GERD and Crohn's

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mkl11
Regular Member


Date Joined Jul 2007
Total Posts : 424
   Posted 8/13/2009 9:21 PM (GMT -6)   
Over the past few months, I've been having increasing episodes of heartburn and burning in my throat. It's now frequent enough (a few times a week at least) that I'm going to seek medical advice.

My question is, are GERD and Crohn's related? Do Crohn's sufferers experience GERD at a higher rate? What aspect of the Crohn's disease could be causing these problems?

Similarly, for you GERD sufferers, what are the treatment options? Changes in diet? Medicine?

Hopefully I'll get into my GI in about a month, but I'm just curious in the mean time.

Thanks!
21 y/o, diagnosed 6/2007

Symptoms currently under control with Humira and a wheat-free, processed food-free diet. Beginning to have symptoms of GERD...


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 6763
   Posted 8/13/2009 10:06 PM (GMT -6)   
I developed severe GERD symptoms about 3 months after the start of a particularly bad flare of my CD. As my GI explained to me, people with CD in the terminal ileum often develop GERD due to a sort of "back-wash" effect. I'm sure CD in other areas can also cause GERD. They did an upper endoscopy on me and my stomach was very inflamed with several spots of recent bleeding. I didn't have H. pylori or CD - just lots of inflammation. I was put on Prevacid, a PPI [proton pump inhibitor]. PPIs are often used to treat GERD.

Diet changes can help reduce the symtpms. Also, changes in meal times and sleeping can help. For instance, one should not lay down for 2-3 hours after eating. That helps prevent "backwash" into the throat. The Mayo Clinic has a good section on lifestyle changes you can read. http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=lifestyle-and-home-remedies

You should also make your GI aware of your GERD symptoms. Untreated GERD can cause permanent damage.


Moderator Crohn's Disease  & Osteoarthritis Forums
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, asthma, severe allergy and a host of other medical problems.
 


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 8/13/2009 11:24 PM (GMT -6)   
about 32% of a study group of Crohn's patients had gastritis. Gastritis is not GERDs, but the inflammation from gastritis can result in excess acidity and GERDs can easily follow if there is any slowing of stomach emptying or weakness of the valve at the top of the stomach. In my case, I had GERDs well before I was diagnosed with Crohn's and after being on Pariet for a year, I went cold turkey and after the rebound acidity, I managed to control the GERDs by diet restriction. The diet somewhat resembled the diet for Crohn's control. I think that this may be because Crohn's disease causes food intolerances and the stomach inflammation is due to the immune response to food proteins. The diet may just be eliminating common allergens from your diet and avoiding triggering an immune response by avoiding the food intolerances. There is a common approach in England that controls a flare by using an elemental diet (search here for "Modulen"). After that controls the flare, the patient should then be tested for food intolerances and the diet adjusted to avoid them. This approach has a rate of maintaining remission better than using prednisone long term at one and two years after starting. Note that individuals can have unusual intolerances and a "one size fits all" diet may not work for everyone. You just have to read this forum to see the range of things that different people here avoid to see how individual these intolerances are.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14994
   Posted 8/14/2009 7:08 AM (GMT -6)   
I suffer with GERD related to my Crohns too. I take Prilosec myself and it works great to keep the GERD in check. I don't really have the acid reflux part of it, but suffer with the backwash that IDES describes.
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium  w/Vit D, and Xanax as needed for my anxiety.  Resections in 2002 and 2005. Also diagnosed with Fibromyalgia, Osteoarthritis, and Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 8/14/2009 10:48 AM (GMT -6)   
I was diagnosed with GERD long before they finally came to the Crohn's diagnosis.  Watching my diet and taking meds have always worked, but I went through a few years where I had to the change the med about every year, as it stopped working.  On my last endoscopy, they said I have NERD now, instead of GERD, which is "Non Erosive Reflux Disease."  Prilosec, Nexium, Protonix - these types of medicines can help.   

Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


frogeleita
Regular Member


Date Joined Jul 2009
Total Posts : 342
   Posted 8/14/2009 11:18 AM (GMT -6)   
i personally feel like they are connected..because i have been told Crohn's happens anywhere from the mouth to the anus..i have taken all types of gerd medications and its something that comes and goes..sometimes things are bad for a while...and its like i never had gerd at all...i hate to say it..but i blame everything on Crohn's any chance i get...

frogeleita
Regular Member


Date Joined Jul 2009
Total Posts : 342
   Posted 8/14/2009 11:20 AM (GMT -6)   
Change in diet and not eating late at night...is the best thing you can do for yourself..stay far away from tomatoes..citrus fruits..fried foods..and i am sorry to say..if it bothers you coffee..athough foldgers (is that how you spell it?) came out with a coffee for sensitive stomach...and my personal take is ..carbs are so soothing to the belly...oh and watch out for some crackers out their like cheese nips or goldfish..they have alot of spices in them!

Blossom
Regular Member


Date Joined Mar 2008
Total Posts : 173
   Posted 8/16/2009 11:38 PM (GMT -6)   

Hi,

I've had GERD since I was in my early 20's (maybe even earlier), but did not get Crohn's until around the age of 45.  Over the years, I've had to take stronger and stronger anti-reflux medications, and now I'm on a proton-pump-inhibitor called Zegerid.

I recently had a small bowel resection due to severe stricturing of my terminal ileum, and for several months prior to my surgery, I noticed that my GERD was the worst it's ever been.  I was even eating low residue, low fiber, and extremely bland foods, yet I still had severe problems.  I even slept sitting up (in a recliner) for 5 months prior to my surgery.

Since my surgery for the stricturing, my GERD seems to have settled down somewhat, but I'm sure I'll be on PPIs for life.

So, a short answer is that I think a Crohn's flare can make GERD worse.

 

 

 


54 year old female;
 
Have had Crohn's of terminal ileum for over 9 yrs.   My first small bowel surgery was on 7-30-09.
 
On Humira since Dec. 2008.  Allergic/hypersensitivity to Pentasa, Entocort, and 6-MP.  


Keeper
Veteran Member


Date Joined Jun 2008
Total Posts : 1058
   Posted 8/17/2009 11:19 AM (GMT -6)   
A lot of GERDs is likely due to the level of fat in the diet. Undigested dietary fat slows stomach emptying and weakens the pyloric valve, so reflux is a common result of too much fat - like fried stuff. Strictures also cause slowed peristalsis and can do much the same thing - slower stomach emptying and increased opportunity for reflux. Blossom - if your surgery removed the terminal ileum, it also removed one of the sections (the most dominant one) of the gut that slows the digestion when undigested fat is detected. That would account for the improvement in stomach emptying. If you don't have an exceptional amount of fat in your diet, it may be that you have had an insufficient pancreatic response - resulting in inadequate digestion of fats. You might try adding digestive enzymes to your diet.

PPI's are really undesirable. They are associated with an increased likelihood of osteoporosis and hip fracture. They interfere with iron and other mineral absorption. They also reduce stomach acid levels so low that they prevents your stomach enzymes from working. They are also a known cause of SIBO (Small Intestine Bacterial Overgrowth). SIBO here probably results from undigested food triggering the various peristalsis slowing mechanisms.

ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 8/19/2009 11:17 AM (GMT -6)   

I forgot to mention that raising the head of your bed with a 2x4 may help...all of my GIs over the years recommended it and it really does help me. 

Keeper, I have heard about the side effects of PPIs recently also, but the pain associated with the acid reflux is worse to me than the risk of osteoporosis.  I take calcium and vitamin D daily.  I have very little fat in my diet and tried acidolpholis (sp.?) but it didn't seem to help.  With all of the side effects that go along with biologicals and other crohn's drugs, the risks of PPIs seem very little to me.  But, that's just my opinion. 


Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 

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