Heartburn Ideas??

chevtow · Aug 10, 2014

I have to take a pre-op C-diff test. I figured no biggie - poop in a container bada boom bada bing. Never realized I had to go off my Dexilant for 2 weeks.

Holy hell !! It's been 4 days and sleep is very fleeting because of the heartburn/reflux. I'm even sleeping in a recliner to keep my head up. Trying Tums, Tagamet, even baking soda mixed with water. Results have been less than spectacular.

Does anyone have any brilliant ideas for me to try for the next 1.5 weeks? Thanks in advance

Spiky Bugger · Aug 10, 2014

First, I have no idea other than sleep sitting up.

Then, I'm hopping in here because I've had numerous tests for C-diff, when I had c-diff, and never had to stop taking my PPI, which is Prevacid Solutab.

Then, there are different kinds of c-diff tests...some more accurate, some faster, some cheaper. This explains them. http://www.cdc.gov/hai/organisms/cdiff/cdiff_faqs_hcp.html. Again, I know I have had at least two of these tests and neither required that I stop taking my PPI.

Finally...why are you being tested? C-diff testing is often not great. One kind of test gives frequent false positives, another gives frequent false negatives. If you are having frequent diarrhea that doesn't resolve on its own or respond (or respond for very long) to treatment, it would make sense to test you for c-diff. But if you are not sick...wtf?

Also...there was some argument in the medical literature that c-diff is associated with PPIs, but I didn't see anything that said that PPIs interfere with c-diff testing. And I just checked two online lab test places and neither had any prep for those tests.

ETA: Call a couple of local labs, like Quest and Lab Corp and ask them if you need to stop PPIs for two weeks prior to c-diff testing. To me, this makes no sense, because someone who DOES have it could be having horrible diarrhea, maybe hourly. In my case, easily 15 times a day. Stopping a drug and waiting two weeks before testing and then waiting for results before treatment can begin seems a bit extreme.

DianaCox · Aug 10, 2014

Are you sure you are being tested for C. diff? I'm thinking you're being tested for H. pylori.

http://www.medscape.com/viewarticle/465198

Should a proton-pump inhibitor (PPI) be discontinued prior to a urea breath test (UBT)? If yes, for how long before the test?

Any medication that decreases the density of Helicobacter pylori organisms in the stomach will affect the accuracy of tests that identify active H pylori infection. In general, most experts agree that antibiotics and bismuth should be withheld for at least 2 weeks and preferably 4 weeks before performing a UBT or stool antigen test. This recommendation has not been validated with studies using the UBT. However, at least 1 study has found that biopsy-based rapid urease testing (RUT) results obtained 1 month and 6 months following antimicrobial therapy are equivalent. With this thought in mind, it seems reasonable to extend the observations for the RUT to the UBT, as they are both functional tests of H pylori urease activity.

PPIs have also been found to adversely affect the sensitivity of the UBT and stool antigen test. Studies have reported that between 33% and 50% of patients taking conventional doses of a PPI develop a false-negative breath-test result and that this effect resolves within a period of 7-14 days. The mechanisms responsible for the effects of PPIs on the UBT remain incompletely defined. Possible explanations include a direct antimicrobial effect of PPIs on H pylori or pH-dependent suppression of H pylori urease activity. It appears that individuals who experience the greatest levels of gastric acid suppression with a PPI are the most likely to develop a false-negative UBT result. If this observation is correct, high-dose, histamine-2-receptor antagonists may also cause false-negative breath-test results in a small percentage of patients.[1-3] Recent data suggest that the administration of citrate as the UBT test meal may decrease the likelihood of false-negative results in patients taking PPI therapy.[4] Despite these observations, it is still currently advisable that patients withhold a PPI for 7-14 days before undergoing the UBT.

chevtow · Aug 10, 2014

I'm sorry, it is H. Pylori. Shouldn't ask questions when sleep deprived

MyNewLife · Aug 10, 2014

I don't take a PPI unless I need to take an anti-inflammatory. Dr Oz showed that melatonin works when taken two hours before bedtime. Worth a try. I take it because I can't sleep but I don't have Gerd problems. Could be coincidence but might be worth a try. I take two 5mg tabs before bed (I don't make it longer than 20 minutes tho

JackieOnLine · Aug 10, 2014

I found Gaviscon works better than Tums - it's over the counter and foams up weirdly but maybe that's why it works. I only tried the unflavored but I see it comes in flavors.