Long term PPI use (how to stop?)

[maldorf]

Yes I get this as well. Mostly with rice for some reason. It gets stuck in my throat and I feel like I’m choking, but I can still breathe. I end up throwing up or making myself throw up to dislodge it. Happens like once every couple of weeks if not more often

Thats it. If it gets bad enough you have to get surgery. They go in and stretch out your throat. So far I have avoided that.

 

[maldorf]

Ever look into Plummer-Vinson syndrome?

Never heard of that. I will look into that. I am doing ok now. With all of my other big health problems, the throat is minor now.

 

[heavyhitter]

Is there anything that can be done to mitigate or improve this without surgery? It’s scary as hell when it happens

Thats it. If it gets bad enough you have to get surgery. They go in and stretch out your throat. So far I have avoided that

 

[Muay Thai]

I'm using Famotidine 20mg/daily in the am pre meal like the Omeprazole.

Are you stuck on heartburn medications? - Harvard Health

Many people with acid reflux heartburn end up taking medications for life, but it may not be necessary in all cases. The most effective treatments for acid reflux are drugs in the class called prot...

www.health.harvard.edu

copy and paste article or summary plz I have to be a member to view that link :/

 

[maldorf]

Is there anything that can be done to mitigate or improve this without surgery? It’s scary as hell when it happens

You need to try either a drug like Pepcid, I take it now, or a PPI. The PPI I took was more effective but I got terrible muscle cramps from it and had to stop. I had an endoscopy done and thats where they discovered I have eosinophilic esophagitis. The OTC Pepcid I take now is working pretty good. I started out with a prescription dose of 2 OTC tabs 2x a day and then eventually worked it down to just 1 tablet 2x per day. Im doing fairly good now. If you leave it untreated too long it will get worse!

You probably should see a GI doctor and have him do an endoscope of your upper GI.

It scared me too at first, especially since I have heart failure. It puts a lot of stress on you and bothered my heart at the same time!

 

[heavyhitter]

You need to try either a drug like Pepcid, I take it now, or a PPI. The PPI I took was more effective but I got terrible muscle cramps from it and had to stop. I had an endoscopy done and thats where they discovered I have eosinophilic esophagitis. The OTC Pepcid I take now is working pretty good. I started out with a prescription dose of 2 OTC tabs 2x a day and then eventually worked it down to just 1 tablet 2x per day. Im doing fairly good now. If you leave it untreated too long it will get worse!

You probably should see a GI doctor and have him do an endoscope of your upper GI.

It scared me too at first, especially since I have heart failure. It puts a lot of stress on you and bothered my heart at the same time!

I’ve been seeing gi doctors for 15 years for
This. I’ve had two endoscopes but maybe it’s time for another? Ppi’s is a no go for me. They absolutely crippled me with vomiting and Diarhea for years. Now I treat with betaine and digestive enzymes and have muuuuuch less reflux. But twice in the last month I’ve done that choking thing again

 

[Stewie]

Are you stuck on heartburn medications? Published: July, 2014 Taper off heartburn medications if you are willing to make lifestyle changes to prevent the problem from coming back. To any man once tormented by frequent heartburn from stomach acid backing up, not taking your daily tablet of omeprazole (Prilosec) or lansoprazole (Prevacid) might seem like a bad idea. These and similar drugs, known as proton pump inhibitors (PPIs), are the foundation of treatment for chronic acidic heartburn, also known as gastroesophageal reflux disease (GERD). But some men with GERD may be able to leave their heartburn pills behind. That means one less pill to take—two if you must take them twice a day. It also means lower costs and less of a chance of unwanted side effects. Once off the PPI, you could go back to taking antacids only when you need them. "If the symptoms are gone and you are willing to make lifestyle changes, you could try to taper down on the medication," says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center. "Lifestyle changes are important to keep the problem from coming back." It has to be done carefully. If you suddenly stop taking PPIs after being on them for a long time, your GERD could come galloping back with a vengeance. Who can stop? You can taper off PPIs if you have garden-variety GERD and no other complicating medical conditions. But your doctor may advise you to keep taking a PPI if either of these conditions applies: You have a history of ulcers and need to take aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). This includes men who take daily aspirin for heart protection and those who take NSAIDs for arthritis or other conditions. You have been diagnosed with precancerous changes in the base of the eso-phagus, known as Barrett's esophagus. How do they work? Proton pump inhibitors (PPIs) shut down the acid-producing "pumps" in the stomach. Taken before your first meal of the day, PPIs sharply reduce acid secretion and therefore the irritation it causes when stomach contents back up into the esophagus. How do you get them? These PPIs can be obtained over the counter in the United States: esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and omeprazole plus sodium bicarbonate (Zegerid). These are available only by prescription: dexlansoprazole (Dexilant), pantoprazole (Protonix), and rabeprazole (Aciphex). Image: Thinkstock

How to taper off​

There is no universally recommended way to taper off PPIs. Dr. Wolf advises people taking the lowest dose of a PPI once a day to gradually replace the PPI with an acid-reducing drug in the class known as H2 blockers. These include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid).

