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Old 02-05-2010, 09:18 PM   #1
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Getting off PPI's and acid rebound

I wanted to share my story and see if any of the veteran group members have suggestions or feedback. This is my first new threat on this forum.

I was diagnosed with acid reflux approximately three years ago via endoscopy and placed on Aciphex (20 mg). Within days, my symptoms went away and I was able to eat, drink and resume my normal life without symptoms of heartburn, nausea, pain, etc. I felt I was the most fortunate person on earth, and went on about my business. I was told the Aciphex was safe and I could continue to take it indefinitely. Therefore, for two years my PCP refilled my prescription and I faithfully took the medicine without a worry. I must say that I never bothered to read any literature about potential side effects since both the GI doctor and my internist felt very comfortable with me taking it long term or as long as needed. Nobody brought up the issue of bone loss, increased risk of hip fractures or acid rebound, and I was too busy to bother to look any of it up.

Fast forward to this past December. I went in for my regular annual physical and happened to have a Dexa bone scan as part of my checkup. I had undergone one two years prior as a baseline which was normal, but because I am now going into menapause at 54, my internist wanted to repeat it. To everyone's surprise, it was discovered that I have advanced osteopenia on both hips, which the doctor assumed is likely due to the Aciphex (since my body is still producing estrogen and I am a fairly active person).

The internist's and OBG's unequivocal recommendation was that I immediately begin to take Actonel (the once a month version). When I brought up all the potential nasty side effects (I did my homework this time) and my concern about this drug's effect to simply let old bone build up and prevent cell turnover, they both said I should still take it. What if I develop worse symptoms of GERD? Then, they said, I should simply double up on the Aciphex, and so on.

I was very upset for a couple of days and kicked myself for not having done the research on the Aciphex and increased risk of osteoporosis. in the first place. I then called the doctor and asked her nurse whether it would not simply be more beneficial for me to get off the Aciphex or switch it to a less potent medication like an H2 blocker while I simultaneously increased my exercise and intake of Vitamin D3 and calcium. I still got the same response. Just take the Actonel and increase the Aciphex as needed to deal with any GI side effects of the Actonel.

I made the decision to withdraw the Aciphex on my own, but did so very quickly over only the course of two weeks. I had not heard of acid rebound, but intuitively knew that my body was likely dependant on something I used for nearly three years. I switched to Zantac 150 mg twice a day, began to take more calcium citrate with 1000 mg of vitamin D3, and braced myself for what was to come.

The first week off Aciphex and on Zantac was incredibly rough. I ate a lot of Tumms and experienced a lot of rebound acid. I found this board where I learned about acid rebound for the first time, and felt a bit of hope that perhaps I could slowly weane myself off the medicine. I realized my mistake of having withdrawn the Aciphex too quickly, but I thought it was too late to go back now that I had been without it for a week.

Today is the fifteenth day without Aciphex and I must add I have some better days and worse days. I am still on the Zantac, but have used less Tumms and Gaviscon, and gradually added some natural remedies. I am taking tablespoons of Aloe Vera juice which I find soothing (though it does not taste good). I suck on DGL several times a day (though the effect lasts very little) and have started the Melatonin at night. I am doing a little bit better as the days go by, and hope to be able to come back and report again my progress in another week or so.

I have learned a few hard lessons. First, I have learned to always do my homework. All medicines have side effects and some type of trade off. I have been trading off the health of my bones for the luxury of eating whatever I wanted whenever I wanted. Second, I still like my personal doctor, but I will never blindly follow her advice again. I have realized that physicians today have no time to solve puzzles. It is easier for them to give me another pill than to sit down and sort through options. I feel I am a motivated and health conscious individual who will try other methods to restore bone health. Yet my doctor simply wants me to take this new medicine, Actonel, which to me sounds like poison to the body, and then take even more Aciphex to deal with the side effects of the Actonel when the Aciphex is what most likely caused the rapid loss of calcium in my hip bones. That just sounds crazy to me unless I absolutely have to stay on the Aciphex which I am not convinced I have to.

