Serious Stomach Side Effects

[2ndchances]

  Hi everyone,
I want to start with my gratefulness for the fact that my boyfriend is three months post treatment and he is undetectable so his doctor said he has cleared the virus! The problem is while he was taking it it was giving him very serious heartburn, they gave him Nexium for a bottle in two days. We thought it would stop, now that he's off he's taking double the Nexium and still has unbelievably serious reflux that makes him throw up. He really is in agony with this he sometimes wonders if it was worth it? He does have an appointment with a gastroenterologist but there's nothing like talking to other people who have been through it. I'd appreciate any comments thanks so much guys I wish everyone well.

[Lynn K]

He should not take more than the daily recommended dose of Nexium unless his doctor has said to do this. More is not better and could complicate his symptoms. Unless his doctor has said to double his Nexium dose discontinue this immediately.

Has he previously been diagnosed with a hiatial hernia or other gastrointestinal problems? This is not really a known side effect of DAA’s

Which medicine did he take?

His gastroenterologist will get this sorted out soon I am sure.

Does he have advanced liver disease like cirrhosis? Liver cirrhosis can be associated with nausea and vomiting.

[Mugwump]

Very unusual reaction, Lynn is spot on with her comment.

He is on the right track seeing a GI specialist. Here on this site very few have reported what could be considered reflux during or after treatment. I would suspect that a full abdominal ultrasound is called for to determine if there are new bile duct issues going on contributing to the situation. Some here have had flare ups of bile duct problems but it has not been a common side effect of any of the DAA treatments.
I have found that cutting back on fats and meats to no more than 6OZ of fatty meats per day helps greatly with my digestion. I have cirrhosis and if anything my bile production has been decreased in relation to the amount of liver damage that I have. So a change in diet has helped me to avoid digestive issues to a great extent both during and after treatment. Before treatment if I ate large amounts of protein per day I paid the price with indigestion and the inevitable bloat that it creates. I am 66 years old so cutting back on fats and heavy proteins in my diet is a good idea regardless.
Like anything else if I do large amounts of work then I can eat a little more fats and proteins but no where near as much as I was eating before I developed cirrhosis and was working hard and exercising heavily.
So my suggestion to him is to moderate his diet somewhat and make sure that reasonable hydration is maintained. If the issues are not at least eased by this measure then at least you can rule out fat and hard to digest proteins as being part of the problem. The digestive system works in a feedback loop to the liver and sometimes things can get seriously out of whack. One can create too much bile and it can take time for the digestive system to get into a balance especially if all of a sudden the liver is working well but the bile system attached to it is not.
All the best to you and your boyfriend.
Eric 

[2ndchances]

Hi Lynn,
Thank you for the response yes his doctor did up his dose  to 80 mg of Nexium 40 mgs 2x's day.
no he doesn't have any cirrhosis, or liver disease, he was always on a low dose of Protonix but his acid reflux is totally under control as soon as he started the m
Mavyret his stomach got out of control. His doctor did say that it was a very strong antiviral and that some people may have a reaction while taking it, but that it shouldn't still be this serious this long after. Yes I'm very concerned that it could be something more serious. It is interesting to know that no one else has it from this so it might as you said be something totally different. I will keep you posted though.

[2ndchances]

Eric,
thank you for your reply. I must say that as I was reading it and you mentioned the bile duct problem I was floored because yes I do vaguely remember them saying there was a bile duct problem. Something that I'm sure wouldn't have been figured out by the GI thank you so much now I have something to look into. And I will pass on your recommendations, he doesn't eat much meat but he does drink a lot of coffee and I think that may also be contributing to the reflux he had no liver issues but he doesn't take the greatest care of his body. Thanks again you guys are absolutely wonderful people all the time and effort you put into that response really showed what kind of person you are. Have a wonderful night.

[Lynn K]

Found these suggestions that may help until he can see a specialist

https://www.healthline.com/health/gerd/nausea#treatment

“Treating acid reflux-induced nausea

You can generally treat acid reflux-induced nausea with a combination of lifestyle changes, home remedies, and medication. Here are some steps you can take:

Lifestyle Changes

Change your eating patterns. Eat smaller meals and reduce your fat intake to curtail indigestion and keep your LES working as it should. Reflux and nausea can occur when your stomach is too empty, so try to eat smaller and more frequent meals.

Stop smoking. Nicotine products can weaken your LES, increasing your symptoms.

Wear loose-fitting clothes. Tight-fitting clothes put additional pressure on your stomach, which can contribute to acid reflux and nausea. Loose-fitting clothes won’t add this pressure.

