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Old 04-24-2010, 03:15 PM   #1
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Hi, I also have Acid Reflux & decided to quit PPI's

I first want to mention, it was a great emotional booster reading Rosebloom's Thread on quitting PPI's due to its "Rebound effect on acid production".

my whole acid reflux condition began sometime in the middle of march this year. I just had a mild sore throat, tightness in the chest area & without much examination, the doctor prescribed "Prevacid" a PPI. If possible I would rather not have taken it if I knew about the "Rebound effect of it".

This whole acid reflux problem or what I think it is has been going on for a month and a half or so. My acid reflux symptoms are most apparent at bedtime when I lie down. I feel something coming up to the area at the back of my throat & then my I feel this burning sensation in my chest, IOW heartburn. Recently I'm starting to get it during the daytime as well, but the symptoms feel worst when I wake up in the morning or when I'm lying down. My throat feels raw & it has this burning sensation as well. My sinuses feel a bit more sensitive these days, and my ears feel a little bit stuffed up & sorta wet. Sometimes, when I wake up I feel like the air that I breathe in is really cold. My facial color has become more tanned like than before (maybe due to multi-vitamin intake).


Now, I have decided to quit taking Prevacid because I believe it was in taking this medication that brought on the symptoms of GERD, since prior to taking this medication for the first time, it wasn't that bad. In fact, I have never really consistently taken this medication over the course of a month or so. The longest I took Prevacid was for 5 days or so, and then I stopped taking it again, then on and off.

Here is my list of things I'm going to do to get over the 3 months (potentially even longer) Acid Rebound from not taking Prevacid.

1) Diet rich in lean meat protein (eg. chicken breast, chicken leg) and bean curd while staying away from caffeinated drinks, fatty foods and citrus.
2) Low-Complex Carbohydrate diet (maybe a slice of whole wheat bread)
3) Eating alkaline forming vegetables & fruits (broccolli, carrots, bannana etc)
4) Eating a tablespoon of Manuka Honey 4 times a day. (i have the umf 5+)
5) Chinese herbal medicine (hangekoubokutou which is supposed to relax the muscles and regain back normal functionality of the body)
6) Aloe Vera Gel (if i can gain access to it)
7) DGL (if i can find it in my local health food store) to soothe my burning throat.
8) Finish eating before 7pm & not going to bed for at least 3 hours after eating.
9) Take Multi-vitamin & Mineral supplement along with my solid food (which should aid in maintaining my health and strengthening my immune system)
10) Perhaps have Gaviscon just in case of emergencies. (better loose than constipated)
11) Elevating head of bed at least to a 45 degree angle so gravity can do its job better in keeping the acid at bay. (i usually can't sleep well with bed elevated, but its better than going into a panic because of throat issues)

I haven't used Gaviscon before, and I have still not yet discovered what is really the underlying problem.

I got a referral to see a gastro enterologist who also happens to use the new pH monitoring system called the Bravo pH monitoring system which actually monitors reflux episodes over a 48 hour period by keeping a record of pH changes where the sensors are placed. This will tell me for sure whether I have acid reflux or whether its some other health condition thats causing it.

I might also go see an ENT specialist to check and see my current throat esophagus condition. If its not too bad then thats great new.

I just don't get why just lying down makes stomach content come up all the way to my throat, even though my head is above my stomach when i'm lying down on my bed inclined.
This might mean I have to have surgery to tighten up the LES or could it be the UES as well since the condition that I have seems similiar to LPR.

Last edited by Administrator; 05-04-2010 at 09:30 AM.

 
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Old 04-24-2010, 11:55 PM   #2
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

When you lie down, all your muscles relax. This makes it easier for reflux to occur.

also, when you are standing straight up...gravity works better to keep things where they oughta be...as opposed to when you are laying flat...or even slightly elevated. Think about it.

 
Old 04-25-2010, 12:09 AM   #3
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

I am happy to see you started your thread and think mine already did what it was intended to do. For those who intend to quit taking PPI's, the weaning off process must be done slowly. Also, if you are not prepared for the rebound and have other remedies at hand to ease the process, the temptation will be to run back to the PPI because the acid is terrible at first. It sounds like you have a great game plan. If you cannot find DGL locally, you can certainly buy DGL and aloe capsules online.

I think I am by now through with most of the rebound and the symptoms I now have are probably what I am going to have to live with.