I am not optimistic that I will be able to get off the Zantac, but I am hoping the Zantac will give me enough relief that I will be able to stay on it or a reduced dose while I follow a healthy diet. I am also hoping the Zantac does not interfere as much with calcium absorption so that my hips do not develop full blown osteoporosis if I continue a regimen of exercise and the calcium with vitamin D3.

I don't know if the natural remedies will help, i.e., Aloe and Melatonin, but will continue to use them to see if they speed up the process and cut down on the acid rebound.

I guess the question has been asked and I have seen several older threads, but are there any of those folks who were trying to get off PPI's a couple of years back still around and did they succeed? Are there any other natural remedies that have helped them?

Neither ginger nor ACV helps me but rather give me more heartburn and irritation so I have stayed away from them.

I just wanted to share my story. Those folks who need to be on PPI's need to be very watchful of their calcium intake and have regular Dexa scans. Had I had one last year, I would have discovered the calcium loss sooner.

Thank you all for "listening" and I appreciate any comments or sage words of advice from the group's veterans.

Rose

 
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Old 02-06-2010, 06:45 PM   #2
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Re: Getting off PPI's and acid rebound

thank you so much for your story, i wish you the best. I am currently having alot of health issues coming off of anxiety meds (i was told they wouldn't harm me) and have not had much success with ppis but am still on prilosec 20 mg twice a day for the time being b/ i tried twice to get off of them now with not very good results (not as long as you). I find it astounding how our drs do not tell us about all of this?! I asked my dr when he put me on it if it was safe, and he told me one of the safest meds out there but i told him how i read about bone loss, etc and polyps and he made it sound like, you are too young to worry about that now. Hes supposed to be my protector and hes not. Again, sorry to hear about your situation, and best wishes with getting off the aciphex and hopefully one day H2 inhibitor.

 
Old 02-06-2010, 08:01 PM   #3
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Re: Getting off PPI's and acid rebound

Quote:
Originally Posted by rosebloom View Post
I have learned a few hard lessons. First, I have learned to always do my homework. All medicines have side effects and some type of trade off. I have been trading off the health of my bones for the luxury of eating whatever I wanted whenever I wanted. Second, I still like my personal doctor, but I will never blindly follow her advice again. I have realized that physicians today have no time to solve puzzles. It is easier for them to give me another pill than to sit down and sort through options. I feel I am a motivated and health conscious individual who will try other methods to restore bone health. Yet my doctor simply wants me to take this new medicine, Actonel, which to me sounds like poison to the body, and then take even more Aciphex to deal with the side effects of the Actonel when the Aciphex is what most likely caused the rapid loss of calcium in my hip bones. That just sounds crazy to me unless I absolutely have to stay on the Aciphex which I am not convinced I have to.
Yes, It is very important, and I can't stress this enough, research every single medication you take/are planning to take. Don't count on doctors to do it for you. Doctors get a financial kickback from prescribing certain drugs, so even though a natural one may do the job more efficiently, they will be naysayers, as their allegiance is to big pharma. Well, I shouldn't say all doctors, some just don't know any better, as when they went to school, they were spoonfed the benefits of prescription drugs.


Quote:
I am not optimistic that I will be able to get off the Zantac, but I am hoping the Zantac will give me enough relief that I will be able to stay on it or a reduced dose while I follow a healthy diet. I am also hoping the Zantac does not interfere as much with calcium absorption so that my hips do not develop full blown osteoporosis if I continue a regimen of exercise and the calcium with vitamin D3.
From what I've read, Zantac doesn not interfere with calcium absorption. If Zantac works for you that's great, I just wouldn't rely on it forever, like I said in another thread, there's a reason why it's only meant to be taken periodically.

Quote:
I don't know if the natural remedies will help, i.e., Aloe and Melatonin, but will continue to use them to see if they speed up the process and cut down on the acid rebound.
I've tried countless natural remedies for hyperacidity, and nada. But I just recently started taking strong probiotics, and I've cut my Zantac pills in half, and in a few days I will try without Zantac.

