Imuran Causing GERD or other digestive problems?

[Jesse88]

Hi everyone.  I'd like to know if any of you who take Imuran have been diagnosed with GERD and if Imuran has been determined to be the cause.  I've been on it for two years and I immediately had stomach problems, but Activia yogurt helped for about one year.  Then I had to go to prescription Priolsec once a day and now I'm having to move up to twice a day.  I hate where this is going and I wonder if switching to another drug (like back to the MTX injections) might be easier on my stomach, but the Imuran works well for me so I don't want to stop it if it's really not the underlying cause of my digestive problems.  Anyone on Imuran have similar issues?  Thanks for your input and help.

[Joe S.]

Jesse88, Gerd or Acid Reflux seems to be common with AI diseases. I do not know that the disease does that or that the medications do. I just know that most of us happen to have problems with this.

[Jesse88]

Thanks for your response Joe.  I have read that GI problems are common with SS but since my started with the Imuran, I'm wondering if there's a connection.  I guess I'm HOPING there's a connection so I can stop taking yet more medication with no end in sight.

[irish]

Jesse, If it was me I would leave well enough alone. YOu could stop all the drugs and then find out that you can't get along without any of them. Going through all the tapering off/quitting and then getting sicker and then having to go back on both of the medications is just too much stress.

Chances are that you were going to get the GERD anyway and it just happened to coincide. We all have a few of these type of instances when we "think" a symptom is related to a med only to find out it is just another blessing that comes with the autoimune disease.  I would bet that about 75% of the people on this board are on a med for GERD. If they aren't they are going to be in the future. Goes with the territory. Good luck. Irish

[BonusMom]

I started Imuran seven weeks ago, but have had GERD before I was aware that I had AI issues.  In fact, that was one of the symptoms of the AI issues, I just didn't know it.

[Epson]

I have to agree with Joe and Irish, I think GERD is common in folks with Sjogren's and I have to watch what I eat and to not eat too late in the day.  I have spent many nights sleeping in a position where my head or upper torso is elevated to keep the acid down where it belongs.

[Jesse88]

Thank you all for your responses.  I'm hoping to be able to stop the GERD medication by switching from Imuran to something else like MTX injections.  I know it would be a very bad move to stop the Imuran unless I replaced it with something else.  But since all this started with the Imuran, I keep thinking it may be the cause.   The fact that so many people with SS have it, (I didn't know that) as well as others without AI issues makes the whole question so muddled.  Like everything else AI related, I guess there is not going to be any clear-cut answer.  :-(

[irish]

I had the GERD for about 20 years before I was diagnosed with Sjogrens. It always came when I had an infection and my "asthma" got bad. A doc told me that I was having reflux from the stress of the asthma.

Weellll, Now that I am all diagnosed I now know it was from the sjogrens plus the myasthenia gravis. I was having symptoms of both disease and no one ever questioned things.

Jesse,  Going from Imuran to Methotrexate may not even be an option. They work in different ways and metho might not work for you. If the Imuran is working I would not change a thing. There does come a time when we all just have to throw caution to the wind and learn to take all these darn meds that we need to exist in our autoimmune world. Not the way we wanted our life to be, but we could be 6 feet under or worse yet paralyzed, etc. We still have things to be thankful for.Irish

[BonusMom]

I've not noticed any changes/improvement in my symptoms since decresing the Plaquenil from 600 mg to 400 mg and starting 100 mg of Imuran, with the exception of an increasing amount of general achiness.

Does Imuran take a while to start working?

[Jesse88]

Hi Irish, thanks for your post.  Before Imuran I was on MTX pills, later injections, which worked well, but I switched to Imuran because I was hoping it wouldn't give me the same skin problems I was getting from the MTX.  I still have those problems with the Imuran as well.  My rheumy does feel that Imuran is a better drug for me than MTX, which is why I'm trying to do my research and weigh my options before asking for a change.  He did mention Cellcept as the next step, but that is also in pill form and can be hard on the stomach.  I'm going to have to think long and hard before making a decision about this.  I know I may end up just having to continue with the Prilosec, but the possible side effects from long-term use really worry me.  If I can get rid of at least one medication, I'll feel better about dealing with the long-term issues of my other meds.  I have to consider all the options. 

