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Raising the head of the bed for GERD

How effective is raising the head of the bed?  Since I get heartburn even while completely upright, I have hesitated to make a big change in my sleeping arrangements.  A friend told me that when she raised the bed a full 5 - 6 inches, she and her husband both felt like they were sliding off the bed all night!  My GERD has become steadily worse over the past 5 years or so and now I am awaiting tests to decide the need for fundoplication.
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Avatar universal
Dear Glenda,
Raising the head of your bed may help because regurgitated gastric contents must now flow uphill to reach the esophagus.  If, however, you have substantial daytime reflux, then the benefit may not be that great.  Ifd you are reluctant to raise the head of your bed, you could purchase a wedge that would raise only your side .  This item is available in many pharmacies.
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FH
I bought those 6 inch flat topped cones to set the legs on and slept on that twin bed one night. I never could get comfty b/c I felt like I was putting on brakes all night to keep from sliding. I did put our kingsized bed up on bricks, which adds about 3 in. to the head height. I think I notice a little improvement, but I still get reflux at night. I don't think it's acid since I take Aciphex and have done the Zantac, Prevacid and Prilosec route as well. I think it's mucus. I too have reflux sitting up in my recliner chair if I go to sleep. I don't seem to have it when I'm awake. My husband asks me every now and then to please remove the bricks, but so far we still have them. And we do slide some even with only 3 inch rise.
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Avatar universal
Hi:

I use something called a Bedge. It is a comfortable foam pad that you can sleep on that will keep youo in a good position at night. I use to have a terrible time regurgitating food at night, and since I bought this, I don't anymore. This way your partner doesn't have to slide off the bed at night. I actually find it very comfortable too.

Be careful about fundoplications. There are some very serious complications that many people do not realize. I know first hand. I had the surgery and had a terrible outcome, and ended up having 5 operations to repair the damage, and now am left with irreversible damage. BEWARE!!!!!

You can e-mail me at ***@**** if you want more details.

Carol
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Avatar universal
Hi my name is Teresa, i am a 28 yr old female. I have been haveing a problem for quiet sometime with an aggrivation right below my breast bone in the diaghpram area where the esagophus ends..It feels like a terrible hunger pain,or sometimes a tightening or sometimes it changes and feels like a small baloon or bubble is being blown up,It makes me feel like i can't breathe
deeply enough and is agonizeing. it can last for hours even days.. ihave been to my doctor and at first he prescribed tagament thinking it was an ulcer, but that did'nt seem to help so i went back and he then said it might be acid reflux so i took a script of prilosec which didn't seem to do the job really either..any other suggestions as to what it might be...Eating relieves it a little but it still feels like a hunger pain (not a pain like a hurt) More like an aggrivation. Yawning seems to help me catch my breath when i can't breathe properly because of it...Thanks ..
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Avatar universal
Hi my name is Teresa, i am a 28 yr old female. I have been haveing a problem for quiet sometime with an aggrivation right below my breast bone in the diaghpram area where the esagophus ends..It feels like a terrible hunger pain,or sometimes a tightening or sometimes it changes and feels like a small baloon or bubble is being blown up,It makes me feel like i can't breathe
deeply enough and is agonizeing. it can last for hours even days.. ihave been to my doctor and at first he prescribed tagament thinking it was an ulcer, but that did'nt seem to help so i went back and he then said it might be acid reflux so i took a script of prilosec which didn't seem to do the job really either..any other suggestions as to what it might be...Eating relieves it a little but it still feels like a hunger pain (not a pain like a hurt) More like an aggrivation. Yawning seems to help me catch my breath when i can't breathe properly  because of it...if there's anyone out there that sees this and has any comments or possible explainations please email me and let me know thanks....
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Avatar universal
Before having the fundoplication, please talk to your doctor about the surgery & results of surgery.  Lots of times, people end up more miserable after the surgery than before.
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Avatar universal
See the Q: Barrett's Esophagus - Billy Caddell 12/15/1999 in this Forum.

I've tried the raising the head of the bed (blocks, etc.) and then used a 12" latex foam wedge. Raising the headboard does make one slide to the foot of the bed. After five years, my wife and I bought a dual king adjustable bed. We've had them for over a year and I have just about eliminated the REFLUX at night. With the adjustable bed we raise the head about 10-12 inches and the foot about 6-8 inches, this prevents sliding down the bed. For added comfort we purchased talatec latex mattresses (the best on the market). I highly reccommend this combination. However, they are not cheap, about $3,000 for the pair. What is your health worth?

