Acid reflux / heartburn
- Thread starter NateJS345
- Start date
LittleLab4CF
Super Moderator
Ooh, heartburn, if that's what it is, might be a standard symptom of CF. I'm frequently saying that I have GI dominant CF, a less serious form of CF. I'm beginning to feel that GI dominant issues don't get the attention and respect they deserve. Pulmonary issues are more deadly and usually more urgent, but they both impact the quality of life.
I'd be interested in understanding why the shift from a PPI, Proton Pump Inhibitor, to Zantac. Generally speaking if you need a PPI you're going to need the augmented use of something like Zantac. The only good reason for suspending its use, aside from not needing it, is the long term use. My doctor(s) rarely have said that in ten years or so I will have some bone loss the use of one drug or another, PPI's especially.
Anytime I hear heartburn and CF in the same sentence I start to think about everything that feels like heartburn, but isn't. Got your gallbladder? People describe it, including me, as an exquisite case of heartburn, hiccups or a burp/belch caught in the high stomach. A pancreatic attack is similar but called epigastric pain. Both exceed the notion of heartburn in terms of distress.
Heartburn begins as hyperacidity, usually treated with a PPI or antacid if it's occasional. When stomach acid is churning on nothing, eventually it erodes the protective mucus layer and being stomach acid, it burns the lining of the stomach. The actual burning of the stomach lining is very much like a sunburn. In fact many CFers, especially when the entire gut is tender, it's been compared to a sunburn of the viscera, that won't go away. Stomach acid on food does produce hydrochloric acid gas. As a child out of his depth playing with my chemistry set, amply supplied with a stock of powerful and dangerous reagents courtesy of the local drug store, with my father's permission, I encountered a gas from a strong acid. Called fuming nitric acid, when I got it home I decided to smell the fumes.
A dilute acid is used to cauterize a stubborn blood vessel in a nosebleed. What I drew a breath of instantly eroded my nasal mucosa and I had the nosebleed of my lifetime. Lessons learned that day have been worth the mistake, I had an instant understanding the strength of laboratory grade chemicals. My point for anyone who doesn't respect the potential strength of stomach acid, hasn't gotten a nosebleed from vomiting. Heartburn is an already burned stomach lining, exposed to stomach acid and the fumes. Don't suffer long if this doesn't work. I take an Uber PPI called Dexilant in addition to 2 or more Zantac daily.
Hope that helps,
LL
P.S. The reason for hyperacidity caused by CF. Those CFers who like me, have sweaty hands, a CF classic, make for lousy criminals because our fingerprints will literally etch into metal. Definitely my HCL concentrated sweat removes the bluing on gunmetal, leaving a permanent finger print wherever it's touched. That sweat chloride test for CF is a hint, in effect the test measures the concentration of chlorine in our sweat. Defective mucus cells are lining the gut of CF patients that produces way too much chloride, 2 chlorine atoms looking for a better match, and the stomach has special cells that provide that matches with protons. Protons in this case is a little bit of chemical terminology. Hydrogen like chlorine, hates to be alone and being our smallest and simplest element, a single hydrogen is called a proton.
The strength of stomach acid depends on how much hydrogen and chlorine bind, the more, the stronger. A non CFer doesn't have an excess of chloride ions as we do. This is why gastritis and GERD are so common in CF. PPI's reduce the availability of hydrogen protons. Bummer.
I'd be interested in understanding why the shift from a PPI, Proton Pump Inhibitor, to Zantac. Generally speaking if you need a PPI you're going to need the augmented use of something like Zantac. The only good reason for suspending its use, aside from not needing it, is the long term use. My doctor(s) rarely have said that in ten years or so I will have some bone loss the use of one drug or another, PPI's especially.
Anytime I hear heartburn and CF in the same sentence I start to think about everything that feels like heartburn, but isn't. Got your gallbladder? People describe it, including me, as an exquisite case of heartburn, hiccups or a burp/belch caught in the high stomach. A pancreatic attack is similar but called epigastric pain. Both exceed the notion of heartburn in terms of distress.
