Is it wise to take anti-acid medication with MC?

Here you can find information on medications found by the members of this discussion board to be generally safe and effective, and to minimize the risk of provoking a microscopic colitis flare or relapse.

Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh, mbeezie

Post Reply
denicave
Posts: 10
Joined: Fri Jun 19, 2015 9:49 pm
Location: Texas

Is it wise to take anti-acid medication with MC?

Post by denicave »

I have collagenous colitis, gastroparesis and erosive gastropathy. My gallbladder was removed last week due to multiple gallstones and he found a hernia while in there! Surgery was delayed by 24 hours due to very low potassium, sodium; vitamin d and b12 are also very low. Even though I explained to the anesthesiologist I have had chronic watery D for over a year which would explain the low electrolytes, etc. I still had to see a cardio to make sure my 63 y.o. heart could withstand anesthesia. Honestly! Now I read that the anti-acid medication my GI is prescribing may exacerbate the CC?!?! She insists I have GERD but I have no symptoms, other than a night-time cough. I am a right side sleeper - have tried to change that but always end up on that side. Taking booster dose of Vit D and when I am out and about again will pick up good B12.

Any/all opinions welcome.
Recently diagnosed w/collagenous colitis & erosive gastropathy. Sonogram & emptying test next week. Pain, nausea, feel lousy. 20 + lb gain, abdomen distended to 42". All food makes me sick. Help :(
User avatar
tex
Site Admin
Site Admin
Posts: 35070
Joined: Tue May 24, 2005 9:00 am
Location: Central Texas

Post by tex »

The bad news is that if you sleep on your right side, you create an ideal opportunity for reflux of stomach contents into the esophagus while you are asleep. The problem is that in that position (lying on your right side), the lower esophageal sphincter (LES) is below the level of much of the stomach, and that will allow gastric acid to leak into the esophagus anytime the clinching integrity of the LES might relax or spasm during the night.

The bloating is due to poor digestion caused by food sensitivities, and the extra gas pressure caused by bloating makes the risk of having reflux problems worse, of course.

The simple solution is to never sleep on your right side. Many of us have that same problem if we sleep on our right side, but sleeping in any other position resolves the problem. If for some reason you are unable to avoid sleeping on your right side, then the only other solution that comes to mind is to elevate the head end of your bed by a significant amount, but I doubt that you would be able to elevate it high enough to totally prevent esophageal damage.

For the first 5 and a half decades of my life, I thought that the only way to sleep was on my belly, and it became the only position in which I could sleep (and stay asleep). But when the MC symptoms began to develop, the bloating soon cured me of sleeping on my belly. It taught me to sleep on my back, and even though I've been in remission for over 11 years now, I still sleep on my back.

It might help to place a firm pillow or 2 along your right side to prevent you from turning onto your right side while you are asleep. Avoiding certain foods that promote reflux, and not eating within 3 or 4 hours of bedtime can also help, but they will not prevent reflux if we lie on our right side. Extra vitamin D will definitely help, also.

Removal of the gallbladder will cause bile to be dumped into the small intestine continuously (rather than only after eating a meal that contains fat), and this can cause diarrhea in most cases. A bile acid sequestrant may help to reduce (or even eliminate) the D, if your doctor hasn't already prescribed one.

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.
denicave
Posts: 10
Joined: Fri Jun 19, 2015 9:49 pm
Location: Texas

Post by denicave »

Thanks Tex - I do sleep with a side pillow but will try to sleep on my back going forward. I read a comment you made recently that anti acid drugs can make the MC worse. Do you believe this and why? I want' to be able to discuss it with my GI in an intelligent manner.
Recently diagnosed w/collagenous colitis & erosive gastropathy. Sonogram & emptying test next week. Pain, nausea, feel lousy. 20 + lb gain, abdomen distended to 42". All food makes me sick. Help :(
User avatar
tex
Site Admin
Site Admin
Posts: 35070
Joined: Tue May 24, 2005 9:00 am
Location: Central Texas

Post by tex »

Sorry, I got sidetracked and forgot to comment on the antacid question. You didn't specify the type of antacid, and the type matters. The problem with meds used to resolve acid reflux issues are that they treat the symptoms, not the problem. Of course, that's what most meds do, unfortunately. IOW, antacids will reduce the acidity of the stomach so that any refluxed liquids may not burn the esophagus quite as severely, but none of them will stop the reflux, and that's not good. With PPIs for example, we won't notice any acid burning in our esophagus, but the refluxed acid is still there — it's just buffered so that it is not nearly as acidic as it was previously, so we don't notice that it's still there. Since you're not even noticing any burning, there's certainly no reason to be taking a PPI.

