10 replies to this topic

[MissOcean]

I have a question. When I was in Cozumel, I had really bad heartburn (acid reflux) and it doesn't happen pretty much ever. I am 21 years old, and it was just a strange feeling. I felt like there was something in my throat that I could not burp up. It got really bad when I was under the water! I took Nexium (a fellow diver was nice enough to give me one) and felt a lot better. It happened again at Dutch Springs again. I'm not sure why. Could it be what I am eating before going in?

[DandyDon]

It wouldn't be a bad idea to consult your physician and/or call the DAN non-emergency line -if you don't have a membership card with the number, I'll give it to ya, and we'll talk.

I think this is kinda common, tho. Lots of newbies have a challenge getting themselves to swim horizontally in the water, but if you do manage that okay - or even head down somewhat looking at things, then your tummy, throat and all are at an unaccustomed position. I've had a hiatal hernia for years, so I get it a lot. As a prophylactic measure, I pop 2 Gaviscon before the first dive, more as indicated for other dives.

Edited by DandyDon, 02 July 2007 - 08:16 PM.

[ScubaDadMiami]

Significant Gastro Esphogeal Reflux Disease used to be considered a contraindication to diving. See, Bove and Davis, Diving Medicine, 2d ed. (W. B. Saunders Company, Philadelphia 1990). However, this might be outdated information. (So many people have been diagnosed with this disease over the recent past that there may be a change in this decision by the medical community especially when controlled adequately with medication.)

You should check with DAN for updated information regarding diving with this condition. DAN can refer you to a physician that is familiar with this condition and its relation to diving. You can then be fully examined and a determination made by a proper expert as to whether you have this (or any other) condition.

The cause: During diving, the abdomen is compressed due to the pressure of the surrounding water environment. In normal subjects, the body compensates for this, preventing reflux. However, where there is a weakened esophageal sphincter, this can allow gastric acid to bypass the sphincter, causing irritation of the passageway leading from the mouth to the stomach, producing gastric reflux. If the diver inverts while experiencing this condition, it will allow even more contents to pass. If severe enough, this can cause aspiration of gastric contents, a serious emergency. This is the reason for this condition being considered a contraindication.

A physician familiar with this condition and its relation to diving should be consulted before continuing with diving. Taking the prescription medication of others is not advised. Seek the advise of an expert.

I am not a diving physician nor am I trained or an expert in any kind of medicine. I am just reporting to you what I have read in the literature. You should follow the advise of a physician with knowledge of your specific condition after a proper examination.

[DandyDon]

Very good post, SDM - good, prudent advice. Inhaling gastric fluids can be dangerous. Always remember than you can breathe that puke out thru your reg, keep the reg in your mouth and the fluids out of your lungs.

Hehe, I think that hiatal hernias have become so common among typical USAmericans with our typical high adipose ratios that the contradiction had to be made more reasonable.

BTW, Gaviscon is OTC, even tho it would be good to consult a doc, nonetheless. It was recommended to me by a Trauma physician who is also very DIR into diving, also endorsed by my pharmacist as better than Tums or Rolaids, and most likely couldn't hurt to include on a pre-dive routine.

Edited by DandyDon, 02 July 2007 - 08:51 PM.

[Scubatooth]

Howard

I had a post i was working on and you stole my thunder; do you have a family member thats a GI Doc?

Angela - send a email or call the DAN question line during normal biz hours (9-5) and the medics will answer your question as they have the most upto date info from the latest studies.

Personally for me I have some problems with reflux, because of my crohns, and take antacids from time to time when it gets bad, and nexium is the one of choice by my doctor. As for diving and nexium i have not taken it and dove yet so that would be a question for the medics at DAN to answer.

FWIW

Tooth

[MissOcean]

Thank you for all the great advice! I will def give DAN a call tomorrow! I didn't think it was that serious, but I guess it's important to look into!

[DandyDon]

Here's DAN's response from their FAQ - at least it supports my body position suggestion: http://www.diversale...q.asp?faqid=149

Diving Medicine FAQs
Gastroesophageal Reflux (“Heartburn” or “Waterbrash”)

Q: I suffer from heartburn or reflux. Does this pose a problem for me diving?

A:

“Reflux” is a backward flow of acid or food from the stomach into the esophagus. Symptoms include burning upper abdominal or chest pain, sour taste or food regurgitation, which can happen when divers are in the head-down position. Symptoms can be exacerbated by:

* drinking alcohol;
* smoking;
* an ulcer or hiatal hernia;
* certain medications such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs); or
* a tight-fitting belt or wetsuit.

Physicians treat reflux with medications or through surgery.

While most people may experience occasional mild heartburn, if reflux of gastric contents occurs while one is diving, a diver could be at significant risk. Aspirating food or acid into the lungs or into the regulator could be fatal. Individuals with significant reflux should not dive.

[ScubaDadMiami]

Thanks for the updated information, Don. I pretty much figured it was something like that.

No, Tooth, no family diving docs. However, I have read a lot in the diving medical texts, and I have completed a significant amount of dive medicine training along the way. I was also lucky enough to have some diving doctors as my past instructors.

So, while I certainly would not dispense medical advice, I do find the diving medicine stuff fascinating. Since my life is on the line, I want to know as much as I can for my own selfish benefit and interests.

[Houston Squid]

I have to live everyday of my life with the drug: Omeprazole

I didn't this chronic heartburn/gurd whatever until my mid-30s. Just make sure you get yourself checked to make sure you are not dealing with a gallstone issue or something like that.

It could be all scuba related or something more.

Squid

Thanks for the updated information, Don. I pretty much figured it was something like that.

No, Tooth, no family diving docs. However, I have read a lot in the diving medical texts, and I have completed a significant amount of dive medicine training along the way. I was also lucky enough to have some diving doctors as my past instructors.

So, while I certainly would not dispense medical advice, I do find the diving medicine stuff fascinating. Since my life is on the line, I want to know as much as I can for my own selfish benefit and interests.

[ScubaTex]

While I've suffered from GERD in the past [mostly while sleeping], and was able to eliminate it by weight loss and a change of eating habits [eating very light meals after 6 pm].

But, I too, have experienced slight cases of GERD and indigestion while diving. Usually, it is the result of eating too much before diving, something highly spiced, or eating something which doesn't agree with me. Fruits, especially watermellon and coconut, have an adverse affect upon me. I now make sure I eat light before and/or during the diving day, and stay away from certain foods which cause a problem for me.

Certainly, heed the advice of the others on this board and consult with DAN or your doctor.

Good Luck, Good Diving,
Bill

[Charity6262]

Don't feel bad I have to take 2 40 mg tablets of Nexium, 4 1 gram tablets of sucralfate, and about a bottle of Gaviscon a day to keep the heartburn down enough so I can breath without it hurting. I just turned 21 and almost always it is so bad it hurts up into my sholders but the docs can't find anything wrong ... I think most docs get thier degrees from the backs of there Lucky Charms box ... lol