Heartburn with methotrexate-any ideas please?

dibdab
dibdab Member Posts: 1,498
edited 20. May 2015, 14:51 in Living with Arthritis archive
The rheumy recently upped my meth dose, it's still quite low, but I don't tolerate it too well, lots of nausea and feeling completely wiped out for a couple of days after the injection. I've increased folic acid to 1 every day except injection day on the advise of the hospital, and that had helped with nausea, but since the higher dose I'm really struggling with heartburn. As I sleep badly anyway, being awake most of the night with heartburn is the pits and I'm feeling defeated and weary......but trying not to pile more of my misery on the OH :( . I was just wondering whether anyone had experienced this and found any good self help measures. The GP has given me Gaviscon, but I don't like the thick gloopy texture and it's so sweet.....makes me sound really picky :? , and I already take so much medication I'd love to find a more natural remedy if there is one.

Any advise would be hugely appreciated. Thank you for reading, it helps to know that there are folks who understand the frustrations that go with living with RA.

Thanks

Deb xx

Comments

  • LignumVitae
    LignumVitae Member Posts: 1,972
    edited 30. Nov -1, 00:00
    Oh that sounds truly rubbish. I had that Gaviscon whilst pregnant and for some reason quite enjoyed it then. The thought of the texture or the smell of it now makes me feel ill so I understand your reluctance - although I'd merrily have mugged you for a bottle back then, especially the aniseed.

    I've never been brave enough to try it but a teaspoon of English mustard is supposed to be the bomb to stop heartburn. Maybe worth a try?

    You say you take lots of meds and you are a seasoned arthritic (you have the badge :wink: ) do you use a NSAID? If so are you taking a stomach protector like omeprazole with it? I have used NSAIDs for years but it was only when I restarted drugs after the girls were born that a sharp GP realised I wasn't on omeprazole and got it going. That's despite all those letters between consultant and GP and all those medicine reviews GPs do on long term repeat scripts.
    Hey little fighter, things will get brighter
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    Oh dear dibdab :cry: Much as you dislike it, Gaviscon Advance is the simplest and probably the safest way to deal with heartburn especially at night. You can see how it works just by looking at the spoon after using it. It actually puts a seal on so's the stomach contents have to stay put. Since stomach acid is highly corrosive, and the oesophagus, unlike the stomach itself, has no protective lining, it's not a good idea to have it coming up there. So, really, I'd go with the GP. I dislike the taste and texture too but it does a very good job.

    The other thing I have to do when my stomach is playing up is to ensure I eat and drink nothing for two hours before bedtime. Fatty or spicy foods are bad for heartburn as is coffee. I drink tea by the gallon normally but, when my stomach's bad, I've to switch to water with the occasional Redbush tea (No (or low?) caffeine and tannins). Fizzy drinks are out too.

    If the meth is working I'd be all for modifying the diet, taking the Gaviscon and sticking with it. Do you use a stomach protector? I do, as NSAIDS did for my stomach, and have never had any trouble with oral meth.
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
    Thank you both for the swift reply. LV I too had abysmal heartburn when pregnant with the twins (30 years ago) and glugged gallons of antacid, but somehow it feels much more unpleasant now. I'm not sure I'm brave enough for the mustard!

    SW, I have naproxen and ranitidine, but don't take them all of the time, only when things get really rough. My GP this morning suggested using the ranitidine every day as it might help, so I'll try that, and swallow down the gaviscon whilst trying not to retch :oops: . textures seem to affect me mightily, or maybe I'm just a bit of a baby! I generally have a milky drink at bedtime, but perhaps I'll give it a miss whilst I wait for the heartburn to settle.

    Is it just me or does anyone else fantasise about just not taking any of the meds and seeing what happens, hoping that all the rubbish will magically have healed itself? I know it won't, but right now all the meds are really getting me down and I have to give myself a stern talking to every Friday before meth :(:( . Then I give myself a shake and remember how my poor grandma suffered with RA in the days when aspirin or gold were the only options, and her digestive system was wrecked by it, and her RA just got worse and worse...........bad as it is today, we have a lot to be thankful for I guess.

    Deb x
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    Thirty years ago I think it would just have been the bogstandard gaviscon and, as I recall, a thinner mix. I confess I, too, would lack the heart for LV's mustard suggestion. Maybe if she goes first..... :wink:

    I took ranitidine daily for years before lansop and omep. Again, I'm with your GP. I remember once having a conversation with mine in which I was asking to reduce whichever stomach med I was on at the time. He told me the stomach meds are relatively safe whereas a stomach bleed isn't. I'm naturally cautious about meds. I always try to reduce them once a crisis has passed and I've always believed that pain is at least honest whereas pain relief meds aren't. But some meds just have to be taken. I can't remember ever wondering about stopping the lot. I know what'd happen because it did in my early years before DMARDS. And I didn't like it.

