Heartburn when riding/Hiatal Hernia.

[Chuck]

Ok so as the title says I've been having heartburn when I'm riding. I've suffered from it for at least six years and have seen GP's, Cardiologists and a Gastroenterologist in that time. I have been told that my heart is fine (after many tests and a second opinion) and was diagnosed with a hiatal hernia after having an endoscopy. I've been prescribed Somac, which was only somewhat effective, and am currently trialing Nexium, which after a month and a half has had similar results to Somac.

The symptoms are worse when pushing hard or when going uphill but not totally restricted to those occasions. The symptoms only occur when exercising (I've never experienced it at rest and it goes away if I stop or back off) and can be extremely intense. I had convinced myself that it was heart related such was the intensity but as said above I have been given the all clear by health professionals in that regard.

I am continuing to see my GP about this issue (I'll see her again in two weeks to talk about how effective Nexium has been) but in the mean time I thought I'd broach the subject on here and see if anyone here has had something similar and if they found a solution.

I have asked my GP about a possible surgical procedure but she said that is a last option.

Any thoughts or suggestions appreciated.

[foo on patrol]

I have occasional bouts of reflux but has never reared it's head on the bike. Have you tried quickeze whilst riding? Somac works for me with reflux but I only need to take it about once or twice a year now but when I was taking it daily, I would take it before I ate any food in the morning.

Foo

[Chuck]

Yeah Foo I've tried it on my last three or four rides after a mate I ride with suggested it. It didn't really help and I felt like I had an air bubble in my chest.

[PapaJohn]

Chuck,

I have a similar hernia. Gaviscon is the best reliever I've found. I'm on daily nexium.

One thing I've noticed is that amount of reflux is worse if I am gaining weight, or am a little heavy. My reflux is much reduced if my weight is falling or if I have recently lost 5 kg or more of weight.

I can get it if I am going hard on the bike, I'm guessing the heavy breathing causes a general increase in abdominal muscle tone, It goes. away if I slow down. It helps to take a small sip of water.

[bertiowl]

I also have to use Somac and have had reflux all my life....but it apparently is in some weird way tied to exercise related Asthma which feels like heartburn and for years I put it down to that. Speak to your Dr about a blow test, they may get you to monitor lung capacity etc. You symptoms sound very similar so could be worth asking....a specialist actually fixed the problem for me as the GP only got it half right with doses so its worth getting that extra advice. Good luck

[Chuck]

PapaJohn I did actually buy some Gaviscon a couple of weeks ago but have only tried it the once so far and it didn't really help. I will give it another go.


bertiowl that is interesting, I am asthmatic and have done the blow test many times, my lung capacity is quite reduced. I might bring that up with my doctor next time. How did the specialist fix your problem ? Was it the Somac that fixed things up for you ?


Thanks both for your replies.

[ValleyForge]

Nexium is the strongest, and twice a day Nexium is the "gold-standard". Seriously antacids and surface agents (Gavison) are entry level.

Stop any aspirin or NSAIDs (like Voltaren or Nurofen). Stopping smoking if applicable is really important as well. If your BMI is 30 or less, then further weight loss doesn't help. Some people find reducing alcohol consumption helps too.

There is a fairly strong relationship between asthma and reflux. Around 4 out of 5 patients who have anti-reflux surgery have a significant reduction in their asthma severity.

All up, if you are unable to stop PPIs (Nexium, Losec, Somac et al) after 6 months, then statistically you can assume you will need to stay on them for symptom control life-long.

And the operation is brilliant. Although only have it done by a surgeon who does a lot. Australia leads the world in the surgical management of reflux.

[Chuck]

Thanks for the reply VF. I really think that surgery is the only way I'll get complete relief from my symptoms. Can you suggest any surgeons in Sydney who do this type of surgery often ? (South western Sydney would be even better).

[ValleyForge]

PM'd