Amitriptyline and GERD.

[Abbygal]

Hi everyone I have a rather long story and would like some advise or people to just share some of their experiences with me.

In the year 2000, I had a brain tumor removed from my brain stem. Before this I was experiencing awful migraines with lots of vomiting. After the tumor was removed, I still am not free from my migraines. Have been told I will never be free from them. My neurologist put me on amitriptyline in 2001 to help control the migraines and now it is 2008 and I'm still on the medication and experiencing TERRIBLE GERD symptoms.

After researching a great deal, I have come to realize this medication is related. I am now trying to get off the medication (I made the decision myself, after seeing how bad it is) for good but I feel it's too late. I've noticed a lot of people that have been on it, it has affected their LES and they have needed surgery to correct. I have been to my family doctor that could not correct my GERD, no PPI's or anything have been helping with my symptoms. She sent me on to a surgeon who told me the amitriptyline could be a cause of it and that my sphincter is not functioning properly. He has decided to send me on to a specialist.

I go see the specialist this Friday and I was just wondering what could be in store for me. Does anyone think they will suggest a fundoplication and should I follow through with this if they do? I see a lot of people don't agree with the surgery but at this point I really feel I will never be normal in this area. Just for the fact that I have been on the amitriptyline for 7 years and most people are on it no longer than 6 months. And to be honest, I can't live like this. I've suffered MASSIVE heartburn for at least a couple months now, I can't eat anything I really want to without it affecting me. The cramping in my stomach is what is most bothersome. I feel like I have this really huge burp that won't come out and is crushing me to death. They have me on Protonix right now which helps somewhat with the heartburn but as time goes by, I think it's just getting worse. It's just really bad and most people say to not follow through with this surgery as I can see but in my case, does anyone think I SHOULD if that is what is suggested?

Any feedback will be appreciated Thank you!

[HasLPRD]

Amitriptyline is a tricyclic antidepressant and like other
tricyclics they can have severe anticholinergic effects
such as weakening the LES and causing GERD. I was on
Nortriptyline for only a couple weeks and it caused me
extreme reflux problems while I was taking it.

I was under the impression that LES function would return
after stopping the medication (have you heard otherwise?).
You should talk to your doctor about changing medication
to something with less anticholinergic effects. One of the
newer selective serotonin reuptake inhibitors (SSRIs) perhaps?

Please let us know if the doctor thinks the LES effects from
this drug are permanent. I was under the impression that they
shouldn't be.

Mark.

[Abbygal]

I'm sure after stopping the medication this will probably still be with me. I chose to stop taking it even before I knew it was related with the GERD.

I don't know if they are permanent but beings that I've been on it so long, I was assuming the medication has hurt me more than what I think.

I still have no idea why my doctor has kept me on it for so long. I'm going to discuss a new medication if my migraines return.