You can replace one dose of the PPI with an H2 blocker each week for seven weeks. Or you could just start taking the H2 blocker every day for a week or two before stopping altogether. Ask your doctor for a recommendation.

If you take larger doses of a PPI or take it twice a day, it may be necessary to first lower the doses before replacing them with the H2 blocker. Again, ask your doctor for advice about this.

Lifestyle changes are key​

Without changes in habits, you may end up right back where you started. According to a recent guideline issued by the American College of Gastroenterology (ACG), the following advice is supported by evidence:

• Lose weight. Being overweight is the leading cause of GERD. (Eating large meals may also worsen GERD.)
• For those with GERD at night, avoid eating two to three hours before your normal bedtime. Also, sleep with your upper body slightly above stomach level by elevating the head of the bed slightly on blocks or by using a wedge-shaped cushion. It reduces pressure on the opening between the upper stomach and base of the throat. Just propping up your head with pillows won't work.

Many people find that certain foods cause heartburn, but the ACG does not recommend automatically and permanently avoiding chocolate, caffeine, alcohol, acidic foods, spicy foods, or fatty foods. But if you think certain foods trigger your heartburn, try cutting them out for a while to see if it makes a difference.

However, Dr. Wolf recommends completely avoiding foods with mint, since it may loosen the passageway from the stomach to the esophagus and allow acidic material to back up into the esophagus and throat.

 

[Stewie]

copy and paste article or summary plz I have to be a member to view that link :/

See above post.

Forgot to put in "QUOTES" before time lapsed.

 

[maldorf]

I’ve been seeing gi doctors for 15 years for
This. I’ve had two endoscopes but maybe it’s time for another? Ppi’s is a no go for me. They absolutely crippled me with vomiting and Diarhea for years. Now I treat with betaine and digestive enzymes and have muuuuuch less reflux. But twice in the last month I’ve done that choking thing again

Have you tried Pepcid? If I were you Id give that a go and keep doing what you are already doing too. I can go an entire month without any problems. The Pepcid works decent, especially if you start out on the higher dose. I originally had a script from the doctor for it and the dose was 2x the max OTC dose. I let that run out and now just buy it OTC because its cheap if you buy generic. Just looked, I take 20 mg Famotadine tabs. Started out with 40 mg 2x per day. I was able to ween off that and now just take 20 mg 2x per day. I suffer zero sides from it. Pepcid is NOT a PPI

 

[maldorf]

Are you stuck on heartburn medications? Published: July, 2014 Taper off heartburn medications if you are willing to make lifestyle changes to prevent the problem from coming back. To any man once tormented by frequent heartburn from stomach acid backing up, not taking your daily tablet of omeprazole (Prilosec) or lansoprazole (Prevacid) might seem like a bad idea. These and similar drugs, known as proton pump inhibitors (PPIs), are the foundation of treatment for chronic acidic heartburn, also known as gastroesophageal reflux disease (GERD). But some men with GERD may be able to leave their heartburn pills behind. That means one less pill to take—two if you must take them twice a day. It also means lower costs and less of a chance of unwanted side effects. Once off the PPI, you could go back to taking antacids only when you need them. "If the symptoms are gone and you are willing to make lifestyle changes, you could try to taper down on the medication," says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center. "Lifestyle changes are important to keep the problem from coming back." It has to be done carefully. If you suddenly stop taking PPIs after being on them for a long time, your GERD could come galloping back with a vengeance. Who can stop? You can taper off PPIs if you have garden-variety GERD and no other complicating medical conditions. But your doctor may advise you to keep taking a PPI if either of these conditions applies: You have a history of ulcers and need to take aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). This includes men who take daily aspirin for heart protection and those who take NSAIDs for arthritis or other conditions. You have been diagnosed with precancerous changes in the base of the eso-phagus, known as Barrett's esophagus. How do they work? Proton pump inhibitors (PPIs) shut down the acid-producing "pumps" in the stomach. Taken before your first meal of the day, PPIs sharply reduce acid secretion and therefore the irritation it causes when stomach contents back up into the esophagus. How do you get them? These PPIs can be obtained over the counter in the United States: esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and omeprazole plus sodium bicarbonate (Zegerid). These are available only by prescription: dexlansoprazole (Dexilant), pantoprazole (Protonix), and rabeprazole (Aciphex). Image: Thinkstock

How to taper off​

There is no universally recommended way to taper off PPIs. Dr. Wolf advises people taking the lowest dose of a PPI once a day to gradually replace the PPI with an acid-reducing drug in the class known as H2 blockers. These include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid).

