Dr. Eisner answers your GERD questions: Best time to take Aciphex?
When is the best time to take my Aciphex?
Typically, the best time to take Aciphex and other proton pump inhibitors for gastroesophageal reflux disease are best taken in the morning. By doing so, acid suppression for 24 hours is commonly achieved. While most patients only need once a day therapy, some patients will need a second dose, usually before dinner. First generation proton pump inhibitors such as Prilosec, Prevacid and Nexium are best taken 30 minutes before breakfast. Aciphex and Protonix, can be taken with breakfast with similar effects on acid suppression. You should check with your doctor to see when the best time for you to take your Aciphex would be.
I have suffered from sinusitis for a long time. I also have been told by my dentist that my teeth are very bad, with lots of plaque. Can it be related to GERD?
While acid reflux typically causes heartburn, atypical manifestations are known to occur. Cough, asthma and hoarseness have been the most common of these discussed here before. Refluxed gastric acid may come in contact with structures as high as the pharynx, which leads from the mouth and nasal passages to the esophagus. Less than half of patients suspected of ear/nose/throat complications from gastroesophageal reflux disease (GERD) had classic symptoms of heartburn. Reflux of acid into the pharynx likely plays a role in the development of sinusitis in both children and adults. One study showed that patients with gastroesophageal reflux were less likely to get relief from sinus surgery, unless their acid reflux was treated first. While there are different hypothesis' as to the mechanism, it is felt that acid reflux probably does not reach all the way to the sinuses, but induces inflammation of nasal mucous, blocking the sinuses. Many reports have suggested that regurgitated gastric acid damages the teeth. Dental erosions are three to five times more common in patients with gastroesophageal reflux disease compared to the general population.
My baby cries a lot, refuses to eat and can't sleep. I am wondering if this can be GERD?
Crying, refusing to eat and inability to sleep can be a sign of something serious. While gastroesophageal reflux is a possibility, other conditions need to be considered as well. You need to check with your doctor, but if nothing else is found, reflux should be suspected. Initially, babies with symptoms such as yours were thought to have colic. Babies would cry, regurgitate or spit up after eating, and even fail to gain weight. As in adults, babies with gastroesophageal reflux disease can have symptoms of asthma as well as gastrointestinal symptoms. (Find more information about the symptoms of acid reflux in children and infants here)The diagnosis can usually be made by barium studies, in which the baby is given a bottle of barium, and an X-ray is taken, following the barium through the esophagus into the stomach. In babies with gastroesophageal reflux disease, once the barium gets to the stomach, it will progress back up towards the esophagus. Once gastroesophageal reflux is diagnosed, treatment options can be discussed. If the baby is breast-fed, having the mother refrain from caffeine, chocolate and peppermints can help tremendously. Keeping the baby upright after bottles and keeping the head of the crib elevated as well can help. Typically, when babies start eating solid foods, symptoms will improve as well. If symptoms persist, medications that suppress acid, come in liquid form and are safe for infants and children include Zantac and Prevacid.