 
Old 02-08-2010, 08:34 PM   #4
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Re: Getting off PPI's and acid rebound

Just to provide a quick update: I am still off the Aciphex and on 150 mg of Zantac twice per day. the rebound is slowly going away. I can tell because I am now requiring less over the counter emergency Gaviscon or Tumms. I don't know if I'll be able to reduce or even get off the Zantac completely, but for now plan to take the 150 mg for two more weeks and then see if I can drop to the 75 mg twice a day and so on.

It seems to be getting a bit easier every day. I felt almost normal today. There is definitely hope to get off PPI's, though the first few days off Aciphex (even while on the Zantac) were absolutely horrible and I thought of taking the medicine again daily.

Reading through old threads in this forum definitely gave the information and strength to keep on going and not get back on the Aciphex.

 
Old 02-09-2010, 01:29 PM   #5
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Re: Getting off PPI's and acid rebound

rosebloom, thank you for such an informative and thorough post. I agree with you on just about all points. We have to take responsibilty for the decisions regarding our bodies and the medications we elect to take. Marigold, I want to lovingly scold you for regarding your doctor as a "protector" - no, my dear. Only you can be your own best protector. Doctors are not infallible, and your doctor has hundreds of other patients occupying his thoughts. Each time you walk out the door of that office after an appointment, your problems still loom large in YOUR life but not in your doctor's life. He moves on to other patients with other problems. He is almost assuredly not losing sleep over you at night. I don't mean to sound harsh or portray doctors as uncaring, but it's the only way these professionals can function. The time demands on them are huge, and I think rosebloom is right - it's a rare doctor who has time for any puzzle-solving on a patient's behalf. I assume that, when I leave my doctor's office, it is quickly "out of sight, out of mind." And whether your bones are going to deteriorate from taking too much PPI medication, well, your doctor is probably just not giving that much thought. My GI doc told me just the other day "Oh, no need to worry about that until you're older." Baloney - I'm going to worry about it now and take the least amount of medication I can that will do the job. In general, this is the best advice regarding any medication - take the least you can possibly take to manage your health. The sooner I can get off this PPI, the better. Gotta run...

 
Old 02-11-2010, 03:29 PM   #6
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Re: Getting off PPI's and acid rebound

Hi, So glad to find this sight. I've been on protonix for 7 years. I managed to stop it for awhile but throat pain so bad, gurgling, hoarseness, regurg, came back with a vengeance and I had to restart. Within a couple days of restarting I am symptom free. However, after all I've read I really want to be able to stop taking this but don't see how. Do any of you have advice? Thanks in advance.

 
Old 02-14-2010, 08:24 PM   #7
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Re: Getting off PPI's and acid rebound

Hi Mary:

This is the end of my third week off Aciphex and on Zantac in my efforts to wean myself off the PPI's. I am still having a hard time. Some days are better than others. I went out of town for a few days and committed the sin of having a glass of red wine one time and a cup of coffee on another. Both resulted in horrible acid reflux that lasted for several hours in spite of antiacids. I am back home now and back to my stricter diet and we'll see. But I wish I could say that this is going in a linear fashion. It is not. I have decent days and then days when I feel a lot more acid and burning.

I got myself off Aciphex too fast I think and I would probably now wean myself off more slowly, but the jury is still out. If my symptoms continue as they are now indefinitely, I may have to go back to PPI's. I just want to give my body a chance to get through the acid rebound phase and see if I can control my symptoms with the Zantac and eventually with occassional remedies. I still don't know if I can.

In addition to the Zantac (150 mg twice a day-morning and night), I am drinking sips of aloe vera juice, using Gaviscon liquid here and there, Sucking on DGL and taking Melatonin at night. Not sure what else to use or try but to stay the course another two-three weeks to see if my symptoms start to level off and I can stay off the PPI's.

I wish some of the other group members who have tried this weaning off would come and post here to see if they succeeded long term.

But you can't stop taking them suddenly or the rebound will be awful. I was taking 20 mg of Aciphex, went down to 10 mg for a week and then to 5 mg for another week and I still experienced fairly severe reflux when I stopped and started the Zantac.

