Any tip/Advice to control acidity during Tx

Dear All

I am week 13/24 of my tx. Not regularly but approximately after 2 weeks without any change in the food or eating habbits, there are 5-7 days in which my acidity increased and i feel heart burn and acidity after eating anything whether with spices or without spices. I have heared that its a normal thing during Tx is it ??? Can anyone advice my any tip by which i can control or reduce this acidity problem ?? Thanx Scrooplz

[can-do-man]

Yes this is fairly common during tx, check with you doctor about giving you either nexium, prevacid, or prilosec. All are safe to take, nexium and prevacid worked best for me. Congrats on being over halfway done. Wishing you the best.

cando

[CoWriter]

Make sure you don't take any antacid medication your doctor prescribes at the same time as the Ribavirin so it won't affect the absorption of the Riba.  

[can-do-man]

From what my hepatologist told me was that nexium and prevacid were Proton pump inhibitors and not the same as over the counter antacids which should be taken at least two hours before the Riba.

cando

[jmjm530]

You can take Proton Pump Inhibitors (PPIs) and/or H2 Blockers anytime during the day, including when you take your ribavirin.

Examples of PPIs -- Nexium, Prevacid*, Prilosec, Aciphex
Examples of H2 Blockers -- Pepsid, Tagament, Zantac

You should not take antacids within 2-3 hours of your ribavirin.

Antacids include: Tums,Rolaids, Mylanta, Maalox, Gaviscon, Chooz

*Note: "Pepsid Complete" contains both an antacid and an H-2 Pump so you should not take it within 2-3 hours of your ribavirin. Pepsid AC does not contain an Antacid, so you can take it with the ribavirin.

You should also not take fiber supplements within 2-3 hours of your ribavirin.
Fiber supplements include flax seeds, metamucil, bran and ideally some cereals heavily fortified with bran or flax like Uncle Sam's.

[jmjm530]

The asterick "*" should have been next to "Pepsid", not "Prevacid".

"Zegerid" contains both a PPI and and Antacid so should not be taken within 2-3 hours of the ribavirin for maxium riba absorption.

Also forgot to add that in general the PPIs are more effective for GERD (chronic reflux) than either the H-2 pumps or antacids. That said, antacids and/or H2-Pumps can be used in addition to PPIs, depending on how the GERD presents itself and with experimentation.

I took Nexium twice a day during treatment for LPR (Laryngopharyngeal Reflux) and now only occasionally take a Pepsid Complete if I eat badly or eat a large meal too to bedtime. Because I'm not treating, I don't have to worry about the antacid in Pepsid Complete interferring with the riba.  

[scruples]

I have also discussed this issue with my doc and asked him to recomend some medicine for this problem. My doc said it is highly recomended that i shouldnt use any medicine untill the acidity becomes un-bearable or stays longer than 12-15 days. He only recomended Citris Soda powder to use with water twice a day only for 3 days but it didn't help a lot. Is there any food which can reduce acidity???

[scruples]

Thanx . This info was really helpful.

[jmjm530]

"H2 Pumps" should be "H2 Blockers"

[jmjm530]

Not familiar with "citrus soda powder" but both citrus and carbonated drinks can make reflux worse if it contains those ingredients. Is your doc a liver specialist or gastro who has a very large Hep C practice? The advice of waiting until acidity becomes "unbearable" seems to fly against the type of agressive/proactive strategy that many liver specialists employ to make people as comfortable as possible on treatment. Personally, I'd tell them you want to try a PPI like Nexium, or at least an OTC H-2 Blocker like Pepsid AC.

Everyone has their own triggers but in general the worst offenders  for reflux include: tomato sauce, coffee, chocolate, carbonated drinks, spicy foods, any acidic fruits like an orange.  

"Apple Cider Vinegar" is sometimes recommended on "Health Sites" as a cure for reflux but by most accounts I've read on the GERD boards, it only makes it worse. That was also my personal experience.

Bread seems to soak up excess acid so you might try that with your meals, but really no reason to suffer when there are meds you can take.

[can-do-man]

True enough, nexium was like a lifesaver for me, Completely solved the problem with no sx effects. No need to suffer.

[scruples]

Is your doc a liver specialist or gastro who has a very large Hep C practice? The advice of waiting until acidity becomes "unbearable" seems to fly against the type of agressive/proactive strategy that many liver specialists employ to make people as comfortable as possible on treatment
...........................................................................................................................

yes my doc is gastro with large practice also he has specialization in medicine. According to him that happens during Tx and it usually lasts for 3-4 days and nothing more so i shouldnt use any medicine.


Thanx for mentioning triggers, i'll try to identify which thing is causing this problem. Someone told me Milk, yougurt or olive oil should be used to reduce this problem . Can you give your opinion on this??

[jmjm530]

Milk  should be OK. Yogurt maybe. Olive Oil shouldn't hurt and might help. Triggers are kind of an individual thing. Other reflux strategies include eating smaller meals (which can be counter-productive during tx because of weight loss); not lying down after a meal (very difficult for some on treatment); raising the head of the bed (not pillows but something like a block under the bed frame)

But if it starts becoming a real problem -- beyond that "3-4" days, then talk it over with your doctor again. While many here are started on rx PPIs right away, you could start with OTC H-2 Blockers like Pepsid AC or Zantac. They also start working right away while PPIs can take a few days to kick in. OTC antacids are also OK for occasional use but just be careful about the timing because of the ribavirin.

[jmjm530]

Just wanted to add that the nice thing about OTC H2-Blockers are that they can be taken on and off when symptons present, while PPIs are usually taken daily for longer periods of time. That said, depending on symptons and how agressive the doc is, they sometimes start with the PPIs.

[Myown]

Baking soda mixed in a glass of water should do the trick.

I can't remember how much baking soda - 1/2 teaspoon (?) but not sure. If you google it you will find health sites that will probably have the formula.

MO