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Old 04-15-2012, 08:49 PM   #1
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Question Too Much or Less Acid plus getting off PPI

Hi - I found this board during my google searches and would appreciate any/all feedback.


History

August 1st, 2011, I fasted for 12 hours in the day, then when opening my fast, I hate plenty of food. At night, I drank two bottles of water and drank some coconut water, that is when I noticed that I was having a hard time breathing. I drank too much water and I could feel it, I had to get up and try to walk around, had hard time burping. After a few minutes in stretching I was able to burp and relive myself but i felt some discomfort in my stomach. I went to sleep and the next day noticed discomfort as well.

When eating I would feel discomfort and when not eating as well, I tried to burp but sometimes it was difficult, basically I ended up belching for some relief, but discomfort was constant now and it felt like somebody punched me, the pain was right below my chest plates.

I went to my Primary Care Physician (PCP) after one week, during that first week I took nothing. He gave me dexilant to take, I didn't know what it was, I took it for a few days but no relief.

I revisited the PCP after like 5 days, he sent for me test for gall bladder.

The gall bladder test came back great, no Issues there. He told me to go see a GI.

This is now end of August, saw GI, he said let's do a upper endoscopy to see if there is any Issue.

This is my exact endoscopy report:

"Irregular GE junction was noted in the distal esophagus. Multiple biopsies were obtained and sent to pathology. Gastritis was found in the antrum.
Biopsies of the antrum and body of the stomach were obtained and sent to pathology. The duodenal bulb was normal in appearance, as was the
postbulbar duodenum. Normal duodenal folds were noted. Retroflexed views of the cardia revealed no abnormalities. The scope was then
completely withdrawn from the patient and the procedure terminated.

ENDOSCOPIC IMPRESSION:
1) Irregular GE junction in the distal esophagus
2) Gastritis in the antrum
3) Normal duodenum

RECOMMENDATIONS:
1) await biopsy results
2) anti-reflux regimen
3) continue current meds
4) follow up office in 2 weeks"


Now, when I went to the GI, he gave me Nexium. I had the endoscopy done in two days right after my first visit.

My pain after the endoscopy grew, I even had a slight fever due to the pain, I revisited him thinking something in the endoscopy went wrong, he just told me my stomach is inflamed. He told me to take Nexium 2 X 40g every day for two weeks, and come back see him.

I took 80g for two days then cut it to regular 40g, the Nexium did help.

My biopsy results came in, everything was great with the results.

He told me to continue Nexium for 3 months and come back.

After one month of Nexium, I noticed my burping/belching was coming back, and I decided to stop cold turkey as my stomach pain was gone.

That was a bad move as now I even had sore throat symptoms which I never had. Note: I never had heartburn, just discomfort in the stomach right below my chest plates. About 10 days of not taking anything and trying OTC Zantac, I went to him again in October, he told me to take the Nexium again. We did play with omeaprazole, but Nexium worked better.

I tried Nexium, it helped initially but then stopped working. He told in November to take 80g per day for like 3-4 weeks. I took it for like 12 days and saw no improvement, so stopped and just reverted to one pill per day.

Late November, I revisited him and he switched me to Achiphex. I took 20g per day and it worked great for me.

I continued entire month of December on it and it helped.

In January, 2012, in my follow up, I spoke to him about getting off of it, he told me to switch it to every other day.

I then switched it to every other day and my symptoms did not come back. In the day I did not take Achiphex, I took DGL.

Then in late February, I decided to switch to taking achiphex one day, skip two days. I did notice symptoms like burping come back, but it was maintainable. I just took some more DGL those days.

Now

In mid March, 2012, I went to him again told him I'm doing good and would like to go to H2 blocker, he prescribed me 150mg Ranitidine for twice a day as needed.

Now when I stopped Achiphex I did see a backfire, I saw symptoms come back again, but it was not the pain underneath my chestplate, it's the heartburn, which I NEVER had. I think it is heart burn because I feel tightness and discomfort in my chest. Also, burping came back.

Note, I also increased other supplements. I started taking mastica gum which helps a bit, but DGL so far helps the most. I tried Aloe Vera juice, which I am not sure if it helps.

Now, it's going or I believe already has been a month, and this 4-5 weeks, I think maybe one or two day I was completely symptom free, but every day I have had symptoms, no pain below my chest plate for which I went to in August, 2011, but instead this chest pain which I attribute is heartburn, probably as a rebound from stopping achiphex.

My questions, current regiment, and concerns

This is what I do right now:

1. Take 150mg Ranitidine in the morning before eating anything.
2. Take DGL capsule before breakfast, lunch, and dinner
3. Take Mastica Gum capsules between lunches and at night.
4. Sometimes take 150mg Ranitidine at night.

My questions:

1. Do I have low or high acid? I did good on the PPI, but now that I am off it, I have belching again which is not always the case, I guess there maybe triggers. I don't have the stomach type of pain I had before, but now have chest pain, which I assume is heartburn.

I don't want an invasive test, I heard about the Heidelberg test but I am not sure who to go to, the GI again?

2. What else can I do to get rid of this heartburn which I never had in the beginning? I listed my regiment above with herbal meds.

3. Should I try Gaviscon? I just read about it, I am not sure if this is addictive and causes rebound like PPI? Any suggestions, is it fine to use, or is it like a PPI where it gets you hooked?

4. I am panicky type of guy, should I get done a follow endoscopy, even though I want to avoid invasive procedures, to just make sure my stomach has healed, etc. Or is it not necessary based on what I described. Again, this is more of me just making sure I am not doing harm to myself.