I've had Barrett's Esophagus for several years and MUST sleep with the bed elevated every night or anytime I'm lying down. I now must keep it under control, because it can lead to dysplasia i.e. Cancer of the Esopahgus. REFLUX is something that should not be taken lightly. It leads to Barrett's Esophagus and then according to statistics, 2 out of 10 with Barrett's get cancer.
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Avatar universal
So from your message Bill, I gather that you find this is the best choice for your reflux?  The wedges are ok, I suppose, but I have had trouble with my back since they make you sleep in a kind of folded up position. I am currently sleeping on a 1" board under the matress (from about waist high) and about a 1" folded blanket under the bottom sheet.  Since we have a king bed, my DH is not too disturbed by this.  I figure if we raised the headboard as well, it would give a bit more angle without too much disturbance, but I really haven't seen a big improvement yet.  Yes, if this is to become a lifelong thing, I think the investment is an adjustable bed is definitely in the cards.

Michelle - believe me, I will check out EVERY avenue before choosing surgery, but since I am only 44, I also question the results and side effects of being on strong acid suppressors for the next 40 years.  I also wonder if I can live without the small pleasures of eating things like garlic, fresh fruit or vegetables and even chocolate, not to mention the challenge of getting a complete diet.  We are long lived women in my family!  I feel I have a couple of advantages over some people for the surgery, not the least of which is that a good family friend is a physician who is on the surgical review board for our hospital.  He knows who the best people are to do the job and can help us out that way.  Thanks for your input!
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Avatar universal
Hi Glenda... Thank you for asking this question! I have had reflux for many years, at first only at night, controlled fairly well with Zantac. For the last 3 years I have had it all day and worse at night, medication doesn't work. Right now I'm sleeping propped up on this triangle shaped pillow and during the night I always end up laying flat. I'm considering an adjustable bed, but wondering if it will help when I have reflux all day while completely upright. My reflux gets a lot worse with movement- just walking around! Surgery is not an option for me and I'm concerned about getting Barretts. It's comforting to know I'm not alone, I hope we all find an answer or at least something that will help. Good luck everyone and thanks for your comments.

Hi Bill... It's great to hear the adjustable bed has helped you! If you don't mind me asking- do you have reflux during the day also? If you are on any medications, which do you find most helpful? Thank you!
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Avatar universal
To Bill,
I, too, have Barrett's.  I don't know much about dealing with it"
Please describe  your treatment, and what the outlook is.
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Avatar universal
Have you tried all of the medications including Prilosec and Pantoloc?  Also, why are you not able to have surgery?
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Avatar universal
Does anyone have terrible burning in the throat that they (doctors) cannot find a reason for?  I have had Endoscopy,
laryngoscopy, and barium swallow.  No answers!!  I have been
told that there was some redness around the larynx, but it does
not explain the severity of pain.  I think personally it might be
a weak Lower Esophageal valve allowing acid seepage.  Can anyone
relate??????This is a 24hr problem.
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Avatar universal
John, it sounds a BIT like reflux but you would think it would be inflamed all the way up the esophagus, not just at the larynx.  I suppose one way to test it would be to go on some strong acid suppressors like prilosec.  If the pain went away then, you would have your answer.
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Avatar universal
Hi Glenda,
I have a rather complicated situation. My reflux comes from severe gastroparesis, and I also have chronic intestinal pseudo-obstruction. I have been on TPN (IV food) for years because I can't eat anything, but there's times I can tolerate sips of water. I have a ton of reflux even though I don't eat! My doctor refuses to give me oral meds because they won't be absorbed, any meds I take have to be IV. Unfortunately, the meds available in IV form are very limited. I have 200mg IV Zantac in my bag of TPN which is already beyond the maximum dose, and I've also tried Pepcid and Reglen. I'm going to convince my doctor to give me something, ANYTHING! It has gotten so bad that I'm awakened at night at least 8 times with acid coming up (even if I'm still sleeping upright), I have to take a deep breath to prevent it from coming all the way up. In the morning I still end up with acid in my mouth and a lot of pain in my chest. My voice is even starting to change! During the day I can't walk around without it coming up all day long. I'm pretty miserable and just don't know what to do. If I have an opportunity to try an oral med which do you think would be best? I heard Propulcid is going to be taken off the market soon. :(

I'm told the fundo isn't an option because of my underlying condition, is this true? Will the fundo only help if the LES is malfunctioning, or will it help with reflux from gastroparesis?

Thanks so much for your help! Good luck and God bless you all.

Cassandra
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Avatar universal
How about emailing me at ***@**** and we can talk off the board...
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Avatar universal
Estimada paciente:
te responder
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Avatar universal
I suffered for many years with a gnawing pain after I would eat and when I would lie down I would have an burning sensation in
my upper chest area. MAny nights I would lie awake tasting an
acid like sustance. Sometimes, I would gag and have to throw up.
I tried Pedci AC, which helped a little, but it would get me bound up. I drank Mylanta or Peptp Bismol, but got tired of this all the time. After 6 years of suffering, I went to the Doctor  
and he gave me some prilosec to try. This was like a "miracle"
for me but the symptoms would come back in the early evening.
He suggested a combination of propulsid and prilosec. This was
wonderful. I could eat regularly again without feeling all
that nagging pain.