You can replace one dose of the PPI with an H2 blocker each week for seven weeks. Or you could just start taking the H2 blocker every day for a week or two before stopping altogether. Ask your doctor for a recommendation.

If you take larger doses of a PPI or take it twice a day, it may be necessary to first lower the doses before replacing them with the H2 blocker. Again, ask your doctor for advice about this.

Lifestyle changes are key​

Without changes in habits, you may end up right back where you started. According to a recent guideline issued by the American College of Gastroenterology (ACG), the following advice is supported by evidence:

• Lose weight. Being overweight is the leading cause of GERD. (Eating large meals may also worsen GERD.)
• For those with GERD at night, avoid eating two to three hours before your normal bedtime. Also, sleep with your upper body slightly above stomach level by elevating the head of the bed slightly on blocks or by using a wedge-shaped cushion. It reduces pressure on the opening between the upper stomach and base of the throat. Just propping up your head with pillows won't work.

Many people find that certain foods cause heartburn, but the ACG does not recommend automatically and permanently avoiding chocolate, caffeine, alcohol, acidic foods, spicy foods, or fatty foods. But if you think certain foods trigger your heartburn, try cutting them out for a while to see if it makes a difference.

However, Dr. Wolf recommends completely avoiding foods with mint, since it may loosen the passageway from the stomach to the esophagus and allow acidic material to back up into the esophagus and throat.

Protonix is the one that gave me crippling muscle cramps.

 

[Reload]

So far so good. No PPI going on 3rd day. Only side effect so far seems to be increased saliva production which I'm betting is a protective measure.
The Famotidine seems to be working well.
Thank you Stewie for the cut & paste on that Harvard Health link.

 

[maldorf]

So far so good. No PPI going on 3rd day. Only side effect so far seems to be increased saliva production which I'm betting is a protective measure.
The Famotidine seems to be working well.
Thank you Stewie for the cut & paste on that Harvard Health link.

Thats what I did, switched to Famotidine. Did that many years ago.

 

[Reload]

Another great day w/o any noticeable acid rebound. Day 4 since the switch from the PPI to the H2 blocker. Dealing with a headache but I'm pretty sure that's due to withdrawing (day 3) from caffeine/coffee)...another possible GERD sensitivity I suspect I have along with tomato. Put the head posts on my king size bed up on 5" bricks. Someone mentioned alginate as a possible solution. Been looking into Na+ Alginate as a post dinner prophylactic to reduce the possibility of GERD related aspiration (postprandial acid pocket) at night. The journey continues...

 

[Reload]

Updating this thread...
It's been a week since I stopped the 20mg Omeprazole (PPI) and started the 20mg Famotidine (H2B).
I've had zero acid reflux so far and feel fine. I'm going to reduce the Famotidine dose to 10mg today.
I've also been drinking a tbsp of apple cider vinegar in a glass of water first thing in the am and
5g of Glutamine in the am & pm. Will report back in a week.

 

[Reload]

Off the PPI almost 2 weeks now. I transitioned to the H2 blocker (Famotidine) the day I stopped the Omeprazole.
I have a few days remaining on Famotidine which I reduced to 10mg to slowly taper off and allow my natural gastric
secretion to return.

Results so far: No acid rebound. Strangely my bowel regimen has changed.
My prior bowel pattern (while on the PPI) was 2 loose stools in the am.
The am coffee exacerbated that pattern I suspect. Loose as in mushy with lots of gas.
Minimal smell.

Gave up coffee...again. Headaches for about 4 days after withdrawing from the caffeine.
Good now although I do miss my strong cup of french press.

Started taking an enzyme supplement "Source Naturals Essential Enzymes" with my larger
meals to assist with digestion. Continuing to take a tbsp of apple cider vinegar in a glass of
water in the am with 5mg Glutamine and another 5 grams at night.

New bowel regimen is now a single large well formed, soft BM in the am. Smelly!
Liberating actually. One and done

I should have done this sooner!

