Acid reflux

[ThatsSomeBadHatHarry]

It seems as though every time I am under for more then 35-40 minutes, i experience little acidic burps. I'm assuming this happens because of the angle i swim at (fins slightly elevated) while im along the bottom in conjunction with an enlarged or weak hiatus of the diaphragm. I was wondering if this happens to anyone else.

 

[Mr.X]

It seems as though every time I am under for more then 35-40 minutes, i experience little acidic burps. I'm assuming this happens because of the angle i swim at (fins slightly elevated) while im along the bottom in conjunction with an enlarged or weak hiatus of the diaphragm. I was wondering if this happens to anyone else.

Prevacid!!! I hope you aren't drinking coffee, or OJ before hand?

 

[DocVikingo]

Hi Harry,

Given a diver with an "enlarged or weak hiatus of the diaphragm," there are a number of factors that could contribute to "little acidic burps" or gastric reflux. These include the angles at which a diver may fin, e.g., a prone or even occasionally head down position; breathing hyperdry air; swallowing air; out of the ordinary or immoderate eating and drinking while on a dive trip; failure to take routine medications as prescribed; and, a tight-fitting weight belt or wetsuit.

Often changes in scuba practices, lifestyle modifications, dietary restrictions and a variety of pharmacologic agents can significantly ameliorate the condition.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Regards,

DocVikingo

 

[pescador775]

This happens to free divers and scuba divers. It can be dangerous to the scuba diver if the throat tightens up and interupts breathing. The main danger is panic as the effect only lasts for 10-20 seconds. It can be painful but not fatal. Eating breakfast which includes fats can cause this problem. Also, colas and juices. A combination of acidic food, anxiety and exercise are the causes. Too much blood is diverted from the digestive organs including the muscles which control them. If all else fails, drink plenty of Malox and wash down with a little milk (no chocolate milk) before diving.

 

[TSandM]

"Throat tightens up and interrupts breathing" ??

If you aspirate gastric fluid (suck it down your windpipe), it's going to cause violent coughing and possibly laryngospasm, but that would be very rare.

Esophageal spasms (spasm of the tube carrying food to the stomach) are painful, but they don't interrupt breathing. They are a known symptom of reflux.

Fatty foods delay gastric emptying, causing food to remain longer in the stomach and keeping the intragastric pressure high, which certainly can contribute to a tendency to reflux. I do not believe there is any evidence that esophageal reflux is related to diversion of blood supply from the digestive organs.

Milk contains calcium, which is a secretogogue for gastric acid. Maalox or Mylanta are briefly effective at neutralizing the acid present in the stomach at the time of their ingestion, but their effect is brief, and too large a quantity of them can cause diarrhea. In today's world, with significant reflux symptoms, one is almost certainly better off using an H2 blocker like Tagamet or Zantac, or a PPI like Prilosec, which have a much longer duration of effect.

 

[ReefGuy]

I had this problem when I first started diving. I watch what I eat before I dive, and take a zantac a couple of hours before the first dive. No problems since.

 

[ReefGuy]

Double post

 

[pescador775]

Heh, well, milk coats the stomach and sooths it. Calcium can help prevent muscle spasms, and possibly the heart irregularity which may ocassionally accompany it. As long as milk is consumed slowly, it will not throw clots (curdle). However, it is not for all races, Asians, etc. Milk is basic and certainly is not a secreatogogue for acid. Certain calcium supplements such as dolamite may cause this. Acid reflux may not stop breathing on land but the Scuba diver can only breath through the mouth and reflux can stop breathing, particularly when the diver is horizontal and gets a good shot. Yes, it is called a spasm.

Taking those drugs which TSM mentioned, for a transient problem, is a personal decision.

 

[TSandM]

Calcium as a secretogogue for gastric acid:

http://ajpgi.physiology.org/cgi/content/abstract/289/6/G1084


http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=11551141&dopt=Abstract

There is no particular reason why reflux should stop a diver's breathing any more than vomiting does. Both run an aspiration risk.

If you are having symptomatic reflux while diving, chances are you have poor esophageal sphincter function and you may have chronic reflux. This should be evaluated, as chronic reflux can lead to esophageal scarring and increased cancer risk in some patients. Many physicians, however, are electing to treat symptomatic reflux with PPIs without doing endoscopy, and assuming the condition is adequately treated if the symptoms resolve. This may or may not be a valid assumption.

 

[DocVikingo]

Hi Pescador775,

1. You state: "Calcium can help prevent muscle spasms, and possibly the heart irregularity which may ocassionally accompany it."

This is true, but tetany, laryngospasm and arrhythmias would be expected only in a marked hypocalcemic state, a situation which would be very uncommon in a diver eating anything even remotely resembling a balanced diet. Moreover, if you're concerned about risks to the diver from hypocalcemia, how about all of the neuropsychiatric signs and sympotms that can ensue?

2. You state: "Milk is basic and certainly is not a secreatogogue (sic) for acid."

I believe that you actually mean "secretagogue" and thatTSandM has provided adequate science to dismiss your contention. Should the articles she cited prove difficult reading, there are scads of lay articles indicating that the calcium and proteins in milk will soon increase the secretion of stomach acid, e.g., http://www.healthscout.com/ency/68/418/main.html. I can cites dozens more that state milk has long been discredited as beneficial for all but the most transient relief of heartburn.

3. You state: "Certain calcium supplements such as dolamite (sic) may cause this."

I believe that that the correct spelling is "dolomite."

Regards,

DocVikingo