acid reflux and airlines

[airline mission]

Let's say someone has an acid reflux problem. Let's even say, someone goes thru LOTS of Rolaids, Zantac, whatever, and nothing seems to fix the problem. Let's further say, someone has to seek medical advice/treatment and goes on something like the 'purple pill', or similar medication to control said acid reflux problem. What does this do to a potential airline career if said acid-reflux-plagued person is just reaching the minimums for regional airline, freight, or corporate positions? Is it a temporary setback depending on success of treatment? Or is it an automatic disqualification? Will it keep said pilot from being hired, or even possibly cost the pilot a medical certificate?

If you know the in's and out's of these questions, please respond while I chew on another chalky tablet........

 

[festus]

As long as you can pass the medical-class 1-you should be ok for regional, cargo, and corporate. Many of these companies do not have their own company physical. As for the "purple pill" it may be on the acceptable list of drugs-of course consult a AME. New drugs on the market are not usually acceptable because no one knows any longer or long term effects.

 

[Big Duke Six]

First, if you really are as bad off as you sound, I'm glad you've done it right and gone to a doctor for meds. Beyond being a pain in the @ss (and stomach), that problem is also deadly. It will kill you if left untreated or treated only by OTC medicine.

Second, I've never heard of this condition being disqualifying. I think the ones on the hit list are the medical problems that can leave you incapacitated, i.e. heart or BP problems etc.

I think you should stay on the prescription meds and report it. I don't believe it's a big deal at all. Anyone else?

 

[JRX7]

From AOPA's site:


FAA Recertification Procedure for Gastrointestinal Disorders

[size=+2]T[/size]he FAA allows certification for many common gastrointestinal diagnoses that can be documented as stable and well controlled. Included among this group of disorders are gastric ulcer disease, gastroesophageal reflux disease (GERD), esophagitis, hepatitis, and the inflammatory bowel diseases that include colitis, regional enteritis, irritable bowel syndrome (IBS), and Crohn's disease.


According to the peptic ulcer protocol contained in the FAA's Guide for Aviation Medical Examiners, persons who have had an active ulcer must show at least three months of stability without symptoms. If the ulcer involved bleeding, six months of stability is needed. Evidence of healing must be verified by a report from the treating physician that includes:

1. Confirmation that the applicant is symptom-free.
2. Radiographic or endoscopic evidence that the ulcer is healed.
3. Type, dosage, and frequency of medication used. The use of any medications other than simple antacids and/or sucralfate medications, such as Carafate, for immediate and maintenance therapy of the ulcer may be disqualifying.

A history of bleeding ulcers usually requires interim status reports at six- to 12-month intervals following initial recertification.

Chronic inflammatory bowel diseases including regional enteritis (Crohn's disease), ulcerative colitis, or any diagnosis in this group of diseases, require full medical documentation before a certification decision can be made. If surgery is required, especially for enteritis, three to six months of stabilized recovery is recommended before applying for a medical certificate. Corticosteroids (prednisone), commonly prescribed for acute Crohn's disease, may be approved in dosages not exceeding 20mg. daily.

Gastroesophageal reflux, also known as GERD, is a condition that occurs when the lower esophageal sphincter located between the lower esophagus and the stomach fails to close after swallowing or opens at times when it shouldn't. When this happens, it allows stomach acid to pass into the esophagus and lungs causing a burning sensation ("heartburn") and other symptoms, including chest pains that often mimics angina, the chest pain associated with a possible heart attack.

The cause of the sphincter weakness isn't fully understood. However, certain medications, foods, and medical conditions add to the problem. The treatment for GERD ranges from life-style changes, weight reduction, medication, and, in severe cases, surgery.

The most commonly prescribed medications include Tagamet, Zantac, Pepcid, Axid, Prilosec, Aciphex, and Nexium. The FAA allows all these. At the time of your medical application renewal, you will need a current status letter from your treating physician summarizing the medication history, the dosage, frequency, and absence of side effects. If surgery is necessary, complete hospital records along with a current status report will be necessary.

If you have not previously applied for medical certification, make copies of all records for yourself and provide the completed testing to your aviation medical examiner at the time of your FAA physical examination. If the history requires that the AME defer your application, he/she will send the paperwork for you to the FAA.

