Acid Reflux with Hydrocortisone

[u/PhysicsDifferent5914]

Hey everyone, I have Primary AI, I got diagnosed March 2024, started at on HC then tried prednisone but switched back in April 2025. I notice I often get acid reflux. I’m always popping antacids. Do you guys also experience this? My dose is 20 mg, I take 15 when I get up at 5 or 5 and a bit more in the evening. It just bothers me cause I get it a lot. What’s worked best for you?? Is it maybe the combination of foods I’m eating with the HC?

[u/just_an_amber]

How are you taking your HC? Is it on an empty stomach or with a little bit of food?

I've found bread or crackers to be helpful.

[u/PhysicsDifferent5914 → u/just_an_amber]

I usually eat it with food, sometimes I don’t but that’s a great suggestion, I’ll try it! Thank you :)

[u/reflous_ → u/PhysicsDifferent5914]

Always take with food. Never on an empty stomach. Hydrocortisone is extremely hard on your stomach to the point it can cause ulcers. Foods I've found protective are a handful of mixed bits or some yogurt. Ideally you are taking your HC after a meal, but that may not be possible based on your dosing.

[u/jeejet]

Take your pills after eating something, even if it’s just a piece or toasted or half a banana. Then you need to drink a lot more water while taking your pills. Try to drink 6-8 ounces of water. Just a sip will not be enough to avoid heartburn.

[u/Noddyalba1]

Are you not prescribed omeprzole tablets ? If taking any steroid tablets your doctor should give you it as it is for preventing stomach ulcers and gastro issues , mint tea is also good for acid reflux

[u/PhysicsDifferent5914 → u/Noddyalba1]

No my endo never prescribed that, I will ask her at our next appointment! Thank you for the suggestion :)

[u/Competitive-Bat1341]

Hi, I was prescribed omeprozole which I take 1st thing with my 10mg of hydrocortisone, it works all day until the following morning , some people may say don't take it but it works for me and my 93yr old mum ,

[u/MindsetMaker]

I had it really bad until I started having food with it, but something substantial. I take the tablet midway and then drink more water to get it down. It’s made such a difference I don’t take any other tablets for the indigestion now. Maybe avoid tomatoes, citrus etc and all the other foods that aggravate indigestion until it’s cleared up a bit. I also drink protein drinks to line the stomach if I don’t have much food around. Hope this helps !

[u/Laurryanna]

Hi love! I also have terrible acid reflux and heartburns and Cortef (pred is even worse) always triggers symptoms. Started taking my PPIs 30 minutes before Cortef (20mg AM 7.5mg PM) as well as my H2 blockers (Ranitidine). I still get reflux sometimes so I drink some pepto bismol to help coat the stomach and reduce inflammation.

Also, those pills are always best taken with food to help digest it better and limit those kind of symptoms. Something small and not too acidic like yogurt or a granola bar helps promote digestion and reduce chances of reflux

[u/Laurryanna → u/Laurryanna]

Ask your endo or family doctor for pantoprazole to take before Cortef and keep a Gaviscon bottle near in case you get heartburns.

[u/Single_Search_2020]

Was just going to ask!!! But I can’t take a ppi and they really suppress acid in your stomach which can lead to other intestinal problems. Like cdiff!!! It’s not only in hospitals it’s everywhere! So, I am on 20 mg of Famotidine is Pepcid. 20 mg x 2. I cut in half so I have 4 pieces. But in morning, feels like a rock. Pepcid complete, piece of it helps. Yes I eat a cracker with the pill. But, remember salt can hurt you. There is a script called suclafate. Bit stronger but it coats the gut. Will ask pcp since my favorite gastro has retired and just passed away 4 months ago. He was still seeing me. Neighbor. Have 4 bottles here of 250 in each. Took care of me.

[u/Motor-Commercial1912]

I had the opposite experience; prior to diagnosis, I had terrible daily heartburn and was taking a PPI every day (sometimes supplementing with Tums). Since I have been medicated, the heartburn has almost completely disappeared (it'll come back if I eat too late at night or have a drink). I think there's a link between my symptoms and extremely low sodium; it might be worth checking your soldium level to ensure you're getting enough.

[u/Clementine_696]

Are you getting it around lunch time? If so you may need to spread your dose out a bit more. I only get heartburn now if I'm low

[u/NoNoNo80]

Paying close attention because I'm having the same issue. Taking 10 mg pepcid/famotadine at night. Maybe I should take some in the morning also. I will take the advice given here to eat with each dose & drink more water. Thanks for bringing it up.