When one has fibromyalgia, what's the usual cause of reflux? Is it low acid, high acid or normal acid but faulty digestive enzyme? Thanks.
All the above, as well as Candida and the autonomic dysfunction. If at night time: Acid reflux — also called heartburn or GERD (gastrointestinal reflux disease) — is an incredibly common problem in patients with CFS/FM — and in everybody else, with an estimated 30 million Americans having regular bouts. What's happening? The food-dissolving hydrochloric acid of the stomach refluxes" up through the esophageal sphincter into the esophagus and throat, where it doesn't belong. That means you're even more at risk for acid reflux when you're sleeping and when gravity can't keep the acid in the stomach where it belongs. During sleep, you inhale the acid, break into a sweat, and wake up wide awake — not even realizing you've had reflux! A simple test? For 1-2 nights take an acid blocker at bedtime (e.g., Zantac or Prilosec) to see if it helps. Don’t use these long term though, as they get toxic and worsen the problem. You’re just using them 1-2 nights to see if you sleep better. If they do, stop them and then follow these few simple actions to help keep nighttime heartburn under control: * Make gravity your friend again. Many experts suggest you do that by elevating the head of the bed by 6 inches using strips of lumber, bricks or other clunky devices. I think that's difficult, unnecessary, and looks funky. Instead, buy yourself a sleep wedge pillow, which raises your body from the waist up and works well to keep acid in your stomach (you can see an example of one at Hammacher Schlemmer. * Take bicarbonate of soda at bedtime. I think acid-blocking drugs are usually unnecessary (because your body needs stomach acid) and dangerous (because they can increase the risk of infections, fractures, infections and even heart attacks). But neutralizing acid at nighttime, when you don't need it to digest food, is a good idea. And you can do it simply and inexpensively. Just dissolve 1/2 teaspoon of alkalinizing bicarbonate of soda (like Arm and Hammer) in 4 ounces of water and drink it at bedtime. (Note: This remedy should not be given to children under 16 years old.) * Take 5 to 6 mg of melatonin at bedtime. Studies show that regular use of this sleep-regulating hormone at this higher dosage can help reduce nighttime acid reflux. * Don't eat two hours before bedtime. You want to give food a chance to digest and move out of your stomach before you start to sleep, thereby cutting down on nighttime acid reflux. Hope this helps. L&B, Dr. T