If this is a renewal of medical certification and the FAA requires that you submit the records for review before your next FAA physical examination, send the records yourself to the FAA at the address below before visiting the AME. Use express courier service, either overnight or 2-3 day delivery via FedEx, UPS, or Airborne. It will normally take 90-120 days before you receive a response. Each case is evaluated on an individual basis, however, and significantly longer delays can occur, depending on the case history. If any of the required information is left out, it will take longer for the FAA to reach a decision.

When the FAA approves your case, you will receive an authorization letter instructing the AME to issue your certificate if you are found otherwise qualified.

If you need to contact the FAA, use this address and phone number.

Aerospace Medical Certification Division
(AAM-300)
FAA Civil Aerospace Medical Institute
6700 South MacArthur Blvd.
Oklahoma City, OK 73169

Telephone 800/350-5286

4/04

 

[Big Duke Six]

Hey, looky there! Don't I feel stupid! Good post, JRX7. It was an education for me. I also found www.leftseat.com to be very informative. Learn something new every day...

 

[na265]

I havn't read all of the responses, so, I hope I don't repeat anything here. I have acid-reflux. It went for many years undectected. I had a horrible pain in my stomach and sometimes my esophagus. I found a good GI Doc in Houston who sent me for an upper GI two years ago. He found 4 areas that had to be byopsied. Thankfully the results were negative.

I was put on Nexium for a full year. When I went for my 1st class, I took all my reports and lab work to my AME. He looked over my results, asked a few Q's and issued me my medical. One thing in my favor was that my GI Doc knew I was a pilot and got me the meds that were ok with the FAA.

As was said earlier, don't mess around with this problem. I was diagnosed with Barrett's Esophagial. I have to go to the Doc for an upper GI every 12-18 mo's. It can lead to cancer. If that happens, keeping your medical is one of the last things you well worry about. Good Luck, 265.

 

[TonyC]

Let's say someone has an acid reflux problem. Let's even say, someone goes thru LOTS of Rolaids, Zantac, whatever, and nothing seems to fix the problem. Let's further say, someone has to seek medical advice/treatment and goes on something like the 'purple pill', or similar medication to control said acid reflux problem. What does this do to a potential airline career if said acid-reflux-plagued person is just reaching the minimums for regional airline, freight, or corporate positions? Is it a temporary setback depending on success of treatment? Or is it an automatic disqualification? Will it keep said pilot from being hired, or even possibly cost the pilot a medical certificate?

If you know the in's and out's of these questions, please respond while I chew on another chalky tablet........

You're still chewing on chalky tablets, and I didn't get the impression you've done much more than start the purple pill. Specifically, I did not get the impression that you've had an upper GI.

DO.

You should be more concerned, at THIS moment, about your LIFE than a career. Big Duke Six was right on the mark when he said, "that problem is also deadly. It will kill you if left untreated or treated only by OTC medicine." I had never heard of GERD or acid-reflux or purple pills or esophogeal cancer until my Dad died of it at age 59. His constant "heartburn" was obviously much more than a constant nuisance.

See a gastrointerologist immediately. If it hurts, something's wrong.

 

[Captain X]

Been flying for a 121 carrier for 6 years.....been taking Prilosec or Nexium for 7. Maintained a 1st class medical and a healthy appetite the whole time.

 

[mudkow60]

Try Aciphex...


Used to get heartburn all the time... now, never. All prescription drugs of this nature work in slightly different ways. And I have a waiver for the Navy to fly with this stuff. It is awsome.

 

[FN FAL]

good luck to you "airline mission"...although I never had acid reflux, I must admit the first six months of flying 135 pax in piston twins as captain caused me to have a twitch in my right eye.

Consult your doctor and keep working on the problem...hopefully they and or you will get to the bottom of it.

 

[airline mission]

Thank you everyone for your input here.

I wasn't very specific in my initial posting. Actually, I've never done anything about the problem except Rolaids, Zantac, and that Prilosec OTC stuff. The label on the Prilosec says you take it for 14 days, and then not again for at least 4 months. It warns that if you need it again before 4 months you should seek medical attention. It worked great for the 14! Day 15 I needed something again, and that's when I realized something needs to be done.

I've not seen anybody about it because of my fear of losing my medical, and the possibility of watching my dreams and thousands of dollars go down the tubes. I'm convinced now I need to see somebody, and possibly have an upper GI done.