    Is your heartburn mostly after the meth injections? If so I'd keep Friday and maybe Saturday as non-caffeine, non-tannin, non-fatty, non-spicey days and see what happened. And also do as the GP advises re the gaviscon and ranitidine. You know it makes sense :wink:
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • theresak
    theresak Member Posts: 1,998
    edited 30. Nov -1, 00:00
    I take omeprazole as a stomach protector, but occasionally have to resort to Gaviscon.

    I believe it also helps at night if you can raise your pillow, when you have heartburn - not sure I could actually sleep half-sitting up, but I think it`s supposed to help.
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    Just a thought re the 'milky drink at bedtime'. You might get away with just milk but anything such as hot chocolate or cocoa isn't good.

    Fennel and camomile tea are both good for neutralising stomach acid but let them cool a bit. In fact, let everything cool a bit because hot liquids aren't good either.

    How do I know all this? One guess :lol:
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
    Theresa, I often (attempt) to sleep more upright as RA has generously also given me a lung problem, it's fairly rubbish, but I'll give that a go tonight.
    SW, my milky drink is Horlicks, maybe hot milk is a possibility, though I can drink camomile tea so perhaps I'll put it on the shopping list. The heartburn has started since my meth dose increased and has been raging away since Friday fairly constantly....hoping it will settle soon. I usually eat lots of fruit but have cut it out till the acid reduces....really missing a lovely crunchy pear, or a luscious nectarine :?. I think I'll settle for fruit teas at the weekend after the meth injection , don't drink coffee, but am a real tea belly (got it from my dad, he cherished a good cuppa, one of life's little pleasures, especially first thing in the morning) .

    Mostly I just chug along with the RA and it's joys, but sometimes it all feels a bit overwhelming, and it does seem to have a way of eating into life's little pleasures that gets to me occasionally...........these are the times when this site is so valuable, having others who understand because they are walking the same journey.

    Ramble over..............

    Deb x
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    You're quite right about it eating into life's pleasures and it can be these little things that really get us down.

    I don't know if all fruit would be bad or only citrus. In fact I've a feeling apples are actually good for it. I tend to feel bananas and grapes are 'safe' - on no evidence whatever. But raw veg are good too.
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • dreamdaisy
    dreamdaisy Member Posts: 31,558
    edited 30. Nov -1, 00:00
    I live with a man who now, habitually, downs a teaspoon or two of Gaviscon every evening before bed. He is basically healthy but has the eating habits of a street dog. He refuses to alter so more fool him.

    Neither dairy or fruit plays much of a role in my diet - I was severely intolerant to both as a child so they don't feature but now, when my body demands strong cheese or a fresh orange (the latter usually when I have a sore throat) I obey and get away with it. This must be a nightmare for you and I have no ideas about how to remedy matters - we are all so different in what happens to us and how. I have never regarded cow's milk as being good for humans - it's good for calves but they have very different digestive systems to us mere mortals: I think I'm right in saying that it's the lactose which his very hard for us to properly digest. Have you tried alternatives such as sheep or goats' milk, or the soya-based liquids? DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • barbara12
    barbara12 Member Posts: 21,107
    edited 30. Nov -1, 00:00
    Hello debs
    The others have given you lots of advice, I take peppermint capsules they were given to me a few years ago while in hospital..mind you I am not on the meth..hope things improve for you very soon...
    Love
    Barbara
  • Jaclyncollin
    Jaclyncollin Bots Posts: 36
    edited 30. Nov -1, 00:00
    While, I was on meth, I occasionally had these problems. Most of the times, I relied on my favourite home remedy- apple cider vinegar. Few times, when it didn’t work, Gaviscon was the ultimate saviour. Avoid lying down within 3-4 hours after eating; it makes stomach contents press harder against your lower oesophageal sphincter. I read, even fresh ginger helps relieving heartburn but never tried one. Hope you start feeling better soon.
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
    Thank you all for your advice and kind thoughts. I'm happy to report that a combination of ranitidine and gaviscon have calmed things down internally.......though I'm still too wary to attack the fruit bowl :( . So today I plan gaviscon at bedtime only, and ranitidine daily as the GP suggests.

    Friday is meth day again, feeling a bit unsure, but realistically the joints are better, so I'll be gritting my teeth and going for it......hoping for a better weekend.

    Deb xx
  • frogmorton
    frogmorton Member Posts: 26,765
    edited 30. Nov -1, 00:00
    Well done Deb - I am pleased it's settled :)

    I have my fruit in the morning and always avoid bananas at night :? sadly....I love bananas...... :(

    Good luck with the MTX tonight. My youngest, Lucy has hers on Wednesdays too (as chemo therefore no folic acid).

    Love

    Toni xx
    Love

    Toni xxx