Don't depend on Carafate to protect your throat...

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bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/3/2011 9:30 AM (GMT -6)   
Hi everyone --
 
I know that struggling with LPR symptoms is a real challenge, especially to try to protect your throat at night.  I don't eat after 3pm, sleep on a wedge, and chew two Gaviscon tablets before bed at 12-1am.  I met with my GI on Thursday, and explained this as well as the fact that the Gaviscon doesn't quite make it through the night.  I wake up with a sour taste in my mouth, and sometimes some minor burning.
 
So, he gave me some Carafate suspension samples, and wrote me a prescription for the tablets.  He advised for me to put the tablets in a small amount of water for 30 minutes or so before bed, and the tablet will dissolve and subsequently coat my throat on the way down.
 
Thursday night/Friday morning I just used the suspension, and I picked up the prescription yesterday and used it last night.  I wasn't impressed with the suspension yesterday because I noticed more burning than usual in the morning, but THIS morning I woke at 4am and my mouth was on FIRE!!!  This is unusual, and has never happened with the Gaviscon.  I got up and chewed two Gaviscon tablets, and managed to get back to sleep.
 
I'm frustrated, because every time I experience something like this, it's further damage that I can't really recover from when I'm getting constantly dosed with reflux daily.  I'm having much more difficulty swallowing right now...
 
I know Carafate has other uses, but if a doctor gives it to you primarily to "protect your throat," this is not an effect it offers.  I think it's simply too thin a solution, either the suspension or dissolved in water, and doesn't foam like Gaviscon does.  Gaviscon isn't a perfect solution either, but it's the best I've found so far.  By the way, I've found that the regular strength Gaviscon tablets, available from Amazon, work much better than the maximum strength liquid that's usually available in stores.
 
-Bruce

sunbeam48
Veteran Member


Date Joined Jun 2011
Total Posts : 795
   Posted 12/3/2011 11:37 AM (GMT -6)   
Have you tried sleeping more upright than your wedge provides? This could be two wedges, wedge plus books under head of bed, an electric bed, or sleeping the first half of the night in a recliner chair or sofa with back support. This might be more effective than the carafate.

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/3/2011 11:48 AM (GMT -6)   
Hi sunbeam --

Thanks for your suggestions. I'm currently at about 10-12", which is as high as I can comfortably go. For several months I was at 18", but it made my sciatica intolerable because my discs in my lower back couldn't decompress at night. Plus, I didn't notice any appreciable difference in reflux symptoms at that height from where I am now.

I still have to do my traction exercise on the floor to relieve the sciatica, but I can function better at the lower wedge level.

I also was sleeping the whole night on a recliner for a while, but if I woke up halfway through the night to move, I'd probably have difficulty getting back to sleep.

-Bruce

sunbeam48
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Date Joined Jun 2011
Total Posts : 795
   Posted 12/3/2011 12:41 PM (GMT -6)   
"I'd probably" suggests you haven't tried this yet, so maybe you should. I went with the electric bed, but that's not the most affordable solution for many. Someone here said it was surprisingly easy to get back to sleep when they switched. Ya just never know, and it may be better than the burning. I used to wake up at 3:30 am with that burn.

I have lumbar stenosis, so I also need to get some horizontal time.

belljar1995
Regular Member


Date Joined Dec 2011
Total Posts : 93
   Posted 12/3/2011 10:58 PM (GMT -6)   
HI Bruce
I'm new to medicating the GERD/LPR thing, but my ENT recommended Gaviscon Advanced (sold in the UK) because it has more sodium alginate than the US brand does and as a result makes a stronger foam barrier. I live in NY, but was able to order it online from express chemists . It also has liquid and tablets--I got the liquid. It does seem to "keep things down" for quite awhile. Maybe a stronger formulation will work???

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 12/3/2011 11:11 PM (GMT -6)   
Hi Bruce,
Are you not able to take PPI's, or are you getting these symptoms even on them?  Did the Carafate suspension seem to work better?  If you've read any of my posts, you'll know I'm a big proponent of Carafate suspension, and find it helps my reactive stomach tremendously.  Since my wrap is created out of my stomach, it also becomes easily irritated, and the Carafate coating really makes it feel better.  I've never heard of Carafate as a solution to acid reflux, but I know it's the drug of choice for bile reflux.  It was originally developed to protect the stomach lining while ulcers healed. 
 
