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Crohn's Disease Forum » General IBD Discussion » Choking on stomach fluid at night


08-20-2013, 07:16 AM   #1
Ribo
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Choking on stomach fluid at night

Not sure if this is where to post this, but I've recently been having a problem and not sure if its common or not.

At night, if I lay down, I'll awaken maybe two to four times a week choking on stomach fluid / bile. Almost like I vomited just a little bit. I then spend as much as a couple of hours coughing and choking, trying to clear the burning and taste from my throat.

I've gotten to the point where I feel like I need to try to sleep sitting up to avoid the situation. I'm guessing its GERD related. Generally happens if I have any severe bloating when I'm going to bed.

I often have obstructions and suspected 'partial' obstructions that generally I deal with and clear on their own in time, so I wonder if the severe bloat, when it happens, is just another incident of this and as things don't flow down through the bowel, they slowly flow back up thru the esophagus when I'm fully at rest.

Does that make any sense at all, has anyone else had this? It's a little scary as I'm concerned about aspirating something and causing yet more problems.
08-20-2013, 07:20 AM   #2
lisakuney
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Usually, docs recommend elevating the head of your bed a few inches (can put a brick under each leg of the top half).

Have you asked your doc about an acid blocker, like Prilosec or something?

I get the same thing, I call it "backwash". Blergh.
08-20-2013, 07:26 AM   #3
Ribo
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Usually, docs recommend elevating the head of your bed a few inches (can put a brick under each leg of the top half).

Have you asked your doc about an acid blocker, like Prilosec or something?

I get the same thing, I call it "backwash". Blergh.
I'm on protonix, twice per day, for the GERD. Been on it a while. This really only started a few weeks ago, since my last hospital stay with an obstruction.
08-20-2013, 08:49 AM   #4
DJW
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I get that once or twice per year. Freaked me out the first time.
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08-20-2013, 10:46 AM   #5
rob101
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Have you tried chewing fennel seeds after eating ! I found it would help.
08-20-2013, 06:17 PM   #6
shamrock15
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There is a valve at the top of your stomach, and it is possible that there has been some damage to it. Have you had an endoscopy to see if your stomach/esophagus are o.k.? Make sure your GI knows about this. Another possibility in the meantime is to lie on your right side to encourage emptying of your stomach into the small intestines.
08-21-2013, 02:43 AM   #7
nogutsnoglory
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Have you discussed this with the doctor prescribing the protonix? It sounds like its not doing its job. I agree with elevating your head, they sell triangular blocks at some surgical supply stores to position your head. I'd also stop having food or drink a few hours before bedtime.
08-21-2013, 01:18 PM   #8
UnXmas
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Yes I've had this. It wakes me up at night sometimes. My reflux and heartburn seems to get worse throughout the day, sometimes making it impossible to eat much in the evening.

Supposedly, along with medications, it helps to avoid eating anything for a few hours before you go to bed, sleep with at least two pillows to keep your head raised, and try drinking a glass of milk when it gets bad.
08-21-2013, 04:32 PM   #9
Cat-a-Tonic
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I have severe GERD, and I've found that many of the GERD medications slowly lose effectiveness for me over time, but that I can revisit them later and they work okay again. You mentioned being on the same med for awhile, so I'd say it's probably time to revisit what dosage you're on and if a med switch might be necessary. For me, I went from Zantac, to Prilosec, to a double dose of Prilosec, to Nexium, to now I'm on a combo of Nexium, quadruple dose of Zantac, and Tums (the Tums are on an as-needed basis). My current combo is working well for the most part, but I know I may have to shuffle things around again at some point.

The key is to keep on top of it. Before I added the Zantac to my current cocktail of GERD meds, I was waking up with sore throats almost every day. Apparently the refluxate was coming up my throat while I was sleeping, but it wasn't waking me like how you described. On my current mix of meds, I very rarely wake with a sore throat anymore. Zantac didn't do much for me on its own, but a stronger dose of it and combined with my other meds, it is clearly helping. It'll take some trial and error, but it certainly sounds to me like it's time for you to try something new for the GERD, as waking that often with that severity of symptoms is not good.
08-22-2013, 02:20 AM   #10
Ribo
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Thanks all. Very helpful stuff, and nice to know I'm not alone here.

Cat, especially appreciate this advice, I'll have a conversation with my GI along these lines when I see him next week.
08-22-2013, 09:30 AM   #11
Cat-a-Tonic
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Glad I could help, Ribo! One more thing I should have mentioned - there is a test to measure the severity of your GERD, which might help you make more informed decisions about your medications. I had the test done last year, it's called the "pH impedance test" I believe. Basically, they stick an NG tube in you for 24 hours and measure how many times you reflux, how high in your throat the refluxate goes, how acidic it is, how you respond to reflux triggers (they tell you to eat reflux trigger foods during the test), how well you respond to your reflux meds (I was instructed to take all my meds as normal), etc. It was very informative for me. I knew I had GERD but I didn't realize it was so severe. They give you a score - anywhere from 0 to 100% above normal. Obviously 0% would be normal, no GERD, and 100% is like the worst GERD possible. I scored a 95% above normal! So obviously very bad. According to my results, I had 48 separate incidents of reflux in 24 hours, with the longest single episode lasting over 5 hours, and about half of the episodes reaching the top of my throat. And it seems I reflux more often than not when I'm lying down/sleeping. I knew it was bad, but didn't really realize it was quite that bad, so that was eye-opening and caused me to pay more attention to my GERD and be more proactive about treating it. It wasn't very pleasant to have an NG tube in for 24 hours and to have to eat with a tube in my throat, but I feel like it was worth it to know exactly how bad my GERD is. Just a thought for you, something to consider.
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