Stay upright after eating. Keep stomach acids in your stomach by staying in an upright position for two to three hours after eating.

Elevate your head when you sleep. Put 6-inch blocks under the head of your bed to assist gravity in keeping the acid in your stomach.

Home Remedies

Chew gum. Chewing gum can reduce your incidence of acid reflux, according to a study published in the Journal of Dental Research. It can also help eliminate the sour taste in your mouth that can cause nausea.

Harness the power of ginger. The National Center for Complementary and Alternative Medicine suggests checking with your doctor about taking ginger supplements as a natural way to relieve nausea”

[2ndchances]

Lynn,

I knew some of those but some new ones also, thank you. I just read the bottom of your post where it says what you went through with treatment got choked up I can't believe you've been through all that and then on the bottom where you wrote I am free just it was very inspiring just reading that and I'm so glad you're free of it. His doctor said after 3 months of being free of the treatment he would know that he is hcv free is that true? Or will he need to be tested again he told him no. he's been tested twice in three months as undetectable and he just took one more blood tests on Thursday we're awaiting those results now. He started out with his numbers in the four hundred thousands.

[Lynn K]

The majority of doctors believe that if you are not detected at 12 weeks post treatment that means you can be called cured. The odds of relapse after that time is very rare. We do have one person here who may have had a very late relapse after several years. This is just being investigated currently by his doctors no one is sure what is going on in his situation.
But for most the estimate is about 99.8% likely if being hep c free.

The thinking is the most likely way of becoming infected again is with a new infection.

My pretreatment viral load was about 2 million but viral load has little to do with either severity of infection or difficulty of cure.

I was additionally tested at 6 months and one year post because of my treatment history and was still not detected. As long as he does not have elevated liver enzymes it is very unlikely his hep c has returned. Bear in mind if he should want to test for hep c later on he will need to do the HCV RNA test. Those of us who were once infected will always test positive for hep c antibodies.

[lporterrn]

I suspect an unrelated problem - it happens. Sounds like that appointment is the next right thing! Hope it is soon.

[untreated]

I have been having similar problems myself of late-i am 28 weeks post harvoni and had a little melt down last week believing the hep c had returned but it had not. Thank God.
How are his stools? Strange question to ask I know but they would be affected by his bile ducts also. They may be thin too. This may be a sign of ulcerative colitis a very treatable stomach condition.
Now I am no expert but supposedly once cures your immune system is still working in over drive as it had been when infected with hep c. Therefore your immune system can attack the healthy bacteria of your stomach mistakenly leading to issues you describe you boyfriend as having.
It may be something to say to the GI. Anyway, Hope that helps. And best of luck to you

[northfork]

Taking d-Limonene has helped my reflux issues. I had it before treatment and less after clearing the virus, but occasionally it flares. Bananas and any kind of sweet pastry sets it off, and chocolate .

[Mila]

Hello...it has been a while since I visited. Glad to know so many are still recovered. I too have been without HepC for 2 years and mostly feel great.

I wanted to address the stomach side effects 2ndChances brought up.

I had TERRIBLE heartburn when I got off of Harvoni. I had bad stomach issues from day 4 of treatment. My doctor treated the post tx, unending reflux with 1 month on Famotidine. For a week after I stopped taking famotidine, my reflux came back really strongly. I waited it out instead of going back on medication and ate a lot of salads and cruciferous vegetables for several days after and it did not return. I did this because leafy green vegetables are alkaline and balance out the acid in your gut. Try this. At worst you will have eaten some fiber. Do not use the acidic dressings like vinegrettes or any vinegars at first.
 
One you thing you have to know about acid reflux medication is that it stifles the production of stomach acid, so when you go off the medication your body responds to what has not been there. It is fair to say do not begin with the most acidic foods or drinks (i.e. coffee, soda, lemonades, pizza etc.) Start reintroducing the offending foods slowly and you might find that your problem is much less. Coffee is one of the biggest contributors to acid stomach so please reconsider drinking it regularly.

I have been off tx for 2 years with no recurrence (YAY!!) But I have not been left without issue. As a result of the Harvoni I have Celiacs disease. I did not have it before I took Harvoni, but I now know that 4 days in to treatment my stomach changed and has never changed back. What changed it was the elimination of gluten in my diet. I have not read that others have had this response to the Harvoni, but I wanted to address the acid reflux because that is manageable.

Try removing coffee and gluten and see how it goes.

Meanwhile congratulations on your non-infected status!!

