What type of acid reducers are being prescribed after esophagectomy?

I'm also 2 years down the track. I take Omeprazole, acidex (which is like pepcid) and sucrulphate (caraphate).
Sleeping elevated sufficiently is key tho. I also do not eat after 6 pm

@seanski, good question. @suensteve17 your reply reminded me of this discussion that @lori57216 started a little while ago.

- Adjustable bed frames: Acid reflux after esophageal cancer treatment https://connect.mayoclinic.org/discussion/adjustable-bed-frames/

Sean, what has been working for you?

I am taking 40mg of Pantoprazole in the morning and 20mg Pepcid before bed and that works pretty well. I tried cutting down to 20mg of pantoprazole in the morning and the same at bedtime, but that wasn't working. It would be nice to find a lesser dose of something that would work.

I had gastroesophagectomy with the anastamosis in the neck. I sleep flat and am not on any acid reducers. The only time I wake up coughing is when I am on my back in a lazy boy. I'm a side sleeper and don't have any problems flat in a bed. I am told that this is unusual. I guess I caught a break on this topic.

Knowing what you have is key... acid reflux... or bile reflux. Bile reflux is a different animal.

For acid reflux... maybe take a swig of Gaviscon Advance at bedtime. This helps a bunch.

I had a esophogectomy 3 and a half years ago and just started to get acidreflux I have been on omeprazole 20 years 20 mg now I'm on 80 mg and pepcid twice a day just started the higher dose of omeprazole and pepcid I'm worried that my cancer has come back I go Monday for a endoscopy.

I take generic protonix & pepcid twice a day and also cholestyramine, a bile sequestering powder because I continue to have reflux, bile reflux and aspiration, for 4.5 decades prior to cancer and since. I am grateful for any relief from these extremely painful acid secretions that have led to 21 bouts of pneumonia and probably a few hundred episodes of bronchitis, with lung scarring and pulmonary nodules that need to be monitored for cancer. I accept that I will be on medications for the rest of my life. I hate it, but hate and fear cancer and pneumonia more

Hi from Tasmania, I had an esophagectomy 18 months ago and had no problem with reflux for the first 12 months. My surgeon said that proton pumps in the remaining gastric tissue are often shocked into a state of inactivity for a period post surgery. Once started, the reflux problems increased over a 3 or 4 month period and the dose of Esomeprazole required to keep me symptom free increased from 20mg to 40 mg to 60mg. It takes a good week of regular dosing to accurately gauge the efficacy of any given ppi dose and taking it on an empty stomach and refraining from eating for about 60 minutes is important - the potency of any dosed is reduced by the presence of food. I’ve been able to reduce the dose a little by taking (Esomeprazole) 60mg for 2 days followed by 40 mg for 2 days ( it only comes in increments of 20 mg. )
Some people don’t seem to be troubled by reflux post esophagectomy - it’s difficult to understand why that is, given the absence of the lower esophageal sphincter. Some specialists in Australia want to limit the dose of the ppi meds and supplement with a histamine blocker. In Australia there are prescribing restrictions on some ppi’s - it may be to circumvent these restrictions. It’s very important to make sure you don’t have reflux damaging esophageal tissue - also be aware of nutrient deficiency risks associated with long term ppi use (mainly vit B12). All the best for the future. Geoff

My husband uses Zegrid (OTC omeprazole + sodium bicarb) three times daily. 1 before breakfast, 1 before supper and 1 before bedtime. He also sleeps inclined. I am a pharmacist and did a great deal of research and found that Zegrid showed better coverage for the awful nocturnal acid reflux than some of the other PPIs. For a while he also used Gaviscon Advanced liquid (higher amount of alginate available in the UK through Amazon and not to be confused with the lower alginate US version) before bedtime. He is 3.5 years post-esophagectomy and things have greatly improved to the point he very rarely has reflux (was having it several times monthly with aspiration, coughing, hypersalivation, and extreme burning). We also experimented with Voquezna, a newer class drug that blocks acid differently than PPIs and H2 antagonists. It can be used on an as needed basis, does not take a "build-up" time for efficacy, and can be taken with or without food. He still uses this if he has a meal later than normal or something new that we are not sure about. It is difficult to get insurance to pay for, but we have been successful in getting insurance to pay with prior approvals from his oncologist. The manufacture, Phathom, also provides a savings card (just check online). It should also be noted that H2 antagonist (such as Pepcid) are known for rapid tachyphylaxis.... fancy word for tolerance with continued use (some studies showing after a few days).

I am post esophagectomy almost 7 years in June and have been on Pepcid and omeprazole but starting last July I took two omeprazole a day upping it from one -one at 4:15am and one at 7 PM but my recent bone density test showed that I lost 8% of my bone in 2 1/2 years where before I was stable so I'm gonna have to get an infusion of reclast because I exercise 40 minutes in the morning and I walk more than two hours a day and I think the omeprazole is what it is at fault and I take three Pepcid a day also I'm gonna have to talk to my Gastro about what you said that you can build up a tolerance to Pepcid because I think Pepcid might take away bone from me also and if it's not doing me any good maybe I'll have to quit using it Last December 2 years ago, I suffered with eight refluxes and I can't go through that again I have burning for an hour and I use Pepcid 2 cups of throat coat tea, and Tums and it's very frightening and very painful. I had one episode about a week ago. That was the first since last July. I'm also gonna ask him about Voquenza but I never deviate from my diet which is mostly vegan and I stop eating at 4:45 at night and go to sleep at nine or 930