Finding Reflux Relief When You Have Bladder Cancer

You may know gastroesophageal reflux disease (GERD) by its more commonly known name, heartburn. Also called acid reflux or, simply, reflux, it affects at least 20 percent of the US population alone.¹

Safety concerns around a common medicine for GERD

Unfortunately, one of the most popular medicines previously used to treat GERD was pulled from pharmacy shelves by the FDA last April over safety concerns.²

Ranitidine, sold under the brand-name Zantac, is currently under scrutiny because it may contain certain impurities— specifically NDMA— linked to cancer. This includes bladder cancer.³

Zantac may have been effective in treating GERD, but people with bladder cancer are understandably avoiding it at all costs.

Still, GERD happens. What can you do about this unpleasant problem without taking ranitidine?

Reflux: Chronic condition, side effect, or both?

A case of reflux can happen only once in a while (usually a brief instance with acute discomfort following a heavy meal) or as a chronic condition (happening frequently, especially while trying to sleep).

Some people have reflux only as adults, while others begin to experience it in childhood. It’s typically treated with over-the-counter medications in mild or infrequent cases. For more severe cases, a thoughtful drug approach tailored by a doctor can bring relief.

The two most common over-the-counter medication classes approved to treat GERD include H2 receptor blockers (H2RBs) and proton pump inhibitors (PPIs).

H2RBs

H2RBs generally reduce your stomach acid. This eliminates symptoms and allows the esophagus to heal in about half of those who use these drugs. H2RBs include cimetidine, famotidine, nizatidine, and the now-recalled ranitidine.

PPIs

PPIs work by limiting the amount of acid secreted by the stomach. The esophagus may experience a rapid reduction in symptoms and healing in as many as 90 percent of users. Some common brands include Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole).

The International Foundation for Gastrointestinal Disorders recommends that, because reflux may be chronic for some, the long-term use of medications (both prescription and over the counter) “should be under the direction and supervision of a physician.”⁴

This also includes doctors we seek for separate conditions, such as oncologists. They may prescribe medications for a preexisting heartburn problem.

However, reflux may also occur for the first time in people diagnosed with and receiving treatment for cancer, as heartburn is a well-known, unpleasant side effect of chemotherapy.⁵

What time of the day does GERD occur?

For some people, heartburn can happen at any time, day or night. Others experience reflux only during the night as they sleep. It creeps up while the body’s reclined. Without the pressure of gravity experienced while standing, the contents of the upper part of the stomach may reverse course and re-enter the throat.

When this happens, these contents bring stomach acid with them. All this unpleasantness rises into the throat, often disrupting breathing. It creates that awful burning sensation and acidic bad taste in the back of the mouth that can keep you awake at night.

GERD, cancer, and poor sleep

Treating GERD surely brings relief to anyone. But if you have bladder (or another form of) cancer, it’s more than just about finding some relief.

Reflux can significantly disrupt sleep, leading to daytime fatigue, mood disruptions, and opportunities for cancer to continue to spread.⁶

Meanwhile, several hours of uninterrupted sleep:

• help the body to work to fight active disease in the body
• improve your sense of well being
• give you more daytime energy
• promote the repair and healing of the side effects of chemotherapy and radiation treatment

Self-help solutions to overcome reflux

If GERD keeps you up at night, consider some of these self-help solutions and, if they aren’t cutting it, talk to your doctor about a medication that can safely help you overcome your reflux.

• Change your eating habits. Try to eat at least two hours before you expect to go to bed (even better—three hours). Make sure you eat slowly. Avoid large, heavy meals, which take the digestive system more work and time to process. Know your reflux triggers, as well: some common foods to avoid include fried food, tomato sauce, chocolate, mint, garlic, onions, fatty meats, liquor, carbonated beverages, and red wine.
• Avoid tight clothes. Restricted waistlines place pressure on the abdomen, creating obstruction. Who doesn’t like to slip into pajamas after dinner anyway?
• Elevate the head of your bed. You can pick up 3-inch risers at a box store or use small blocks of wood or books you have around the house. This creates a way to allow gravity to do its work without disrupting your sleep.
• Sit upright after dinner. For the same reason, you need to avoid a horizontal posture after eating to ensure the contents of your stomach will continue to move down and out rather than back up into your throat.
• Sleep on your left side. GERD mostly flares up when you sleep on your back or your right side.