Question:
I am waken every night with acidy vomit in my throat, taking Nexium.

I am 8.5 months po, open distal(150cm.)RNY, transected, have my gall bladder and appendix. I have no other problems, no pains other than this reflux. Started at 302, now 230. The nightly acid reflux has been going on for 2 months. I have not lost any weight in 3 months even though I am following the rules and surgeons eating plan. My entire digestive system seems to be slow and constipation is a major problem due to iron supps. When taking the iron, I have to take senokot too. Been taking Nexium for 2 months, it has lessened the acid part but it's starting to not work very well. 2 nights ago was particularly bad. I woke suddenly, coughing like I had inhaled something toxic. Throat was filled with burning vomit. Very painful and scary. When I throw this stuff up, it's reddish brown liquid, no solids so I know it's not coming from the pouch but farther along in the intestine. Nothing similar happens during the day. No heartburn or pain at all. I have tried changing my meals, foods, gone off vitamins for a week then back on, no eating after 6 pm, plenty of water all my waking hours, more exercise, less exercise, sleeping propped up on 4 pillows. I've tried all that I can think of. I don't need pills, I need to know why digested food is backing up into my throat. I know it's not supposed to be doing that. Has anyone had this at any time postop?? If so what was your diagnosis? I suspect something is wrong with my lower anastamosis(not the pouch one) or my gall bladder or a fissure between the pouch and unused stomach. I will be seeing my surgeon on Monday April 26/04 and I would like to be prepared with any info that may be helpful. According it his secretary, he doesn't have any other GB patients with a similar reflux problem. She has never herd of a fissure between the stomachs. All opinions welcome.    — mary ann T. (posted on April 21, 2004)

April 21, 2004
I had really bad acid reflux also. Things did not turn around until my GI doc gave me liquid Carafate. It is an older ulcer medication, but since it is liquid it seemed to coat the pouch and work better than Nexium or Prevacid. Now that it is healed up, the Prevacid works just fine.
   — Carla B.

April 21, 2004
I have been on prevacid for the past 5 years and it is the best, however, my mail order Rx switched me to nexium, and it hurt my tummy and didnt do a thing for me so they swiched me back to prevacid and no more problems. You might ask your doctor so switch you to prevacid if nexium isnt working for you, dont suffer, ask for something else ASAP, good luck.
   — wizz46

April 21, 2004
Sounds almost more like bile than acid. You're not describing heartburn, but vomit in your words. Have you had a scope AND UGI? A fistula is possible, but rare. Still, acid is usually what is seen, not bile. I think you're aiming at the right target with the lower anas., just from my guessing. I've seen a few cases where the connection was made too close to the pouch and the bile comes down the path and back up and into the pouch, much as a loop gastric bypass works. You do need to pursue it, however, because continued bile into your esophagus can do permanent damage. Chase them down!
   — vitalady

April 23, 2004
I would also check into having a sleep study done. It could be a possibility that you've developed sleep apnea. This could cause a suction like situation that would draw stuff up from your digestive tract to your esophagus. I'm not a doctor, but this is what I had experience prior to wls. Just a suggestion.
   — Renee B.

April 24, 2004
You could try taking the nexium twice a day. My stomach was bothering me with only once a day and I asked the surgeon if he thought twice a day would amke a difference, so we tried it and it did help. With the color of the stuff being red I hope he does and EGD to test for a bleeding ulcer though. Bile would be green.
   — catleth