This gets worse even. Last December I had surgery to fix my throat because of a sleep apnea problem. My medical was to expire in January, and so I had to 'fess up about the diagnosis and surgery in January. The AME gave me a class I, but I was supposed to have a follow-up sleep study done 3 months after surgery, and then have the results sent to the FAA. I didn't have the sleep study done, because my problem is definitely fixed, and I wanted to save about $2000 on the sleep study (for multi time). Am I just screwing up here by not following thru on the sleep study?

I really want to make this career change, but I feel like I'm about to walk thru a minefield with the FAA. Oh I know, they're here to help me.

Thanks again for the input. These are excellent posts. Blue skies and cast iron stomachs to you all.

 

[TonyC]

The label on the Prilosec says you take it for 14 days, and then not again for at least 4 months. It warns that if you need it again before 4 months you should seek medical attention.

Forget about flying, forget about the sleep study, forget about reading another post - - get a phonebook and find a doc, get the Upper GI done YESTERDAY.


There's a reason the label says that - - it's a matter of
LIFE or DEATH!

Please go now.

Sleep study next, and then flying. But now, get your stomach fixed.

Don't make me start telling stories.

 

[350DRIVER]

airline mission,

Do one thing at a time my friend, there is absolutely no need to make a conclusion based on opinion from this board. In most cases the cause is gastroesophageal reflux (GERD), errosive esophagitis, Zollinger-Ellison syndrome, or something else a long those lines that can be solved with medication. . Most likely the doctor is not going to order that you have an upper gi done until you first give medication a try which in most cases will solve this problem. Prevacid, Nexium (the "purple pill"), are two of the more popular medications that seem to be prescribed the most to treat this problem. Depending on the severity of your situation the dosage will be somewhere in the neighborhood of 20mg to 40mg per pill. Prevacid is a pump inhibitor (PPI) that seems to work well in most cases as well as Nexium , problem with Nexium is that it seems to cause headaches which is one of the most common side effects so you may want to try Prevacid initially. If it is indeed something more serious than the above mentioned condition(s) then you will most likely have other more painful symptoms that would raise a red flag.

A person suffering from the above must monitor the diet, this is very important. Cut out all milk, nuts, chocolate, alcohol, caffeine, and any other food that may disturb and bother the stomach and cause this problem.


If the medication is not working then the doctor will order the upper gi and possibly other tests to determine the problem, causes, etc.


Take one step at a time....


3 5 0

 

[airline mission]

GREAT info! Sounds like Prevacid is in my very near future. I'm going to see a doctor early next week.

I'm the optimist though, so I can't help but asking...what's next? I would really appreciate good input about the sleep apnea problem. The AME told the FAA about my sleep apnea and the surgery to correct it. He got a letter from my surgeon that basically said that the results of the procedure appear to be very positive. Because the surgeon recommended a follow-up sleep study for proof of success, the AME told the FAA that a report of the sleep study would be coming 3 months after surgery. So here's the question. If I didn't do the sleep study, would the situation just.....go away, as far as the FAA is concerned? What about airline interviews? Would the letter the surgeon sent be enough to help me get hired, or would the airlines just hire the other guy and leave me to my medical past? I'd love to put that $2000+ to use on flying, instead of doing a study to prove what I already know! But if there's just no way around it, then I want to get on with it.

I'm impressed that there were so many good posts to my questions. It's great to see pilots willing to help out another pilot. Thanks!

 

[TonyC]

airline mission,

Do one thing at a time my friend, there is absolutely no need to make a conclusion based on opinion from this board.

Absolutely right - - see a doc. Now, even if it's my opinion that you should see a doc, you should STILL see a doc.

If it is indeed something more serious than the above mentioned condition(s) then you will most likely have other more painful symptoms that would raise a red flag.

Except for the post-op pain (my Dad had most of his esophagus and some of his stomach removed to try to get rid of the cancer), the only pain was chronic heartburn.

Medicating to stop the pain will provide no information about what damage has already occurred. Scoping can provide information in the form of pictures and biopsies.

Take one step at a time....

STEP ONE: Get the scope.

I admit I'm sensitive to this issue - - I watched my Dad die from what he characterized as heartburn. He watched his diet, didn't sleep for an hour or so after eating dinner; he mixed baking soda in water for temporary relief - same effect as Alka-Seltzer, but lots cheaper. One day he had difficulty swallowing a bite of steak, 3 months later he was gone.

Don't take it lightly.


Just my opinion, and I won't belabor it any more.