And routinely using antacids can cause other problems, because by reducing stomach acidity, we also reduce the ability of our stomach to digest foods. That means more gas and bloating, and more undigested food floating in the toilet. And reduced stomach acidity means that some bacteria that would normally be killed by the acidity, will now be able to survive, and escape into the intestines, where they can possibly generate an infection, if they are able to gain a toehold. PPIs, for example, are well known for allowing intestinal infections (such as C. diff) to develop.

Some of us can tolerate H2 blockers, such as Zantac, Pepcid, or Tagamet, and these are not as risky as using a PPI, because they do not cause permanent changes in the parietal cells of the stomach, the way that long-term use of a PPI will do. Unfortunately, some of us cannot tolerate either H2 blockers or PPIs, because they will trigger MC symptoms in some MC patients.

The simple antacids, such as Pepto-Bismol, Rolaids, or Tums, are probably the safest remedies that can be used, but their effects do not last very long.

But as we get older, most of us do not have too much stomach acidity — we have too little. And that's why we have acid reflux. If the acidity of the stomach contents is below par on the backside of the LES, it's clinching strength will be reduced. The more acidic the stomach contents, the tighter the LES clenches, and obviously the tighter it clinches, the less likely we are to have reflux problems.

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.
denicave
Posts: 10
Joined: Fri Jun 19, 2015 9:49 pm
Location: Texas

Post by denicave »

Oh my word, this is a vicious cycle - the meds make the MC worse, right now all food causes the D, if I take magnesium to help Vit D that means continued WD, then lower Vit D and B. If I take the bile salts for lack of gallbladder that can cause WD. Doctors can't help and all the info on this site is making my head spin. I can't take steroids and most antibiotics cause side effects. I feel helpless and doomed at this point. No one understands(well some of you do) the humility from accidents, the constant pregnant stomach despite being a relatively small person, feeling fat and much more. I get tired of saying I don't feel well so I just respond I am fine. My employer has been understanding, but now that the gallbladder is out, they are expecting a complete turnaround. And I am sore from the surgery.

Guess that is my pity party rant. I truly feel overwhelmed.
Recently diagnosed w/collagenous colitis & erosive gastropathy. Sonogram & emptying test next week. Pain, nausea, feel lousy. 20 + lb gain, abdomen distended to 42". All food makes me sick. Help :(
User avatar
jlbattin
Rockhopper Penguin
Rockhopper Penguin
Posts: 760
Joined: Tue Jun 30, 2015 9:02 am
Location: Colorado

Post by jlbattin »

Denicave,

I got a magnesium spray and spray it on a couple of times a day on my legs and have been using Epsom salts lotion at night.............the spray nor the lotion cause diarrhea. There is a lot of info on here about magnesium. Use the search button and then ask whatever you don't understand.
Jari


Diagnosed with Collagenous Colitis, June 29th, 2015
Gluten free, Dairy free, and Soy free since July 3rd, 2015
User avatar
tex
Site Admin
Site Admin
Posts: 35070
Joined: Tue May 24, 2005 9:00 am
Location: Central Texas

Post by tex »

We all feel overwhelmed at first. We have to take life a day at a time and learn as we go. It gets easier as we learn what to do and begin to see improvements.

As Jari posted, use topical magnesium, not oral magnesium, if oral magnesium causes D for you. Topical magnesium works just as well as oral magnesium, and as Jari pointed out, it does not cause D.
denicave wrote:If I take the bile salts for lack of gallbladder that can cause WD.
You don't need any bile salts — you have too much of them. As long as you have a liver, you will still produce them. All the gallbladder does is store them — it doesn't produce them. The bile acid sequestrant that I mentioned in a previous post is to bind the unused bile acids so that they do not cause D when they get to the colon.

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.
Post Reply

Return to “Information on Medications”