Night reflux - bile was causing mine

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Richard1980
New Member


Date Joined May 2011
Total Posts : 3
   Posted 5/26/2011 6:23 AM (GMT -6)   
I know there are wide range or issues under the GERD banner, but I thought I'd post my experience on the off-chance it helps anyone with a similar problem.
 
It all kicked off during a period of stressful events. I would typically wake up at 2am with acid in my throat, vomit, then lie awake uncomfortable, restless and sweating until the alarm went off.
 
I tried:
* Avoiding stress - helped
* Meditating - helped a bit
* Regular exercise - helped a bit
* Drinking decaf green tea (L Theanine is supposed to be good for stress) - helped
* Cutting out spicy/tomatoey/rich foods - helped a bit
* PPIs - helped a little bit
* Cutting out alcohol - helped a little bit
* Cutting out caffeine - helped a bit (via reducing stress, I reckon)
* Avoiding foods for 3/4 hours before bed - helped a bit
* Sleeping on a GERD bed wedge - helped
* Supplements (magnesium, B12, B-complex, C, D) - no help
 
Eventually, I was as chilled out as I'd ever been. The source of stress was gone. And I was doing everything I could to avoid reflux. But I was still waking up at 3am - 4am feeling a little queasy, and completely unable to get back to sleep. On a bad day I'd still vomit in the morning. I had blood tests - normal. I was tested for H pylori - negative. I had a gastroscopy - normal. By this stage my doctor basically just said "live with it".
 
I had a feeling my problem may have something to do with excess bile, as the vomit was sometimes quite a lurid yellow, and PPIs didn't really help.
 
Then, after battling with my body for about a year, I stumbled upon the paper "Regulation of bile acid synthesis in man. Presence of a diurnal rhythm." (google it if you want, it's free) which told me two things:
* Bile production varies throughout the day. It starts ramping up at about 4am, peaks at about lunch time, then drops off heavily after lunch
* The paper also makes fleeting reference to the way bile production is regulated by bile acids returning to the liver after being reabsorbed in the intestines.
 
Then I figured it out. I like a decent breakfast - some protein and carbs to keep me going through 'til lunch. Maybe I was producing excess bile? Maybe my healthy breakfast was 'using up' all that bile so there was no negative feedback?
 
Well, I tested it out. I replaced my balanced breakfast with a meagre bowl of cereal, followed by cups of green tea and feeling hungry until about 11am (when I'd relent and have a snack). The mornings were a little unpleasant for a few days as all that excess bile was swept through to my intestines, but the feedback was almost immediate. After a few days I was sleeping through the night and the bed wedge had been relegated to the cupboard. I've had no problems since.
 
I'd had lots of advice to watch what I ate before bed. No one had ever mentioned breakfast. If you think bile might be your problem, it might be worth a try.

Post Edited (Keith29) : 5/26/2011 5:29:30 AM (GMT-6)


stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 5/26/2011 7:51 AM (GMT -6)   
Hello Keith and welcome to HealingWell.
 
Thank you for sharing what has worked for you. It is good you have decreased your reflux sx and many of us have been able to identify what foods trigger their GERD.
 
I am glad you found our forum and do take the time to read through the many posts by other members who have posted great information on how food plays a role in reflux.
 
Kindly,
Kitt
~~Kitt~~
Moderator: Anxiety/Panic, Osteoarthritis, GERD/Heartburn and Heart/Cardiovascular Disease.
www.healingwell.com

"If you can't change the world, change your world"

bittersweet603
Regular Member


Date Joined May 2006
Total Posts : 93
   Posted 5/26/2011 3:28 PM (GMT -6)   
Interesting theory. I had been researching bile production and bile reflux obsessively over the past few months before commiting to surgury because I had chronic gerd worsened at night with nausea sometimes vomiting of bile and regurgitation into my throat nonstop. It also burned on my left side and I had gastritis.. I came to the conclusion that it was possibly my gb causing this problem as your gallbladder stores and releases the bile when it sees fit. My PCP said it sounded like I had an over abundance of it, yet I showed no stones. I had my gb out with my Nissen surgery and since then have had about 75% of my symptoms dissapear. I still deal with gastritis though and its worse at night..I am curious how the affect of redirecting the bile from your liver to your intestines and not through your gallbladder helps anything if at all from it refluxing into your stomach?

