Nighttime Indigestion with Ileostomy - Positional Issue?

My husband has had his ileostomy for 5 weeks, and for the past week, he has had indigestion at night when he lies flat in bed. He is fine during the day. He takes Pepcid, and it resolves eventually, but I am wondering if this is a known positional issue with an ileostomy? It does not seem to be related to what he has eaten. Any ideas?

Is this indigestion high (chest like heartburn)?

Or low (abdomen like a stomach)?

Likely electrolyte imbalance caused by malabsorption. For example,

Sodium and calcium buffer acid in your body. Hydration is particularly important for those of us with ileostomy, but be careful with electrolyte drinks. Some ileostomates use them without taking the same amount of water, and then electrolytes can have too high a concentration.

Or perhaps it's how soon he lies down after eating,

I would try Gaviscon first. But you have to chew it until it gets really foamy and then swallow it so that it's a raft that floats on top of your stomach acid and prevents it from coming back up the esophagus. It doesn't work like Tums or similar antacids.

Finally, either a doctor or a clinical dietitian could take a look at your blood work and see with a chem panel (a complete chemistry profile) where some of the specific highs and lows are.

I too have similar symptoms and my electrolytes are normal. Initially, I took 20mg of Pepcid with dinner (6 PM) but currently, I take 10mg. I do not eat or drink anything after dinner except for taking my blood pressure meds with a sip of water at bedtime. I start bedtime sitting up on 2 pillows until I get sleepy and then I shift to one pillow, usually laying on my right side, which theoretically would facilitate gastric emptying. I have had no further problems. If you do not do this, you might try Pepcid Complete, which is Pepcid combined with an antacid.

I might mention that since my ileostomy, I have noticed I belch a lot. I cannot explain it since I have no problems with transit or obstruction. I would rather the air come out above rather than my ileostomy whistling. No, I am not swallowing air, but I do consume my share of milk products, which could explain this.

If he lies on his left side, he will get relief. It happens to me too at times.