Reflux/Steroids

  I have been on oral steroids and theophyilline of varying doses for 4 years.  I have had a reflux problem for sometime now, and my specialist gave me ranitidine.  It does not seem to do very much at all.  At night in paticular the reflux is bad.  I also have CVID and often have mild diarhoea.  Any suggestions on how to get rid of the reflux and diarhoea??  My GP has been slack at helping with this, more concerned I think about the asthma side.  Any suggestions?
Dear Sally,
Many medications can decrease lower esophageal sphincter (LES) pressure and thus make reflux worse The lower esophageal sphincter is a muscle that separates the esophagus (foodpipe) from the stomach . It functions as a barrier to prevent acid produced in the stomach from flowing back into the esophagus. Acid in the esophagus can cause the symptoms of gastroesophageal reflux and the inflammation associated with esophagitis. Theophylline preparations can decrease lower esophageal sphincter pressure and make reflux symptoms.Oral steroids have not been shown to have an effect on the lower esophageal sphincter. Although ranitidine is a good medication there are others (some stronger than ranitidine) which might help you obtain some relief. Dietary and lifestyle modifications are also important. Ask your doctor for anti-reflux measures  It seems to me that your  physician is currently trying to focus on treating  the asthma. When treating chronic illnesses there is often a delicate balance between treating the condition and causing intolerable side effects from medications. The best thing to do is keep the communication lines open between you and your physician so that you can be treated with the least amount of side effects.
In terms of the combined variable immunodeficiency (CVID) and the diarrhea, sometimes this immune disorder can affect the intestinal tract causing poor absorption of nutrients and diarrhea. It

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