I don't want to become discouraged and will continue to post here until I succeed in becoming more symptom free or decide that I have to go back to the PPI (which I will regret).

All the best to you,

Rose

 
Old 02-15-2010, 11:37 AM   #8
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Re: Getting off PPI's and acid rebound

The PPIs knock back the stomach acid so much that they effectively mask the malfunctioning of the LES. If the LES STILL isn't working correctly, you find out when you go off the PPIs and stomach acid production resumes and - surprise, surprise - the refluxing resumes because the LES is still not doing its job. The $20,000 question is how to get the LES functioning properly again. PPIs don't do anything for the LES, and that's a frustrating problem. As far as I know there is no drug that can tighten up the LES. The best we can hope to do is keep from relaxing it by avoiding relaxing agents - alcohol, tea, etc. - but most of us only have limited (to no) success with that. Both of my esophageal sphincters are apparently malfunctioning and I do not know why; therefore, it's hard to attack the problem.

 
Old 02-20-2010, 08:02 PM   #9
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Getting off PPI's Update

I posted about three weeks ago for the first time about my quest to get off PPI's after finding out that I had developed Osteopenia in my hips after only two years of therapy with the PPI Aciphex. I became very concerned when I found out I had developed Osteopenia after only two years with the minimum dose of Aciphex (20 mg the first year and 10 mg the second-yes, I used to cut the pill in half when I discovered that half the dose worked pretty well).

The acid rebound was terrible the first week, and then leveled off. This is the end of the fourth week off Aciphex, Unfortunately, the acid rebound (or symptoms of GERD) continue even if not as terrible as the first week. I have one episode of pretty bad heartburn about every three days or so even with a fairly healthy and restricted diet. I am identifying some of the triggers. For example, I had a very small glass of red wine with dinner once, and a piece of fried fish on another occasion. I am still taking Zantac 150 mg twice a day and trying other natural remedies like drinking Aloe Vera gel, probiotics, yogurt, almond milk, etc. I am going to try to cut back on carbs even more and not eat things I know are acidic. I really miss my coffee, but I am afraid that is a pleasure that may be gone for a long time. if not forever. My current diet is more limited but healthier for sure.

Is anyone aware of acid rebound lasting longer than four weeks? I don't want to give up and go back on the Aciphex, and I don't want to take the Actonel the doctor recommended for the Osteopenia either. Aside from the stomach side effects of the Actonel, I don't like what I have read about how that type of medicine works.

What makes this process so difficult is the lack of support from the medical establishment. My doctor wants me to go on the Actonel for the Osteopenia and double up on the Aciphex if I develop stomach symptoms as a result of the Actonel. I think that is simply crazy, to add one drug to treat the side effects of the other. My other doctor, the OBGY, also thinks I should take the Actonel and stay on the Aciphex rather than get off the Aciphex to slow down the bone loss and allow my stomach to absorb calcium better. Therefore, I feel like I am on my own doing this. Both of my doctors expect me to fail.

I would not mind staying on the Zantac forever or another H2 blocker if I have to, but I want to avoid going on a PPI again if I can in order to save my bones. But I don't want to do damage to my esophagus either and I don't know how long the acid rebound is supposed to last after two years on PPI's.

I found a new product called Prelief that one is supposed to take before eating and takes the acid out of food (not the stomach). I took two tonight and they appear to have limited my heartburn after dinner. They are advertised as a "nutritional supplement" that can be taken safely up to four times a day. I'll use them for a few days and see if they cut back on the burn after dinner. I read about it on the People's Pharmacy website. I wont be sure if it works until I have tried it for several days, though.

I guess I need feedback from anyone on the board who has gone through this and has had acid rebound last longer than four weeks. I don't want to give up if I am just about to turn the corner and start feeling better.

It is a weird thing to say, but I think those who experience regular GERD symptoms understand this. It is hard to live worrying about when one is going to experience symptoms. It's like the person who is always anxious about experiencing another anxiety attack.