Heartburn begins as hyperacidity, usually treated with a PPI or antacid if it's occasional. When stomach acid is churning on nothing, eventually it erodes the protective mucus layer and being stomach acid, it burns the lining of the stomach. The actual burning of the stomach lining is very much like a sunburn. In fact many CFers, especially when the entire gut is tender, it's been compared to a sunburn of the viscera, that won't go away. Stomach acid on food does produce hydrochloric acid gas. As a child out of his depth playing with my chemistry set, amply supplied with a stock of powerful and dangerous reagents courtesy of the local drug store, with my father's permission, I encountered a gas from a strong acid. Called fuming nitric acid, when I got it home I decided to smell the fumes.
A dilute acid is used to cauterize a stubborn blood vessel in a nosebleed. What I drew a breath of instantly eroded my nasal mucosa and I had the nosebleed of my lifetime. Lessons learned that day have been worth the mistake, I had an instant understanding the strength of laboratory grade chemicals. My point for anyone who doesn't respect the potential strength of stomach acid, hasn't gotten a nosebleed from vomiting. Heartburn is an already burned stomach lining, exposed to stomach acid and the fumes. Don't suffer long if this doesn't work. I take an Uber PPI called Dexilant in addition to 2 or more Zantac daily.
Hope that helps,
LL
P.S. The reason for hyperacidity caused by CF. Those CFers who like me, have sweaty hands, a CF classic, make for lousy criminals because our fingerprints will literally etch into metal. Definitely my HCL concentrated sweat removes the bluing on gunmetal, leaving a permanent finger print wherever it's touched. That sweat chloride test for CF is a hint, in effect the test measures the concentration of chlorine in our sweat. Defective mucus cells are lining the gut of CF patients that produces way too much chloride, 2 chlorine atoms looking for a better match, and the stomach has special cells that provide that matches with protons. Protons in this case is a little bit of chemical terminology. Hydrogen like chlorine, hates to be alone and being our smallest and simplest element, a single hydrogen is called a proton.
The strength of stomach acid depends on how much hydrogen and chlorine bind, the more, the stronger. A non CFer doesn't have an excess of chloride ions as we do. This is why gastritis and GERD are so common in CF. PPI's reduce the availability of hydrogen protons. Bummer.
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I'm puzzled too by the change from ppi to zantac
Generally ppis are much more effective, but slower to work. zantac can give quick relief when you have symptoms. I add zantac to ppi when my symptoms are bad.
Reflux has been linked to infections like atypical mycobacteria, so it's important to keep on top of it.
And yes, ppis double the risk of osteoporotic fracture, so watch your dietary calcium, vitamin D levels and weight bearing exercise. All important in CF anyway
Generally ppis are much more effective, but slower to work. zantac can give quick relief when you have symptoms. I add zantac to ppi when my symptoms are bad.
Reflux has been linked to infections like atypical mycobacteria, so it's important to keep on top of it.
And yes, ppis double the risk of osteoporotic fracture, so watch your dietary calcium, vitamin D levels and weight bearing exercise. All important in CF anyway
When we were trying to figure out my acid reflux, my doctors switched around my meds too to see if some made a difference or not. It turns out I needed to have surgery to fix mine. Which has improved everything. Follow up with a GI doctor if you're not already doing so. They might have a different perspective on it.
Sorry about not responding. I had problems with my password and since I was on a cell phone, I couldn't change it. I am now at my work computer and have reset the password so all is good. 
To answer your questions, my GI doctor changed from the PPI to Zantac because she had some research that showed the PPI might lead to alzheimer's. I have been doing the Zantac twice a day and it isn't as long lasting as the PPI, but it still works.
I do have my gallbladder, but am thinking about having it removed because I had blockages a few years ago and they opened up the lining to allow the stones/sludge to move more freely. The downside I had to take Urisodial to help the sludge buildup. But she is recommending I get it removed.
To answer your questions, my GI doctor changed from the PPI to Zantac because she had some research that showed the PPI might lead to alzheimer's. I have been doing the Zantac twice a day and it isn't as long lasting as the PPI, but it still works.
I do have my gallbladder, but am thinking about having it removed because I had blockages a few years ago and they opened up the lining to allow the stones/sludge to move more freely. The downside I had to take Urisodial to help the sludge buildup. But she is recommending I get it removed.