A lot of days I do not eat breakfast and just have lunch, I still get the burning in my stomach at night time..wonder if it is still caused by bile..

Neptunian808
Regular Member


Date Joined Dec 2010
Total Posts : 86
   Posted 6/3/2011 8:42 PM (GMT -6)   
this is interesting i spit bile every morning, actually everytime i sleep even if i take a nap if i sleep for more than 3 hours i'll be spitting bile when i wake up, i just wish there was a way to stop it.

Richard1980
New Member


Date Joined May 2011
Total Posts : 3
   Posted 6/22/2011 6:49 AM (GMT -6)   
I'm now wondering if it's more down to the amount of fat intake, rather than the timing of the meals.

I mean to keep it simple: eat less fat -> make less bile -> get less bile reflux?

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 7/22/2011 10:59 AM (GMT -6)   
I don't know if anyone will reply to my post since this thread is old but here goes.

I had my gall bladder removed 16 years ago and I've never been the same. GERD got worse through those years as did the UPQ pain which is killing me as I sit here typing.

I also have diarrhea following the GB being removed and it's worse now that my reflux is out of control due to an open LES and hiatal hernia. It's also quite painful

It's interesting to me that one thing works well for this person and something else for another person. Nothing has worked well for me and that's the reason I'm having Nissen Fundoplication next week.

I'd love to change my diet or manipulate a meal or the timing of one and have all my symptoms magically disappear. I've tried so many things in the last 20 years and I just get worse as time passes.

I know I have too much bile in my stomach/ intestines but it's not a morning, afternoon or nighttime thing; it's all the time.

Just adding my two-cents.
Carpe Diem - Seize the Day!

If you would ask me what I came into this world to do, I would tell you I came to live out loud. - Emile Zola

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 7/22/2011 11:35 AM (GMT -6)   
keith
thanks for the information and the suggestion...im going to try this approach and see how much it helps, best wishes, mt

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 7/22/2011 3:57 PM (GMT -6)   
Blurb (very techi reading) relating to the above comments by myself:-
http://www.nature.com/gimo/contents/pt1/full/gimo24.html
"Contraction of LES cells by maximally effective dose of acetylcholine (ACh) is shown as an example of signal transduction in response to high doses of agonists."

AND

http://www.disease-treatment.com/showthread.php?t=95345
"The neuronal nitric oxide synthase--mast cell axis plays
an important role in the esophageal mucosal defense system. Systemic PC
pretreatment affords effective protection through ameliorating the
bile-induced ATP depletion and secondary inflammatory reaction"

This second ref opens with "Biliary regurgitation plays important role in gastro-esophageal reflux disease"

http://journals.lww.com/shockjournal/Fulltext/2008/12000/Oral_Phosphatidylcholine_Preserves_the.19.aspx?WT.mc_id=HPxADx20100319xMP
This 3rd ref talks about PC being protective. In the article it refers to "LPS" - I think it means lipopolysaccharides produced by bacteria.

If anyone is able to digest (ha ha) this stuff and comment, I would be interested to hear your thoughts!
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 7/22/2011 4:21 PM (GMT -6)   
Almost everything worked at one point in time to some degree or another with my past experience with GERD. The mind is a fascinating thing. Whether some of the things we hold fast to would hold up in clinical trial or not is sometimes of import and at other times it's not. If we feel better then why not stick with whatever we're doing that seems to help as long as it can't hurt.

This was my approach to my nearly 7 year battle with a "silent" gall bladder. I had no idea that it diseased and neither did the top docs in their field in the state in which I live. I had no pain and my tests were perfect except for a slightly elevated sed rate which was dismissed as "normal" after all those years.

When it started to rupture in the hospital after having my very first pain I realized that my healthy lifestyle and my forays into natural medicine had nearly killed me. My gall bladder was about to rupture totally consumed with gangrene.