Now they are going to restrict prescriptions for propulsid.
Does anyone know of an alternative for this drug?
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Avatar universal
Theresa - I take my pantoloc in the evening rather than the morning and that has helped quite a bit.  But if you still need something that works like propulsid (a motility medication), there are other things you can try, such as motilium, which don't have such scary side effects.  But if propulsid is the only thing that works for you, I am sure you will still be able to get it - I hope!
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Avatar universal
Hi there...
Thank you for responding, I'm sorry I couldn't get back to you sooner! I haven't been able to e-mail you because something is wrong with my e-mail program, it will receive incoming mail but won't let me send any. When I push send it acts like it's going to send it but takes forever, then it tells me "connection timed out." That must be computer talk for a brain fart. I'm not too good with computers as far as troubleshooting goes!

If you don't mind, can you respond here in the forum? I would be really interested in any advice you can give me. This problem is pretty frustrating... what I wouldn't give to get a good night sleep! If you'd rather not write here, I'll be trying to fix my computer in the meantime and will e-mail you as soon as I get this figured out. Thanks again!
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Avatar universal
i am on previcid for intestinal metaplasia will this condition be cured or will i have to worry about barretts?
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Avatar universal
Sorry about your email troubles - I have a computer specialist in my house so I don't have to worry about stuff like that (of course, half the time the computer is in pieces on the floor, but I live with that *LOL*)

Your situation sounds very extreme.  I can't imagine you have much of a life!  I am imagining you have been tested every which way - gastroscopy, colonoscopy, etc?  I gather that the gastroparesis is a partial paralysis of the whole gastro system - top to bottom, so to speak?  If that is the case, the way I understand it, the fundoplication would not help in the least unless you also have the loose muscle at the top of your stomach.

I would think that they would have you on more motility drugs, although I see you have tried Reglan.  There is also motilium and propulsid although it does have some problems.  I forget what is in Zantac and Pepcid, but I have had such good results with Pantoloc, I cetainly recommend it, although it costs a small fortune.  But then, your grocery bills are pretty small, eh? (*LOL* If we can't laugh, we really ARE in bad shape!)

In spite of the pantoloc, my acid is getting continually worse so I do also take Gaviscon at night.  I chew the tablets, but you might not be able to do that - the liquid maybe?

Please feel free to post here - I was just thinking it was easier to email - obviously got that one wrong!  I'll check in daily.

Glenda
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Avatar universal
sue
To anyone thinking about having a Nissen Fundoplication, I would reconsider.  I had one in May of '98 and wish that I hadn't.  I only had relief for 2 months before the symptoms started up again. Now if I feel nauseous, I'm not able to vomit. I can eat nothing without having symptoms.  I feel a pressure on my chest after eating.  This is no way to live!!  Sue
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Avatar universal
Hi:

Sue, I agree with the fundoplication. It isn't all it's cracked up to be. I suffer everyday as a result of this horrible operation. If anyone already has gastroparesis, don't even consider having the fundoplication it will make things worse. I know, I am living it. I have a more restricted diet now than I did before the surgery.

Just be careful and do thorough research before opting for this avenue. There could be more and worse problems afterwards.

Carol
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Avatar universal
I don't think fundoplication is a good option for gastroparesis.  From what I am hearing, it is really only good for people with a loose LES (lower esophogeal sphincter).  Right now I am still awaiting the test (gastroscopy and sigmoidoscopy) that will tell me if that is my problem or not.  The only person I know who had fundoplication was really a matter of life and death.  She was very young (under 20, I think) and was not able to keep anything down at all.  She had the old style "open" (non-scope - had to open the whole chest - ouch!) surgery and is sure it saved her life.  Of course, I am not in that difficult a situation and if it is not the right choice for me I will surely be able to live with the lifestyle restrictions that GERD causes.  Certainly people with diabetes and other chronic things survive without eating exactly what they want all the time (not to mention people in 3rd world countries who barely eat at all...)  But I do trust my doctors and I think I mentioned before that we have a personal friend who is a good position to advise us on all the options, including who is best to do the surgery, if that is chosen.

I am so sorry that the surgery did not solve your problems!  I do appreciate the input and I am sure many, many people who come to this board will, too.  The internet is such a good place to hear all sides of a story - one thing I am sure of, no matter how much I trust my doctors, is that they will downplay any problems and stress the positive.  I think that is probably a good thing - I want to feel that they are confident they can help me:-)
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