Carafate and Gaviscon are very different.  Carafate has no antacid properties.  It's meant to coat your stomach period.  The suspension does do a good job of coating the esophagus as well, and the advantage is that it lasts up to 6 hours, where Gaviscon and Maalox products are much shorter-acting.
 
I've taken Carafate tablets in the way your doctor suggested, and while they work some, it's not at all as good as the suspension, which coats evenly. 
 
What you're describing almost sounds like a reaction to the drug.  Could you be sensitive to it?  Perhaps the more you used it, the more it irritated the throat tissue?
 
As far as sleeping goes, raising the head of your bed 7 or 8 inches by putting something under the legs is far superior to a wedge.  The wedge allows you to slide down, and actually puts your stomach in a position that promotes reflux, because you're kind of bent in the middle. 
 
While some seem to find it unpleasant to sleep on a "hill" like that, it's something that can be adjusted to with time, and it is very beneficial.
 
Refrain from eating 4 hours before bedtime to be safe. 
 
Have you tried a liquid Gaviscon or Maalox product?  You might find it even more soothing than the tablet form.
 
I hope you find a solution to your problems.
Best wishes,
Denise

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/4/2011 12:37 AM (GMT -6)   
Hi belljar --
 
If you were able to get the UK version of Gaviscon, as your ENT mentioned, that is the superior formulation.  I'll check out Express Chemists...
 
Hi Denise --
 
Yes, I am intolerant of all PPIs.  I've tried them all, and they cause massive headaches, even days after I stop taking them as they work their way through my system.  That was one of the main reasons propelling me towards the TIF surgery.
 
The reason I took the Carafate was for the "coating" properties to protect my throat as I sleep, and I realize that it's mostly meant for stomach complaints.  But the doctor assured me that it would be better than the Gaviscon for my throat.  I knew that the Gaviscon wasn't lasting through the night, and was looking for something longer-lasting.
 
I could even tell as I swallowed the suspension that there wasn't any appreciable coating going on, at least not like what I feel with the Gaviscon.  The doctor also described it as not being a drug, and, therefore, no side-effects.  It's just an inert substance with a therapeutic application.
 
The wedge I use is a special wedge that goes all the way down to my hips, and I've built up an elevated platform for my pillow so my head can be at the right position, beyond the wedge (I'm 6'1", so I need the extra).  I'm at about 12" or so.  I was at 18" for several months before the surgery, but I didn't notice any improvement at that angle, and it was very hard on my sciatica.  I don't slide off the wedge.
 
I started off with the liquid Gaviscon, but I agree with the various reviews I've seen on the web -- that it's inferior to the regular-strength tablets.
 
I don't eat past 3pm, and go to bed at 12-1am, to make sure my stomach is completely empty, and the Gaviscon can have maximum effect.
 
Thanks so much for your suggestions!
 
-Bruce

belljar1995
Regular Member


Date Joined Dec 2011
Total Posts : 93
   Posted 12/4/2011 2:20 PM (GMT -6)   
Yes, Bruce, it came in the mail a few days ago )just 3 days with express shipping!

mock turtle
Regular Member


Date Joined Mar 2011
Total Posts : 467
   Posted 12/4/2011 3:45 PM (GMT -6)   
bcfromfl

yeah i did the super-duper incline of bed thing too...probably over 12 inches incline at one point

and yep i had joint pain or what ever pain in legs and hips also as a result

so yeah the bed is back down to around 8 inches inclined at the head board and im sleeping in a recliner until past midnight and then to bed

(aint it fun!.... even the recliner "hurts".... angle of back near lumbar, due to night time slouching causes its own set of problems...guess we get to choose our poison! ha ha ha ha ha....ok its not so funny is it

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 12/4/2011 3:46 PM (GMT -6)   
Hi Bruce,
I'm sorry to hear that you are struggling, and the things you're trying, aren't helpful.  Have you looked into the possibility of a Nissen surgery?  I understand that GI docs aren't thrilled with recommending the surgery to those of us with atypical symptoms, but while the % of success is a bit lower, I know many who have been helped, including myself.
 
