Getting off PPI's and Acid Rebound-What has worked for me- Four months later
I joined this forum in late January in desperation right after I made the decision to stop taking the Aciphex (a PPI) I had taken for three years to control heartburn and symptoms of acid reflux.
First, acid rebound is a very, very, very (and I want to emphasize the very) real phenomenon. I shudder when I think how misinformed many doctors still appear to be in spite of the mounting evidence that acid rebound can take months to work itself through. I was not a well informed consumer when I began to take Aciphex three years ago. I saw it as a miracle cure for my symptoms, and took my two physicians' word (the general practicioner and GI doctor) that it was a safe medication to take long term.
My decision to stop taking Aciphex was a personal one based on the discovery that I had developed severe osteopenia (the precursor of osteoporosis) in both hips after taking the Aciphex for only three years. My bone density had been well within normal range in 2007 as measured by a Dexa scan performed in the office of the same doctor who prescribed the Aciphex in the first place. I have now researched the literature and found research as far back as 2006 warning of the increased risk of hip and other fractures for individuals who take PPI's for more than three years.
By the way, my doctors' solution to the osteopenia problem was to start taking a Biphosphonate (Actonel, Boniva) and then double up on the Aciphex if the Actonel caused any GI side effects. Unlike three years ago, however, I did my reading this time and decided that was a route I did not want to take.
I am not encouraging people to stop taking their PPI's or other medications prescribed by their doctors. But I think it is important for all of us to do more independent research and become more informed consumers. For people like me who have decided to stop taking PPI's for one reason or another, my experience in trying to get off this medication may be helpful.
I took my last Aciphex pill on January 22nd and today is May 17th. Up until about a month ago, I was not confident that I could stay off the Aciphex long term. I am now beginning to feel like I can. I think it is safe to say that my acid rebound lasted approximately three months or a little bit over. I experienced fairly severe rebound, and I was one of those people who felt for a long time I had to be dependent forever on a PPI or some form of acid suppressing medication. I had daily episodes of heartburn and other symptoms that far surpasssed anything I had experienced before I began to take the Aciphex. My stomach was bloated. I became constipated, experienced horrible gas and pains on top of my stomach and then there was the relentless heartburn. I substituted the Aciphex with Zantac 150mg twice per day which I took round the clock until about a week ago. But my rebound was fairly severe. I was miserable with one GI symptom or another.
I tried many different remedies and supplements along the way to ease my discomfort. I tried two rounds of orange peel extract or D-Limonene at $30.00 a pop (one takes one capsule every other day for twenty days). That did not seem to help at the time I tried the treatments. It did not seem to hurt either.
What has worked for me are the following:
1) Taking calcium/magnesium/vitamin D3 supplements. I take mine in liquid form for easier absorption and because I read somewhere (I wish I could recall the source now) that calcium in liquid form is more easily absorbed and also has a strengthening effect on the LES. I don't know if this is true or not but, since I have to take these supplements anyway, it does not bother me to take them in liquid form. I found a supplement that contains all three which I purchase at a local healthfood store. I take two tablespoons a day. I also take other supplements in pill form such as fish oil, probiotics, B12 and a multivitamin. I am also taking fiber supplements to keep me regular.
2) Believe it or not, the old Apple Cider Vinegar remedy has worked for me. I remember trying apple cider vinegar three years ago and being horrified by the taste (I diluted it in cold water back then). Besides, if the doctors provided me with a newer, improved, scientific, safe medication, why would I not go for that instead of some old wives' tale? Another poster here reminded me about ACV about two weeks ago, and suggested I try it again. I began taking ACV about a week and a half ago three times a day. I now take it twice a day (morning and night). I take two tablespoons diluted in a glass of water at room temperature and I sip the mixture through a straw. It definitely has helped my heartburn. I am still not sure how it works. I have read the whole thing about the acetic acid and other nutrients in ACV. I don't know if that is the mechanism of action or if it is a placebo effect, but taking ACV twice a day has coincided with my ability to stop taking Zantac daily round the clock. I have taken one Zantac over the past ten days which is fewer than the two I required daily until I started the ACV.
3) DGL and aloe vera juice definitely helped me when my esophagus was red and inflamed. I have cut back on the DGL now and suck on one here and there through the day. I am no longer taking aloe vera juice daily, but would have no problem using it again if my esophagus becomes irritated by gastric acid. I have also purchased slippery elm lozenges and an antiacid called Briosch (both online from Amazon) and use them sparingly as needed. The Briosch is pure bicarbonate of soda in a lemmony fizzy drink that is very pleasant to drink. It's like Alka Seltzer but without the aspirin.
4) I have cut out caffeine, particularly coffee, alcoholic drinks, dairy and many carbohydrates. I now drink almond milk and coconut juice (both agree with me). I can drink certain decaffeinated teas, like decaf green tea. I cannot have raw peppers or tomato based red sauces. However, I can eat fresh tomatoes in a salad if I don't consume too much. It seems like all in moderation. I eat earlier and less. I eat more small quantities throughout the day as opposed to big meals. I am not overweight. I do not smoke and was not a heavy drinker before reflux hit me three years ago. I think the cause of mine is probably a combination of middle age, menopause, changing hormones, etc.
I think I have outlined all my "secrets." I want to emphasize in closing that different remedies will work differently for different people. Some people may need to stay on PPI's forever. Others may need to take them periodically and others may not need to take them at all. It worries me that we don't even need to go see a doctor anymore before we can grab that PPI prescription at the drugstore.
I also worry that many people who experience rebound mistake it for the disease and run back to the PPI after a week because they find the symptoms of acid rebound unbearable. Acid rebound is real and it can last several months before gastrin (hormone) levels in the blood normalize and the proton pump cells stop dumping so much acid into our stomachs. Therefore, read up and be prepared in the event you choose to go off PPI's. Sadly, do not expect a lot of support from your doctors if you want to get off this type of medication. I received the silent treatment when I discussed this with my family doctor in January and she then mailed me a prescription of Aciphex and Actonel along with my lab results "just in case."
I am glad to report I am no longer taking Aciphex, Zantac or any other acid suppressing drugs and have by now experienced days at a time with few or little symptoms.
Here is wishing everyone well.
Last edited by Administrator; 08-26-2011 at 01:34 PM.