My plan is to slowly wean myself off from 150 mg to 75 mg of Zantac. I may do that by starting to take the 75 mg in the morning and then seeing if I need another one at lunch. If not, then I'll not take another Zantac till dinner which is my biggest meal of the day.

I am glad my thread was helpful. When I started posting here in January I noticed that folks posted once or twice in desperation and then sort of disappeared. Therefore, it was hard for me to know whether they succeeded in their effort to get off and stay off PPI's. I wanted to chronicle my journey so others could see exactly what happened to me, what I did to get through it and just how hard it was.

Most important, do not get yourself off the PPI suddenly. Start reducing the dose, taking it every other day, supplementing with Zantac or another H2 blocker as needed, etc.

Good luck and I'll be checking.

Rose

 
Old 04-26-2010, 08:32 AM   #4
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Are you saying that acid rebound is the regurgatation that comes up into the sinuses, mouth and throat and is caused by weaning yourslf off PPIs?

 
Old 04-26-2010, 10:27 AM   #5
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

In addition to all your symptoms, I've also found that I am very seldom hungry.
In order to keep healthy, I have to force myself to prepare & eat at least 4 healthy meals per day.
Could this 'forced eating' lead to other health risks?
Carmenn

 
Old 04-26-2010, 10:47 AM   #6
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Hi All, I don't want to get to the details of my condition but I am in the same boat. I have Gerd + IBS and am going crazy with the withdrawal rebound. I am at only weeks now







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Last edited by Administrator; 04-26-2010 at 11:11 AM. Reason: removed copied and pasted info: disallowed

 
Old 04-26-2010, 01:16 PM   #7
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

I'm actually doing pretty well. I have been off PPI's for about 2 months now and only take a Pepcid chewable before sleeping. All my muscle aches are gone since I stopped my PPI. My throat still bothers me some times but nothing like it use to. I'd rather have a slight sore throat then walk around like an old man. Every joint was aching, now I have no aches at all. I am riding a bike on the weekends and am able to run without painful knees. It's funny how one thing can lead to another, then another etc. It starts with reflux, you take PPI, you get aches and pains, reflux gets better then worse, you take more reflux meds, you feel worse etc. etc. etc. Fortunately I'm going in the right direction now.

 
Old 04-26-2010, 08:14 PM   #8
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Quote:
Originally Posted by neddyflanders View Post
I'm actually doing pretty well. I have been off PPI's for about 2 months now and only take a Pepcid chewable before sleeping. All my muscle aches are gone since I stopped my PPI. My throat still bothers me some times but nothing like it use to. I'd rather have a slight sore throat then walk around like an old man. Every joint was aching, now I have no aches at all. I am riding a bike on the weekends and am able to run without painful knees. It's funny how one thing can lead to another, then another etc. It starts with reflux, you take PPI, you get aches and pains, reflux gets better then worse, you take more reflux meds, you feel worse etc. etc. etc. Fortunately I'm going in the right direction now.
I am so glad to hear you are doing much better and have been able to stay off the PPI's.

I feel I am doing better too, though I am afraid to call a victory too soon and wake up with horrible heartburn tomorrow. Maybe there is a way to live without the PPI's after all.

Rose

 
Old 04-26-2010, 08:45 PM   #9
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Quote:
Originally Posted by hawkins6 View Post
Are you saying that acid rebound is the regurgatation that comes up into the sinuses, mouth and throat and is caused by weaning yourslf off PPIs?
Acid rebound is the excess acid production that occurs to many people when they suddenly stop taking a PPI. One's body produces an excess of the hormone gastrin as a result of the acid suppression caused by the PPI. When the PPI is gone, the gastrin signals the proton pumps in your stomach to start dumping acid (because the PPI is no longer inhibiting the pumps) and thus the rebound effect. The theory is that you will experience rebound and excess acid until the gastrin in your blood levels off or goes down.

What you are describing to me sounds like GERD or reflux. You can experience reflux with or without taking or quitting a PPI. The rebound is an excess of acid your stomach produces as a result of stopping acid suppressing medication.

Rose

Last edited by rosebloom; 04-26-2010 at 08:46 PM.

 
Old 05-03-2010, 07:45 AM   #10
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Okay...time to start over again...

I went to see a Gastroenterologist at a University Hospital in which he spent over an hour talking to me about my situation and how I should deal with it. He prescribed me:

PPI - Omeprazole 20mg
Prokinetic Agent - Mosapride citrate hydrate
Tense Muscle/Anxiety reliever - tandospirone

for a period of 21 days.