I think I've pretty much allowed the same thing to happen to me with GERD. I've changed my diet, taken literally dozens of meds/ppi's, lost weight, reduced stress, slowed down, stopped my job and just about every other little thing was suggested by various docs as far back as I can remember.

Sometimes it is what it is. We need to stop and listen to our bodies. We need to really speak openly to the doctor we're going to and listen to what he says in reply to our honesty. I think I did that very thing a few weeks ago and I think I was really heard for the first time in a long time by my GI doc.

It's 4:20 pm where I live and my acid is finally letting up a little. It's been a long hard day since that same acid literally awakened me before sunrise this morning. I didn't wake up and get acid. It woke me up as it always does.

I'm ready for the surgery. . .
Carpe Diem - Seize the Day!

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 7/22/2011 4:37 PM (GMT -6)   
I'm sure I will eventually grow weary of trying to fix myself. However, those of us who are not eligible for surgery and suffer badly from the side effects of the drugs that are meant to fix us, are likely to keep trying to find better solutions.

Good luck with your op; I wish there was an op for gastritis!!

MMM x
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 7/22/2011 5:18 PM (GMT -6)   
It's not a question of being turned down; the wrap won't fix inflammation of the stomach! I've been told my gastritis and oesophagitis is mild. I guess if I progress to full blown Barretts they might offer me surgery, but it still isn't going to put out the fire in my stomach, and the drugs don't either!

Is your op soon?

MMM x
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 7/22/2011 5:22 PM (GMT -6)   
So sorry I misunderstood. I too have gastritis but it's always showed up on my EGDs as mild. It showed up as mild this time as well but with my LES wide open the symptoms the gastritis is causing are very painful now.

Have your upper and lower sphincters been tested through a manometry test? That's the only way my LES showed up. No other tests including barium showed it.

I see the surgeon for the second time next Wednesday and he may be able to do the surgery on Friday because he knows how much I'm hurting.
Carpe Diem - Seize the Day!

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 7/22/2011 5:31 PM (GMT -6)   
I'm in the UK so things are done a bit differently - or rather it's all more protracted. My GP (PCP) sent me for gastroscopy again this year (had one in 2007 which was normal despite a whole host of symptoms). The GI cons reported his findings and discharged me back to my GP, saying I was not bad enough for surgery. I was struggling to tolerate ppis at the time due to severe skin reaction - I was basically told to find a way to tolerate them (control the skin somehow) or manage on very high dose Ranitidine. I came off ppis, managed for a while on said high dose of Ranitidine, had massive flare up, became anaemic and went onto Lansoprazole 30 mg each night. Luckily I have managed to calm my skin down so I just have to put up with the other ppi side effects (constant hunger sensation and low blood pressure).

I have found the GPs put pressure on you to have the gastroscopy, then once they have the findings of that they seem to lose interest - they just expect you to take the drugs unless you have severe reflux or strong indications for surgery. So I haven't had any other tests like pH monitoring or manometry- the surgeon said that would only be done as a run up to surgery. And I absolutely do not cope with tubes etc down my throat, so I'd have to be unconscious for any further tests anyway!!

Good luck next week - could be a major turning point for you!

MMM x
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

somedaysarediamonds
Regular Member


Date Joined Jul 2011
Total Posts : 363
   Posted 7/22/2011 5:37 PM (GMT -6)   
I'm hoping it will end up being a very good change for me. I know what you mean about the GPs ORDERING the tests and then really not knowing what to do with the results. I go back to all the gall bladder tests that were ordered time and again for me all those years ago. Not a bad test in the bunch but my GB was about to blow from gangrene. Gangrene!

PPIs make me wacky in the head. You don't stop to think that something for your stomach might cause anxiety/depression. The GI gave me a new one about 6 weeks ago and I couldn't believe how badly I felt. We googled the drug and one of the big side effects was anxiety. I noticed I felt so much better when I had to be off it while fasting and stopping meds for the ph and manometry studies.

GERD seems to be no respecter of persons or international boundaries.
I'm in OK-lahoma where the wind comes sweeping down the plain . . . :)
Carpe Diem - Seize the Day!
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