I've had similair GI problems for the past year (GERD/acid reflux not a HH) so I know what you're going through =(

As far as biking goes I try to drink 4-5 oz every 15 mins and wait several minutes after drinking before getting into the aero position. But to be honest it keeps me from riding aero a lot of the time. Being aero is great and all but the nausia/headaches and who knows what else isn't going right are a bigger negative than sitting up if you ask me. I have the opposite approach on the run I try to take sips fairly often to keep things down.

I've also noticed eating certain types of foods in the hours before working out makes a difference. I've been eating bananas, yogurt... gels and liquid calories mostly pre workout and that seems to help.

Nexium has worked fairly well for me during exercise as well. I had stronger symptons during training with the other similair medications (aciphex,prylosec and 1 I'm forgetting).

Good luck!

Thanks for your thoughts. Hopefully the Nexium will work. I may try to raise my aerobars (gasp!) to bring my position up a bit and see if that has any effect. I'll try drinking more often on the run as well.

I have had a few athletes with this over the years. Take the ppi, but also supplement with an H2 should you experience problems while on the bike, you can still ride an aggressive position.

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

Brian, what's an H2?

E.

rolaids, tums, one of the otc anacids/hb meds. You can take them with you on the bike and pop them as needed. Try in training first of course. You should also take your ppi 20 min prior to your first meal of the day, or prior to exercise if that is where you have the most problems.

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

Thanks for the info. I like Tums, they're yummy. I gave them up a few years ago when I had to switch to the more heavy duty HB stuff. I try them in combo with the Nexium though.

Getting the scope was interesting, I don't remember a stinkin' thing. I guess the dr. showed me pictures of my esophogus, they wheeled me out to the car etc, I was awake and moving, but don't remember any of it. Freaky.

Drugs = fun!

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

Oh yes, better living through pharmaceuticals should be my tag line :-)

My wife had problems with regurg/acid reflux a number of years ago. When she switched from a high carb diet to a lower carb/higher protein diet, it went away. When she slipped back to high carbs, it came back. Coincidence? I think not!

How can one justify a low carb diet when training for long course races?

I have found that Asian food agrees with me most, everything else causes problems.

I've been using that line for over five years. It's our professions motto!

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

Use the power of Beta Oxidation.

Several issues here. First of all, Nexium does not specifically treat a hiatal hernia. This is simply a condition where the stomach is partially in the chest. It may be associated with acid reflux which is what the Nexium is treating. All PPI's will reduce the acid. They will not change the reflux but it is less irritating to reflux non acidic contents of the stomach than to reflux stomach acid. For that reason, no amount of medication designed to reduce acid will stop you from regurgitating in the aero position.

H2 is a designated histamine 2 receptor antagonist and includes cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). Rolaids and Tums are anacids which work by neutralzing acid rather than slowing production.

Sadly, swimming, bike riding, especially in the aero position, and weight lifting are the exercises most associated with reflux. Foods that exacerbate this include all tomato products, chocolate, peppermint, spearmint all by directly decreasing the pressure at the end of the esophagus. Other foods, especially fatty foods and protein will slow the stomach emptying which leaves the food and fluid around to be refluxed again and again.

Eating smaller amounts and avoiding exercise and lying down within 1-2 hours of eating will reduce reflux. As far as long course and refueling, liquids are refluxed more easily but also empty faster. There is a medication called Reglan or metoprolol which will help the stomach empty faster and this is used when reflux cannot be controlled with acid reduction alone. Reducing your weight to ideal body weight is helpful--even a loss of as little as five pounds may significantly decrease reflux. If you can remember weighing less and having fewer or no symptoms, then it is worthwhile trying to achieve that weight again. Unfortunately, some people are rail thin and still have significant reflux.

Hope this answers some of your questions.

   

A seldom-noted side effect of PPI drugs is they can suppress absorption of some nutrients, including B vitamins and iron. This is more likely to cause issues with athletes than others. I took aciphex and then prilosec for a number of years and then discovered that I had some (mild) anemia problems. This can be a real performance killer.

Just make sure if you take this stuff, you get your ferritin and folate levels checked periodically.



- jens

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My latest book: "Out of the Melting Pot, Into the Fire" is on sale on Amazon and at other online and local booksellers

Hi QR Girl -

I'm glad you wrote in because I've battled this for several years myself. I was getting to the point that I was regurging on the bike so much (in an aero position) that I could keep anything down. I also have a HH and I'm taking PPIs and it has helped. As another mentioned smaller sips (but more frequently) and experimentation in food types all have helped. PM me if you want to talk more about it via phone.

David

Has anyone had the surgery to fix a HH?

My GI has recommended Nexium for two weeks then to wean myself off of it and see what happens. (This is according to my BF, I was totally out of it, post scope, when given the advice.)

I don't see why the heartburn/reflux wouldn't come back as I'm not fixing the source of the problem.

QRgirl

I just had the same test a couple of weeks ago. I think the biggest thing you need to worry about is berrets (sp?). The acid in the esophagus can cause long term damage and potentially lead to cancer. I am on the same meds and have to be retested after a couple of weeks. Stay away from the crappy food and the booze.

Been battling GERD for a couple years now (confirmed with a barium swallow/x-ray). At some point I am going to have the surgery, mainly because of the potential for throat cancer in chronic cases. Anyway, here are some tips.

The best tip I have for training is to chew gum. This keeps you swallowing constantly which will force any reflux back into your stomach. In addition, the saliva is an acid-reducer.

Also drink more often, and smaller. For swimming, I chew a couple tums/rolaids 1/2 hour before I swim and I try to swim on a semi-empty stomach.

Some general tips, not related to racing/training.

Avoid alchohol, caffine, and eating late. Wine is real bad. I have cut back to just one cup of coffee in the morning (from a pot a day), and also I try to eat 3-4 hours before bed time.

If, however, you end up drinking some wine, or eating late, or both, (I am guilty), make sure and chew 2-4 Gaviscon before going to bed. Gaviscon is an antacid, but it also has a foaming agent. What this will do is create a layer of foam in your stomach that floats on top of the fluid and acts as a barrier between your stomach and your esophagus. This (along with prevacid) has been the best thing I have done.

Another thing is to get a foam wedge which will raise your head and upper body while you sleep, allowing gravity to help keep the acid out of your stomach. Using pillows and raising only your head doesn't help.

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Jago
"Slow... but mellow"

Resurrecting this old thread...

I have been through a lot of testing this year including endoscopy, esophagram with barium swallow, and manometry testing to learn that I have a hiatal hernia and difficulty swallowing with food getting stuck. I have no evidence of GERD or acid reflux and had no positive response to the multiple anti-acid medications. Currently, the clinical diagnosis is Achalasia Type 3 which my GI believes is being caused by the hiatal hernia. I have seen only two posts that folks have asked if anyone has had a hiatal hernia repaired and returned to training and racing, there was very little or no response. This string had the highest responses but it was mostly focused on acid reflux.

I am preparing to go in for another endoscopy to measure the size of the hernia and potentially inject Botox in my esophagus to see if it will help my lower sphincter to release more easily. Anyone have experience with the Botox injections and/or hiatal hernia repair (which appears to have multiple options)? What was the recovery time period and/or long term impacts? My understanding is that one side effect is a high risk of developing reflux or GERD post surgery.