Second, does anyone have a better experience with one H2 blocker versus the other? I am taking the Zantac 150 mg twice a day, but would be willing to try another if recommended. I just don't want to go back on a PPI if I can help it.

I have to add that I had no side effects on the Aciphex other than the bone loss from my hips. I had been pretty ignorant and not supplementing my diet with enough calcium or taking the right calcium supplements (I would take calcium carbonate here and there or all at once instead of calcium citrate with vitamin D spread through the day). I have changed all that now and I am also taking 1000 mg of Vitamin D3 daily to help increase the calcium absorption.

I am slowly learning my lessons and now researching anything and everything that is prescribed.

Any feedback from forum members will be greatly appreciated. Anything else anyone can suggest in terms of remedies, things I can do.

The apple cider vinegar does not work for me. Raw apples also give me heartburn.

I have also realized reading through this that what works for one does not work for all.

Thanks all for "listening." I feel fortunate to have found this forum to come to vent, obtain support and share information.

Rose

 
Old 02-25-2010, 02:41 AM   #10
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Re: Getting off PPI's and acid rebound

Good luck to everyone who is trying to come of their meds. I am on Ranitidine 150mg twice daily and am trying to stop. So far I have managed to reduce it to 150mg in the morning and 75mg in the evening, which isn't much but it's a start.

Just a word for those taking Gaviscon or other antacids in "emergencies" on top of their normal meds. These alkali antacids are great for working instantly to reduce the acidity of stomach, but can also cause a rebound effect themselevs as the stomach tries to make more acid to compensate. I would suggest sticking to DGL, slippery elm bark or similar which do not affect pH. I have found slippery elm bark powder to be very effective, but I don't use capsules you can buy, instead I mix two heaped teaspoons into a mug of warm water and drink it all in one go. This coats the oesophagus and stomach with a protective layer of mucilage and is also quite nutritious.

 
Old 02-27-2010, 08:37 PM   #11
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Re: Getting off PPI's Update

Rosebloom- I have been reading all of your posts. I was hoping to read that you had success in managing your GERD without going back to PPIs. Sounds like youíre hanging in there so far. I have been dealing with GERD for about 5 years, and have been on PPIs for much of that time. I started to feel better, and had a scope that showed my eroded esophagus had healed. So, I went off my Protonix (40 mg 1x day). I was doing ok for a few months with just taking Tums, with some days better than others. For a few weeks at a time, I would feel the need to make myself throw up just to get rid of that stuffed, bloated feeling. Also, I developed a lot of trouble swallowing. I was going to go back to the doctor after the holidays, but right around Christmas I had what felt like a heart attack. I have been in and out of the hospital with shortness of breath, chest pain, and trouble swallowing. All the tests were normal. Everyone was trying to tell me that it was simply anxiety, and gave me Ativan (who wouldnít be anxious when they feel like theyíre choking on their food??). However, I did have another EGD that showed mild gastritis and esophagitis. I also had the manometry test done that showed mild peristaltic weakness. Through this all, I have been suffering terrible reflux. I eat small, mild meals, eat at least 3-4 hours before going to bed, but have worse symptoms now than when I was off meds, and eating bad foods late at night. I canít help but wonder if my few months off PPIs somehow made my condition worse. I am currently on Prevacid 30 mg 1 x day, but it is not helping at all. Iím afraid my doctor is going to tell me to increase my meds, but I do not want to take more. I am so afraid of what these PPIs are doing to my body. I just turned 46 and am premenopausal. I think that with my weak LES, my situation is helpless Ė I do not want to have nay kind of surgery. I have cut back on the Ativan Ė those types of meds are supposed to make GERD worse, so it makes no sense to me why I would be prescribed that! I share your frustration and concerns and feel like none of the doctors are addressing my concerns over the PPIs. I will definitely get the Dexa test done, though having been through so many x-rays while in and out of the hospital, I donít relish the idea of subjecting myself to more x-rays. Iíll also increase my calcium and vitamin D. I hope that you post again and share how youíre doing.