My bet is I'm better assimilating the nutrients in my meals now with a return of my natural stomach acid
and supplemental enzymes. I don't have that bloated stomach feeling and in general feel better.
Nice feeling removing a medication I likely never needed in the first place.

I should preface that I'm NOT eating 6+ meals/day while doing this. 3 healthy meals incorporating fermented
foods like sauerkraut and pickles. Healthy fats/oils. More green leafy veggies. Little more fiber. Less carbs.
I'm trying to do this in baby steps so it becomes routine. I still drink a beer daily, maybe two.
Alcohol is next on the list of things I'd like to remove from the routine but it's my only vice.

10mg Test/daily. Olly mens multi vite. 80mg Telmisartan/day. ACV, glutamine and an enzyme supplement.
Simple!

 

[heavyhitter]

Off the PPI almost 2 weeks now. I transitioned to the H2 blocker (Famotidine) the day I stopped the Omeprazole.
I have a few days remaining on Famotidine which I reduced to 10mg to slowly taper off and allow my natural gastric
secretion to return.

Results so far: No acid rebound. Strangely my bowel regimen has changed.
My prior bowel pattern (while on the PPI) was 2 loose stools in the am.
The am coffee exacerbated that pattern I suspect. Loose as in mushy with lots of gas.
Minimal smell.

Gave up coffee...again. Headaches for about 4 days after withdrawing from the caffeine.
Good now although I do miss my strong cup of french press.

Started taking an enzyme supplement "Source Naturals Essential Enzymes" with my larger
meals to assist with digestion. Continuing to take a tbsp of apple cider vinegar in a glass of
water in the am with 5mg Glutamine and another 5 grams at night.

New bowel regimen is now a single large well formed, soft BM in the am. Smelly!
Liberating actually. One and done

I should have done this sooner!

My bet is I'm better assimilating the nutrients in my meals now with a return of my natural stomach acid
and supplemental enzymes. I don't have that bloated stomach feeling and in general feel better.
Nice feeling removing a medication I likely never needed in the first place.

I should preface that I'm NOT eating 6+ meals/day while doing this. 3 healthy meals incorporating fermented
foods like sauerkraut and pickles. Healthy fats/oils. More green leafy veggies. Little more fiber. Less carbs.
I'm trying to do this in baby steps so it becomes routine. I still drink a beer daily, maybe two.
Alcohol is next on the list of things I'd like to remove from the routine but it's my only vice.

10mg Test/daily. Olly mens multi vite. 80mg Telmisartan/day. ACV, glutamine and an enzyme supplement.
Simple!

You’re definitely assimilating the foods better causing the better formed stool. I too typically had 2-3 very loose watery stools for the first couple hours of the day before coming off omeprazole and using betaine. Now my bowel regimen is similar to yours. And on a side note....coffee shouldn’t be drank on an empty stomach for people with issues like us. Coffee stimulates stomach acid production and release, however, without food already in the stomach to help clear the acid it can cause issues. Also....our bodies make a finite amount of acid daily and I wouldn’t want to waste it on a cup of coffee when I could be utilizing it to digest mess. Sounds like you’re having great progress

 

[Reload]

You’re definitely assimilating the foods better causing the better formed stool. I too typically had 2-3 very loose watery stools for the first couple hours of the day before coming off omeprazole and using betaine. Now my bowel regimen is similar to yours. And on a side note....coffee shouldn’t be drank on an empty stomach for people with issues like us. Coffee stimulates stomach acid production and release, however, without food already in the stomach to help clear the acid it can cause issues. Also....our bodies make a finite amount of acid daily and I wouldn’t want to waste it on a cup of coffee when I could be utilizing it to digest mess. Sounds like you’re having great progress

So far so good and I do appreciate your advice.
You are so right on coffee first thing in the morning. Caffeine, anything with tomato (I'm Italian...wtf?) and greasy/fried foods
appear to be my triggers. I'm keeping my fingers crossed that once my acid production kicks back in that I'll be able to enjoy these things again.
If not, well that's life.

 

[heavyhitter]

So far so good and I do appreciate your advice.
You are so right on coffee first thing in the morning. Caffeine, anything with tomato (I'm Italian...wtf?) and greasy/fried foods
appear to be my triggers. I'm keeping my fingers crossed that once my acid production kicks back in that I'll be able to enjoy these things again.
If not, well that's life.

Those are all triggers for IBS. Coffee specifically triggers stomach acid release, caffeine causes indigestion, tomatoes are highly acidic and are one of my biggest triggers. A slice of pizza has me running to the bathroom before I even finish it