[tomsmom]

Jesse88,
I tried a few stomach meds to help the GERD.  For me, it wasn't the meds causing it, but the autoimmune stuff.  Protonix has been the best of the stomach medications.  I only have to take it in the morning and I don't have any more GERD issues. 
Hope this helps.

[Jesse88]

Hi tomsmom, thanks for your reply.  So I can count you as another whose GERD is the result of the autoimmune issues, and not the meds.  Good to know.

[irish]

Jesse, I don't know if you ever heard the "story" behind the GERD in sjogrens patients. We get the GERD because of the lack of saliva. When we don't have enough saliva or normal saliva our body is not able to dilute the hydrochloride which is secreted in the stomach. That and some other acids which help in digestion of food.

Thus lack of saliva leads to strong acid in stomach literally trying to eat a hole in our stomach lining. I realize that there are some side effects from the meds, but at the same time the agony of living with humongous heartburn is not even an option for me anymore.

I have been on many different meds and have found the prilosec to work the best. I take 2 of them at bedtime. I also find that when I have breakthrough GERD it helps to take a tsp or so of Mylanta. This helps coat the lining of my stomach. There is another med that works well for heartburn. It is called Carafate and I can't remember the generic right this moment.

This med is mixed with a little water and taken as a slurry. Fancy word for smushed up dissolved pill in water! The pill is large and dissolves in the water. Take it a 1/2 hour or so before you eat and it really does help the heartburn. However, it doesn't mix well with other medications. Prevents the absorption of meds.

I also took the Protonix and I thought I would die. I didn't realize at first what was making me feel so terrible. Ended up that this med had dried up so much acid in my stomach that I was having trouble digesting food and moving it through my intestine. It was a terrible feeling.

So,, we all have to do what we think is right for us. HOpefully we get lots of help from friends and medical people along the way so we can make an informed decision. Irish

[Jesse88]

Hi Irish,

I've read about the association between GERD and SS and I know many people with no AI issues also get it.  I'm fortunate in that I have minimal problems with dry mouth, although it has happened a few times and when tested, I did well on one test and failed the "spit" test miserably.  I don't have to use Biotene, though I keep it on hand because I did have those few dry mouth days.  But I noticed something about Biotene (and maybe this is just me) but there seemed to be a rebound effect.  After the Biotene wore off, my mouth was even drier than before.  I know rebound can also happen with GERD meds, and sensitivity toothpastes, (according to my dentist) so this doesn't suprise me.  Oops, I'm getting off the subject!  Sorry.  It's very possible this is SS related.  The only reason I suspect the Imuran is because my stomach problems started the very day I started Imuran and got worse from there.  Right now I'm sipping apple cider vinegar and water throughout the day, a tried and true natural remedy for GERD, and it seems to be helping.  I don't know if it will be enough to eliminate 20 mg. of Prilosec, but so far I've been able to cut back on the second dose and stay at 20 mg.  That's a good start, but I'm keeping notes on the suggestions you made as well.  I appreciate all the information and comments I'm recieving on this subject.  We really can learn so much from each other. 

[BonusMom]

It's because of this forum that I FINALLY understood why I had been so ill with gastroparesis and then finally diagnosed with Sjogrens and Lupus.  It's explanations like Irish's that although so seemingly simple, I could wrap my pea size brain around it and make sense of it  Definitely my AHA moment!

Having never had a lick of GERD prior to all of this, even with any of my three pregnancies,I couldn't figure out why now?  So thank you Irish for your simple, yet thorough, explanations for us brain fog patients.