~Mila

[Mila]

Here are some recipes for green smoothies I posted a few years ago. These could freally help with the reflux and definitely will help your tummy feel better.
Enjoy!
GREEN JUICES
-----------------
Joyful Liver
2 large carrots
1 medium beet any color with greens
2 Sticks celery
1/2 lemon
1/2 lime
---------------

Cool and Crisp
1/2 cucumber (seedless preferred but not crucial)
1 large stalk celery
1/4-1/2 fennel bulb and greens
1 apple your choice (green apple preferred and has the least amount of sugars)
---------------

The Big Green -- Loads of anti-oxidents and anti-carcinogens
2 stalks celery
1/4 cucumber
1 fist full of parsley (Italian preferred but not crucial)
1 fist full spinach & kale
1 large beet with greens (without greens if too bitter)
--------------

Everything All the Time (for a sweeter version add 1/2 a red or golden apple)
1 large carrot
good sized nub of fresh ginger (to personal taste)
2 beets with greens
1 fist full parsley, spinach & kale
1/2 cucumber
2 stalks celery
4-6 broccoli florets
1-3 cloves garlic


FRUIT BASED JUICES
--------------------
Life in a Basket
2 large carrots
1 red apple
1 red beet (greens removed if you want)
nub of fresh ginger
1 fist full parsley
-----------------

Sour Puss
1 large carrot
1 green apple
1 large beet (greens removed)
1 lemon (peeled tho you can use a zester and add some peel)
1 fist full parsley
2 fist fulls spinach
--------------

Sweet Greens
1 green apple
2 stalks celery
1 handfull spinach & parsley

[andrew j]

Hi Mila,

Here in New Zealand it was commonly believed that avoiding gluten could help alleviate gut issues associated with Hep C.
That was certainly the case for me.
I was really unwell when I had Hep C - and noticed a appreciable improvement when I went g/f.
Now, 2 or so years post, I am still g/f.
I can tolerate a tiny taster of gluten (gluten-intolerant rather than coeliac, I think) - but it has to be good quality gluten (made from wholefoods etc), otherwise I'm in for a number of hours of blurriness.

The same applies to my diet in general.
I became a purist diet-wise when I had Hep C.
It was the primary means I had to manage how I felt ... but I still find I have to be careful with everything I eat.
It's amazing how slowly the body / metabolism adjusts / changes / finds a new normal post-Tx, IMO.

Still - I realise that that's all a bit different from what's happening for you - (changes occurring as a result of Tx).

Hoping that you are doing OK today, and

Best wishes,

A.

[WholeFoods]

I had stomach problems too. Ended up having to go gluten free as well. I didn’t get heartburn, but did get some vomiting and lots of diarrhea. Going gluten free helped a lot. 3 years post and the only thing still really bothering me now is bad anxiety. Recently gave up caffeine for that one and it’s helping. It really is a slow road back to health. Hang in there!

[KimInTheForest]

I had some severe acid reflux for first time ever when I was on Harvoni 3 years ago (which cured me of Hep C). My trial nurse didn't think this was a surprising side effect of Harvoni. It was so bad the first time I didn't know what it was, thought I was having a heart attack, and was preparing to go to ER at midnight... then thought maybe this is heartburn, and I did some things to settle it down. I found I had to watch what I ate while on treatment, not go to bed right after eating, and often raise the head of my bed with lots of pillows. But the problem didn't persist post-treatment. I hope you find some answers for your boyfriend's ongoing GI problems!

kim

[Christina166]

Hello I hawe same alrady 7day feeling wometnig and stomach pain doctor in emergency say it’s maby gastrit but need check my stomach to be sure..how is your boyfriend now..Thit he found out from what it was ?

[strangerbynight]

I had stomach problems too. Ended up having to go gluten free as well. I didn’t get heartburn, but did get some vomiting and lots of diarrhea. Going gluten free helped a lot. 3 years post and the only thing still really bothering me now is bad anxiety. Recently gave up caffeine for that one and it’s helping. It really is a slow road back to health. Hang in there!

If you still suffer from anxiety you should go and test for h. Pylori bacteria, i had crazy anxiety not long after the treatment and it took me many doctors to found out i had h. Pylori, went on 2 weeks of a very very strong 21 pills a day treatment and finally i was cured and anxiety gone right after that, its very common to get that bacteria, i heard its a very well known symtoms to have anxiety if you have h. Pylori positve, atleast that was my case, my anxiety was so high that i thought i was going to get crazy too..just want to share my experiences.