What I understand about Acid Rebound so far is that it has nothing to do with the frequency of reflux but rather the quantity of stomach acid (HCL) produced in the body. Correct me if I'm wrong?

According to what I read as I googled...patients that took omeprazole for a period of less than 4 weeks with 20mg dosage once per daily, had shown no hyper-acid secretion (in other words acid rebound). Other sources seem to also suggest that too, but when increasing the dosage to 40mg and for a longer period of time, there was acid rebound but acid secretion went back to the way it was before taking omeprazole. So for me, I would consider it better than Prevacid (lansaprazole) which I was taking before, but still my goal is to quit this PPI.

Doctor told me that the prokinetic agent is supposed to improve the functionality of esophageal peristalysis and the LES (Lower esophageal sphincter) as well, so I wouldn't mind taking that.

The muscle/anxiety relaxant would be helpful in not aggravating my current condition.

New goal: (though perhaps i might take omeprazole for a duration of 21 days and then quit)

- Stop Omeprazole PPI cold turkey (according to studies done on Omeprazole, there seems to be no rebound hyper-acid secretion for patients that took 20mg dosage once daily over a period of 4 weeks or less)
- Take Prokinetic agent 3x daily
- Take Anxiety/Tense Muscle Reliever 3x daily

This should be a nice test to see if things will get back to normal again. Before stopping omeprazole, I plan to first finish taking the anti-biotics I was prescribed by my ENT for the inflammed top part of the esophagus and laryngeal area. After that, no more omeprazole.

 
Old 05-03-2010, 06:38 PM   #11
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Do not stop taking any PPI cold turkey. There was some study conducted that showed that even normal individuals (those without prior symptoms of GERD) developed acid rebound after taking a PPI for a period of time. I don't know if it was longer than four weeks, but I recall it was a short study. You need to wean off the PPI slowly and gradually to avoid rebound. I don't know if most or all people experience rebound, but the rebound will make you run back to the PPI.

You may want to read others' posts here regarding acid rebound and weaning off PPI's before you go cold turkey.

I have realized after much soul searching and trial and error that I may have to stay on some type of acid reducing medicine forever. I don't take a PPI anymore, but still take Zantac twice a day daily, and don't think I can be without it.

You may also want to read about the prokinetics. They too can have serious side effects with prolonged used, so they are not necessarily safer than the PPI's. I know Reglan can cause tardive dyskenesia or involuntary movements with long use. I am not familiar with the one your doctor prescribed, but it may have a similar side effect.

Please read up on the potential side effects of all medications, particularly if you have to take them long term. If your doctor wants you to take the Omeprazole and prokinetic for four weeks, that sounds like a good game plan to help you get through the most acute symptoms. After that, be prepared with a lot of information so you can have a good discussion with your doctor if he/she wants you to stay on these meds long term.

I am writing all this because I am one of those people who used to trust doctors blindly and have learned my lessons the hard way.

Rose

 
Old 05-04-2010, 07:43 AM   #12
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Re: Hi, I also have Acid Reflux & decided to quit PPI's

Today, will be..again..the 1st day off PPI (Omeprazole) except, I'm still taking:

- Prokinetic agent (mosapride citrate hydrate)
- anxiety reliever (sedile)
- Chinese Herbal Medicine (to get rid of the inflammation in my throat)
- anti-biotic (flomox)
- I'm planning on adding a stomach lining reinforcement medicine (since acid rebound is going to be working hard in my stomach)

My dinner: finished at 7:00pm. Will not eat or drink anything after this. Probably sleep by 11pm or so.

- Apple
- Rice (1 and a half bowl)
- fermented beans
- cod fish (marinated with herbs & virgin olive oil)
- Water
- Sea vegetables

So far symptoms include bloating, abdomen is really tight & a tiny pain occasionally. This is why I should take a medicine that actually strengthens the stomach lining at least temporarily until the acid rebound subsides. this so-called acid rebound shouldn't be too bad since I've only taken the omeprazole for about 4 consecutive days only, except when adding the other PPI's like Prevacid that I used to take on an on & off basis, it could be a bit different.

- so far made sure nothing is even applying any amount of pressure to my abdomen area.
- bed is also raised 10inches high

we'll see how my sleep goes today...

 
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