Questions about anxiety and heartburn medications

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MotherGrizzly
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Questions about anxiety and heartburn medications

Post by MotherGrizzly »

Hello there--I'm new to the site and to my LC. I was diagnosed about 5 years ago with IBS, and on 8/31 of this year I found out that I have LC. I've had problems for most of my life with my digestion and diarrhea; currently, I'm in quite a lot of pain that feels unbearable.

My question concerns medications for anxiety and for heartburn. I was diagnosed with anxiety over the summer and my doctor prescribed Cymbalta. At the time, I thought I had IBS, and the Cymbalta constipates me so badly that I have had a terrible D attack once a week since I started taking the drug a month ago. I wondered if anyone takes an antidepressant that does not aggravate our LC conditions.

Also, I have GERD and daily heartburn. If I don't take Prevacid or Aciphex, my heartburn is hideous--yet I saw on another post that Prevacid is a cause/ problem for IBD. So, is there anything to take for the heartburn?

Thanks in advance for any advice--I am so overwhelmed and I don't know what I can/ can't do in terms of my anxiety and my acid reflux!

Jennifer
Just diagnosed LC--thought I was IBS-D for the last 30 years! : /
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tex
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Post by tex »

Hi Jennifer,

The SNRIs have not been in use as long as the SSRIs, so they don't yet have a track record associated with triggering MC. It's beginning to appear, however, that they may cause a similar effect for some people with MC. Doctors frequently prescribe SSRIs to MC patients, because one of their side effects is constipation, and they do help to slow down the D in some cases. Unfortunately, they do nothing to address the inflammation that is causing the D, so the damage continues to accrue in the gut. Of course, for some people, an SSRI will trigger MC, so we tend to view that class of drugs with a jaundiced eye. The jury is still out on whether the SNRIs will turn out to carry the same risks, but we're definitely suspicious of them, in the meantime, (while waiting for case studies to be published, which show the link).

Finding an anti-depressant, (and the correct dosage), that works well, is not an easy task, and finding one that will do so without adversely affecting our MC, can be like searching for a needle in a haystack. Wellbutrin supposedly has fewer side effects than most drugs in this category, but that doesn't mean that it would be effective for you.

GERD is a difficult issue, because the treatment most commonly prescribed to treat it not only perpetuates the problem, so that the body becomes dependent on the drug, (PPIs), but they are also known to cause MC, intestinal bleeding, osteoporosis, and a few other undesirable problems. Acid reflux is a common problem for many people with MC, and so we try to treat it by more natural methods.

I developed a reflux problem about a year and a half ago. It was caused when I was given a PPI for a few days while I was in a hospital, recovering from surgery. My motivation came from waking up in the middle of the night, with a mouth full of burning acid. I didn't have to go through that but a couple of times before I decided to learn how to avoid it. Here are some tips that I used to resolve it, (but I didn't find it necessary to raise the head of my bed):

1. Avoid eating anything for several hours before bedtime, especially the foods in the following list:

2. Avoid foods that are known to cause reflux, such as:

- High fat foods (such as fried foods, high fat meats and high fat dairy products).
- Sodas.
- Acidic fruits such as citrus fruits (i.e. lemons, grapefruits and oranges) as well as the juices made from them.
- High acid vegetables like tomatoes and raw onions.
- Garlic (weaken the lower esophageal sphincter muscle).
- Beverages such as coffee (including decaffeinated coffee), tea and most other caffeinated beverages.
- Alcoholic beverages (weaken the lower esophageal sphincter muscle).
- Chocolate (weaken the lower esophageal sphincter muscle).
- Peppermint and spear mint (weaken the lower esophageal sphincter muscle).
- Chilli peppers and pepper (may irritate a damaged esophageal lining).

http://www.acidrefluxcure.net/diet/

3. Avoid sleeping on your right side. This is very important, because when we sleep on our right side, part of our stomach is higher than the lower esophageal sphincter, (LES), and if the LES is in a weakened conditioned, (which it will be, if you've been taking a PPI), the contents of the stomach can backflow into the esophagus.

4. If all this is not enough, raise the head of your bed a few inches, by placing a brick under each of those legs, for example.

5. If you do this faithfully for a few months, (and avoid PPIs), your LES will slowly regain it's strength, and eventually, (after a few more months), it won't allow the stomach contents to backflow into the esophagus, even if you eat too close to bedtime, sleep on your right side, and eat foods that are associated with reflux. At least that was my experience. To be on the safe side, though, I always try to avoid eating close to bedtime, and I avoid sleeping on my right side.

I believe you will find the following threads to be very informative.

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=14245

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=14344

You're most welcome,

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by sarkin »

Sleeping on the right side totally changed my life. I do not have severe GERD, but all of my symptoms in the beginning were terrible, and this made a big difference. Raising the head of the bed, either with something under the bed-legs, or with pillows, also helps.

My anxiety level was probably mild to moderate, but I can report that it gets better, with progress in healing along the MC path, a workable diet, and time. I believe that Vitamin D has been helpful for me, and also a good B-vitamin complex (gluten-free, soy-free, dairy-free, etc.-free) with enough B-12, B-6 and folic acid especially.

These are among the vitamins we especially have trouble absorbing when our MC symptoms are problematic. Another is magnesium, which can be tricky to take as a supplement, as it can have a laxative effect. I use small amounts in a topical spray, and it has really helped with foot/leg cramps, and I think also with a general state of ease and calm.

Sleeping on the right is *amazing* and I never would have figured it out on my own!

I truly hope this, and all of Tex's helpful and knowledgeable suggestions, help you get past the current overwhelm of symptoms so you can start healing.

All my best,
Sara
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sarkin
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Post by sarkin »

***I meant to say****

Sleeping on my *LEFT* side changed my life - we are scrambling to get ready for a vacation, but as I got ready for bed I suddenly realized I got this backwards.

Just this morning, I rolled over onto my right side to accommodate a cuddle-needy cat, and was less comfortable within 10-15 minutes. And I do not have GERD, nor am I having serious GI symptoms at the moment.

Sorry for the mis-statement!

All my best,
Sara
maestraz
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Post by maestraz »

Hi Jennifer,
FWIW, I have recently weaned off of Celexa (an SSRI) and a month later started Wellbutrin. Too soon to tell how this will work, but my docs were totally in tune with the need to eliminate the SSRI-class meds. But don't just stop taking any anti-depressant suddenly; talk to your doc about how to wean off it. I tapered off of Celexa over a couple of months.

When I have a sour stomach, I take OTC Pepcid. I don't know if that falls into any category that has been troublesome for others, but I do OK with it.

Also FWIW, I have a SIL who has been struggling with GERD for the last few months. He has cut back on alcohol and caffeine and avoids eating anything for a few hours before bed. He has had relief by doing that.
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Post by polly890 »

Do SSRI's aggrevate GERD? SSRI's are the most popular types of anti-depressants, so I would think lots of people would be effected by that. It also makes sense why people with GI issues need anti-depressants; gut problems create lots of anxiety. I wish individual health insurance would cover the alternative treatments people need for this.
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tex
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Post by tex »

That's a good question. Some researchers claim that there is no evidence of an effect, but a quick search of the internet will show that many people taking them claim that there is a connection.

http://www.medscape.com/viewarticle/721067_4

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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