Nocturnal acid breakthrough

[Anonymous]

I know that many of our refluxers have problems with breakthrough acid at night. I just read such an interesting study about breakthrough acid. To summarize, the authors say found that timing of the period of breakthrough acid was related to the timing of the last meds. For patients who took their PPIs once in the morning, the breakthrough acid period was around 10pm, for patients who took their last dose of PPI before bed, the timing of the breakthrough period was between 1-4 am! Of couse this is adult data not pediatric, but I found it so interesting because so many of our refluxers have early morning wakeup issues from discomfort. They suggest using an H2 blocker for these times.

Anyhow, here’s the link. You can read it yourself.

http://www.medscape.com/viewarticle/490723_print

[Anonymous]

OK – this is pretty interesting. Thanks Lori – I know that Matthew’s sleep got better once he stopped throwing up but as i said earlier (i think i discussed this with you about the meds?), i thought that it coincided with the timing of the meds – when i used to give the prevacid before bedtime, i had to deal with 4am wake-up all of the time. Now,we just give it before breakfast and his sleep is so much better, usually sleeps until 6am BUT he is restless from around 9pm-11pm and this is the only period when he wakes up and we have to go in and comfort him…. strange, isn’t it?

[Anonymous]

Thais, so you give the whole dose before breakfast? I was thinking of trying that with Aidan…He does the night waking at 2-4 thing and I give him mylanta

[Anonymous]

Yes, we do the whole dose before breakfast. our GI had always said split the dose but the feeding clinic said that their experience is that it works best if given all at once and in the morning (usually because the stomach is totally empty then, given that our last tube feed is at 1.30am) – we did not do it for a while cause we did not believe it but after a while we tried and works well for us.

Good luck… sometimes you have to try different things with these babies

[Author]

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