 
Old 02-28-2010, 09:24 PM   #12
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Re: Getting off PPI's Update

Hi TVC:

I am hanging in there. I have better days and worse days. I don't know if I'll ever be able to be completely medication-free, but I hope the H2 blockers may be safer than the PPI's for me to use long term if I have to be on something. My main problem with the PPI was that, after only two and a half years, I developed Osteopenia on both hips due to calcium malabsorption, and my doctor then wanted to put me on Actonel and increase the PPI if the Actonel gave me stomach upset. If Aciphex contributed to such bone loss in only two years, then I feared what it might do to my bones if I have to take it for the rest of my life. I have to say that the Aciphex itself was wonderful. I was completely symptom free and could eat and drink coffee and alcohol normally. Now, my diet is much more restricted and I have break throughs of heartburn here and there through the day. The Zantac does not work nearly as well as the Aciphex, which I guess means I have more stomach acid and hope the calcium I am taking is being absorbed better and ending in my bones rather than excreted through my urine.

I have been searching the literature and have come up with literature that says that acid rebound can last two to several months (10) in some people. It sounds like rebound is related to the amount of Gastrin a person has in his or her blood at the time the PPI is discontinued (the body apparently produces more Gastrin as a result of the proton pumps being turned off by the medicine). The more Gastrin, the worse the acid rebound. I have no idea how much Gastrin was in my blood in late December when I began to cut down on the dose of PPI, but the first few weeks were awful. It is gradually getting better. I usually look back and try to remember what it was like a Sunday ago, and I seem to be doing better when I look back an entire week and remember what I felt like a week earlier. I definitely experienced less heartburn today than a Sunday ago!

I am now at the end of week five and starting week six off PPI. If I had not read about acid rebound, I would have been back on the PPI in one week. It's been the thought and hope that the reflux might continue to get better or lessen that has kept me from going back to the Aciphex.

I am also deathly afraid of fracturing a bone due to osteoporosis and I don't want to take Actonel or one of those types of biphosphonate drugs as I am not too happy with the way they work (keep old cells from turning over so you end up with denser but poorer quality of bone in your body). Besides, they are hard on your stomach and I am sure I'll end up with more acid and reflux if I take them. It's a vicious cycle I want to avoid.

What I am doing is the following:

1) Taking 150 Zantac twice a day (morning and at about 5:00 P.M). I am fortunate that I don't appear to have reflux at night. I hope to eventually cut the Zantac to the 75 mg dose, but I am not in any rush right now. I seem to need the two 150 mg doses.

2) I drink Aloe Vera gel once or twice a day (a little bit goes a long way).

3) I suck on DGL tablets. I found some that are Chocolate flavored at a local health store and those taste better than the licorice flavored ones.

4) I supplement with a little teaspoon of Gaviscon here and there.Liquid Gaviscon works best for me.

5) I have avoided coffee and alcohol. I had a glass of red wine a couple of weeks back and the acid was just awful.

6) I take calcium citrate now (I used to take Calcium Carbonate) split into two daily doses with 1000 mg of vitamin D3 for my bones.

7) I take Melatonin 6 mg at bedtime as I read it may help with acid reflux, and I figured it cannot hurt if it does not help much. Helps me go to sleep.

8) I eat yogurt in the morning with honey and flavor my green tea with honey. I used to drink lots of diet coke and have cut those out completely.

9) I have found that ginger tea and camomile tea give me heartburn. I have also found that apple cider vinegar and those types of products do not work for me as they do for some other people. Therefore, I now avoid them.

10) I found a product called Prelief that can be purchased at Walgreens that I can take prior to meals to take acid out of food. That is supposed to lead to the stomach having to produce less acid. It is supposed to be safe and similar to the coffee tamer product I have seen advertised in some websites.

11) I eat my last meal no later than 6:00 P.M. and will usually drink nothing but water between that last meal and the time I go to bed.

12) I never take any pills of any kind, including vitamins, on an empty stomach.

I continue determined to stay off the PPI, even though doing so requires a lot more work and planning, and a stricter diet on my part.