I wish you the best of luck in finding an answer.
Denise

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/4/2011 4:06 PM (GMT -6)   
Thank you, Denise. I think I'm pretty much out of options, and I'm trying to get used to the idea of a Nissen, but I'm still very resistant. I finally was able to find out that the Mayo Clinic in Jacksonville, among other things, specializes in GERD research, and I have an appointment there after the first of the year.

I'm fairly certain the Nissen is what they're going to recommend...

-Bruce

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 12/4/2011 4:20 PM (GMT -6)   
Bruce,
The Nissen procedure is not something to consider without thorough research and exhaustion of all other options.  I agree that a second opinion at Mayo is an excellent idea.
 
I put off surgery for probably 7 or 8 years, and I can blame my GI doc, but I was not all that excited about pushing the issue.  The last four years before I finally realized there were no other options, were the worst and most damaging to my long term health.  (By that time I was taking very high doses of steroids to keep my lungs operational, and I now have adrenaline insufficiency, and skin that bruises and tears easily.  I've been told it's the skin of a 90 year old.)  All this damage was done in the last four years as my GI doc resisted the idea of surgery, and I was fearful to push the issue.
 
You are the only one who knows if the surgery will be worth it to you.  I went forward not knowing if it would improve my lungs.  I just had no other options.  I had to try it, and at least rule out that cause.
 
Thankfully, it worked well for me.  It's a difficult recovery (easier than some of the gastritis/esophagitis recoveries I'd been through), and there are some changes in your GI tract that you'll need to adjust to.  That said, for many of us these are very small inconveniences in light of the improvements we have experienced.
 
Good luck with your appointment.  I'm glad you've joined the forum.  I'm sure your search for answers will benefit many others in the same quest.
 
Best wishes,
Denise

LocalGuy23
Veteran Member


Date Joined Sep 2011
Total Posts : 620
   Posted 12/4/2011 4:35 PM (GMT -6)   
i for one have exhausted all other options for LPR and this condition I cannot live with unless I do something about it. My surgeon has experience with LPR and has assured me he can get rid of my symptoms. I ordered gaviscon advance and will be trying that soon but I'm so determined to get rid of this terrible illness. I am hopeful for LINX and there was a member who flew to Italy to get it done. I would do the same no matter what the cost. You can't put a price on your health. If that doesn't work then there's always Nissen. But LINX could be the future for LPR....who knows.

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 12/4/2011 8:10 PM (GMT -6)   
My ENT gave me a prescription for carafate (I never seem to find someone who has samples) - so I go to WalMart and they give me this sack with THREE bottles of the stuff and then tell me it's going to be $288!!!!! Just be glad you got the samples - and like you - it did virtually nothing. Just ANOTHER waste of money. I got the Dropping Acid book yesterday and I'm starting the diet mid week - some of the recipes look good and some of them look horrible. I'll have to figure something out.

belljar1995
Regular Member


Date Joined Dec 2011
Total Posts : 93
   Posted 12/4/2011 8:31 PM (GMT -6)   
HI Bruce
I;m really new to this, but one thing the GI mentioned to me was that he was "one of the pioneers " in an endoscopic surgery that leaves no scars. They go in through the mouth/esophagus and then "rebuild" the valve-- rather than doing the wrap. This is also different then the stapling procedure.

Again, I don't know too much...sounded interesting...but if it is really new it might not have a track record that is reassuring.

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 12/4/2011 9:31 PM (GMT -6)   
Thank you again, everyone, for your thoughts and comments.  Like nearly everyone else here, this condition has really ruined my life, and I understand and empathize with everyone's experiences.  On one hand, I'd be willing to do just about anything to return my life to the way it was before, but on the other hand, I have concerns that I might be one of the "bad" Nissens...
 
Belljar -- it sounds like your doctor was describing the TIF procedure to you...which I had in August.  It reduced my reflux episodes into the "normal" range, but since I have LPR, that's still too much, and I still have debilitating symptoms.
 
As do many of you, I'm sure, I wish I could have the money back spent on false hopes...
 
-Bruce

glenx11
New Member


Date Joined Sep 2012
Total Posts : 5
   Posted 9/3/2012 10:29 PM (GMT -6)   
Please check the following www link. It has some info at the end about zinc chloride for use similar to a ppi that I've never seen anywhere else before

3ws.charlespoliquin.com/ArticlesMultimedia/Articles/Article/433/The_HCL_Acid_T
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