbg compared to PP. Whether you're just IR or actually DM, the intervention is the same; cut the starch, replace with veggies and healthy oils/fats and lift weights, walk within 45 minutes of eating whenever possible. This can't be emphasized enough; on occasions when my bg went over 200, I lowered it 100 points in 15 minutes walking on the treadmill. Some very good research posted on this web site: www.phlaunt.com/diabetes. > For horses, the recommended dose is 1 tsp/250 lb/day. I guestimate > him at 1000 lb or a little above when I calculate his doses for > chromium and magnesium--which made a huge difference for him very > quickly. To get the carbs out of hay, you soak it. Yeah, I've had to hose it down where I volunteered for horses with coughs, too. In the wild, horses would be eating grasses with higher water content, less caloric and carby. Susan Susan, I just went to a lecture on diabetes that directly addressed the fact that we focus on fasting sugars and completely miss the post prandial spikes. Athough the ADA has never approved hemoglobin AIC for diagnosis--because of the lack of standardization--I often get it to try and see what's going on over the long term. Actually, both the horse and my husband are on glucosamine. The milk thistle makes so much sense, especially for fatty liver disease--I've seen it work wonders in patients with hepatitis C who didn't want the interferon therapy (before there was pegalated interferon and ribaviron.) Brown was doing a study on fatty liver, and I called for info: you had to agree to to two liver biopsies--a dangerous procedure (my mother had a severe complication from one) and the only intervention was nutritional counseling. How that got by the IRB board, I don't know. The benefit needs to outweigh the risk. Both of my huband's parents were diabetics, so we've worried about his risk for years. He was diligent about diet/exercise, but slacked off recently. Time to re-evaluate. Judy > x-no-archive: yes > [quoted text clipped - 45 lines] > > Susan > Susan, > I just went to a lecture on diabetes that directly addressed the fact > that we focus on fasting sugars and completely miss the post prandial > spikes. Athough the ADA has never approved hemoglobin AIC for > diagnosis--because of the lack of standardization--I often get it to > try and see what's going on over the long term. It's just an average, weighted to the recent few weeks, but if someone is anemic or has shorter or longer lived rbcs, it's inaccurate. Also, it's not at all appropriate for dx. My MIL has wrongly been reassured that since getting hers from 6 to 5.7 she's "got no problem now." All she eats is toast, and she's lost all her short term memory! Any spike over 140 at any point is doing permanent cellular damage. > Actually, both the horse and my husband are on glucosamine. > The milk thistle makes so much sense, especially for fatty liver [quoted text clipped - 9 lines] > his risk for years. He was diligent about diet/exercise, but slacked > off recently. Time to re-evaluate. Check out the good peer reviewed research on alpha lipoic acid (for liver and DM/IR) too. I test often, and I've found that even a smide, like two grams of wheat spikes my bg out of all proportion, and kicks up neuropathies even if I use Precose to blunt any rise. Starchless is the way for anyone dealing with these issues to go. Does your husband use a meter to see what his metabolism is really doing? I've been able to detect that my first phase insulin response is poor, but my second phase is still robust. By eating low carb, I'm hoping to make my beta cells last. Susan
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