Thank you for reading my posts and your words of encouragement. Maybe once your esophagus is healed and you can come off PPI's again, you can follow a step down program to avoid developing full blown symptoms again. At any rate, make sure you take calcium citrate and vitamin D3 to keep your bones from losing calcium while you are on the PPI's.

By the way, my reflux developed as I began to go into premenopause at age fifty one. There must be hormone changes going on that contribute to relax the LES. I am not fooling myself that all I experience now is rebound. I am sure part of what I experience is the same old reflux or GERD symptoms coming back again. But I am not in agony as I was the first two-three weeks of January.

What has really upset me is that when I was orginally prescribed PPI's in 2007, the phenomenon of acid rebound was already known. Yet, my physician never told me about it and never suggested an H2 blocker or any other medication first. I was given the PPI prescription, sent away and provided with a year's worth of prescriptions during each annual visit. Her only suggestion to me when I went in this last December, and found out about the osteopenia was to simply add yet another medication with potentially serious side effects. She told me it would be nearly impossible to get off PPI's and I should take the Actonel to prevent a fracture.

When I began to research these forums, I found posts as far back as 2003 describing rebound symptoms and asking for help and information. I know less information was available back then, but I feel doctors should have known more and given more information to their patients so that patients can make better choices. No mention was ever made to me to take more calcium or that the PPI could contribute to calcium malabsorption.

I will never make the mistake again of taking a medication without reading about it first. That I know for sure.

Hope you feel better very soon.

Rose

 
Old 02-28-2010, 09:58 PM   #13
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Re: Getting off PPI's and acid rebound

Hi James:

I hear ya when you say the Gaviscon and other antiacids cause rebound. I use Gaviscon very sparingly, usually a little tablespoon once every two-three days if I feel heartburn at bedtime. I don't want to go to sleep with heartburn and wake up the next day feeling miserable.

I use DGL but that seems to work better when the heartburn has not yet kicked in. I have to look into slippery elm powder. I have seen the pills but not the powder one can mix with water and drink.

James, how long have you been on Zantac? Did you first take a PPI and then went on Ratinidine or has that always been your medication?

I hear even the Ratinidine can cause some rebound but not as bad as a PPI. I know I could not have stayed off the PPI without the help of the Zantac. I think my esophagus would have been damaged by now from the rebound. At least the Zantac has made it tolerable for me to stay off Aciphex for five weeks so far.

I hope to eventually weane myself off the Zantac as well if I can, but that may or may not be possible depending on how bad my reflux is. I have no idea at this point since I had been on a PPI for nearly three years.

 
Old 03-01-2010, 04:23 AM   #14
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Re: Getting off PPI's and acid rebound

I was on a PPI (omeprazole) first for about three months, but it wasn't really helping much. Then my doctor concluded that my symptoms of reflux had been replaced by one of the side-effects of the PPI - chest pains! So they switched me to ranitidine and I saw a massive improvement within days. My previous symptoms such as globus sensation and the chest pains vanished, now I just have reflux every three or four days which is normally quite mild and short-lasting.

rosebloom - did you consider upping your ranitidine to 300mg twice daily for a month or so? This higher does is quite common for such periods before dropping to a lower maintenance dose. As you are in a transition period coming of the PPI it might help.

 
Old 03-01-2010, 06:24 PM   #15
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Re: Getting off PPI's and acid rebound

I had not considered the 300 mg dose since I am sort of doing this on my own and the box says to not take more thatn two of the 150 mg a day. My only worry would be to then experience more rebound from the 300 mg.

James, did you originally take 300 mg Ratinidine and, if so, did you experience difficulty cutting back to the 150 mg? Do you feel like you experienced rebound from the Omeprazole? How long did your rebound last? This is the beginning of my sixth week off PPI's and on the 150 mg twice a day dose of Ratinidine. I have had a hard time finding people who have kept up posting about their rebound beyond the initial stages. It seems like people post at the beginning of the weaning off period and then no more. I don't know if they give up and go back to the PPI or stick it out and simply do not post because they feel better.

 
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