Lastly, I am in Orlando, Florida, so if anyone has any good herbalist or doctors, I would appreciate your feedback. I found one Naturopath who is a MD, his name is Dr. Kalias, but he's not accepted by my insurance, plus he does no insurance claims, he charges a lot, so right now he's not an option.

Looking to make sure I off meds I don't need but am recovering back to what it was like before as well without doing myself harm.

Would appreciate the feedback!

Thanks!

 
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Old 04-15-2012, 09:00 PM   #2
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Re: Too Much or Less Acid plus getting off PPI

80 mg of Nexium is a lot, and (based on the endoscopy) it sounds like your situation isn't all that severe. I have no idea why he put you on such a high dose.

It's normal for symptoms to temporarily get worse after quitting PPI suddenly. When the drug is withdrawn, your body over-produces acid for 1-2 months until things get back to normal. You are still dealing with the rebound, it takes time.

Gaviscon does not cause dependency the way the PPIs do. Take it for symptom relief without fear.

Give yourself another month or so to deal with the rebound. Keep eating bland foods that you tolerate well. Try some deep breathing exercises a few times a day. (Stress doesn't cause this, but it can make it worse.)

And hang in there! We're here to help.

 
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Old 04-15-2012, 09:38 PM   #3
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Re: Too Much or Less Acid plus getting off PPI

Thanks Jane!

Yeah I posted exactly what my endoscopy report said, which to me did not seem like acid reflux but they continued me on that regiment.

Thank you for clarifying my concern with Gaviscon, I will buy it tomorrow and use it for my symptoms. As, after leaving achiphex, I ended up getting this chest pain (heart burn) that I never had before.

Yes, your right about the Nexium, 80g is too high, so instead of continuing it for the 3 weeks or so he said, i let go of it after 10 days.

Quote:
Originally Posted by janewhite1 View Post
80 mg of Nexium is a lot, and (based on the endoscopy) it sounds like your situation isn't all that severe. I have no idea why he put you on such a high dose.

It's normal for symptoms to temporarily get worse after quitting PPI suddenly. When the drug is withdrawn, your body over-produces acid for 1-2 months until things get back to normal. You are still dealing with the rebound, it takes time.

Gaviscon does not cause dependency the way the PPIs do. Take it for symptom relief without fear.

Give yourself another month or so to deal with the rebound. Keep eating bland foods that you tolerate well. Try some deep breathing exercises a few times a day. (Stress doesn't cause this, but it can make it worse.)

And hang in there! We're here to help.

 
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Old 04-17-2012, 03:32 AM   #4
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Re: Too Much or Less Acid plus getting off PPI

I need some advice, past two days I've had continuous pain in my chest, even at night , this is first time this has happened. I have pain burping in my chest, should I see my GI? I'm concerned as to what's happening, but am afraid ill be on the ppi route again

 
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Old 04-17-2012, 11:57 AM   #5
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Re: Too Much or Less Acid plus getting off PPI

Just to add, I don't have a burning feeling, just feels like something is stuck in my chest these past two days, have a hard time burping, when i do burp/belch it is painful. This started after i hate a spicy chicken sandwich at Wendys two days ago, for some reason i thought it would be fine.

I was up at times at night due to the discomfort. I am not sure if that stuck type feeling is come from around my neck where the throat extends or chest, i know i do have chest pains. Can't figure out why or what is the solution there.

Thanks

 
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Old 04-17-2012, 12:21 PM   #6
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Re: Too Much or Less Acid plus getting off PPI

Hi,
I have some of your symptoms plus others.
Have you been checked for a Hiatal-Hernia and H.Pylori.
I had an ulcer (bleeding one) a year and half ago and have similar symptoms again. My H.H causes me to burp a lot. I have gone back on Nexium again but find it dosent really do a lot for me. I find Domperidone helps with the Nausea I suffer from. If you havent been checked for the above conditions it might be worth your while getting both done.
I also worry about taking PPIs as I'm never sure if I have too much acid or two little.
Hope you soon feel better.

Solofelix.

 
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Old 04-17-2012, 12:28 PM   #7
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Re: Too Much or Less Acid plus getting off PPI

Hi - thanks for the reply, I had a endoscopy last August 2011, everything was fine, no hernia, etc., plus no H. Pylori.

This symptom just started two days ago, I've been off PPI for over a month now.

 
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Old 04-18-2012, 11:38 AM   #8
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Re: Too Much or Less Acid plus getting off PPI

Hi - I went to my GI today due to the pain in the chest, he said this is due to Acid Reflux and I need to stay on Achiphex.

Today was exactly one month when I had completely stopped taking Achiphex.

I asked him about acid rebound, he said that is to be expected once you stop, but then he asked me if I have been taking Zatac (2 X 150) per day, I said yes, and he said if I had symptoms all of those days. I said I have had mild symptoms, all manageable, but nothing like the pain for the past two days ago.

He said then I was not taking Zantac as needed but as a need and it still did not resolve the symptoms.

He said to go back on Achiphex (20mg per day) and then I can repeat the test that I did. One month Achiphex one per day, then every other day, then switch to Zantac, and return back in 3 months.

He said I may have to stay on Achiphex every other day.

Wanted to get thoughts from you guys? Should I visit another GI for another opinion?

Thanks!

 
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Old 07-13-2012, 09:16 AM   #9
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Re: Too Much or Less Acid plus getting off PPI

Hi - I want to give a follow up - so after leaving PPI, a month exactly later I experienced heartburn, that's when I posted here, I never experienced heartburn before, I had initially gone due to pain in the stomach.

I went to two GI after I had the bout of heatburn for two days, zantac was not helping, so both said I need to go on PPI again. I took 20mg Achiphex, but that did not heal the symptoms/esophagus, so I started taking 2 X 20mg.

Right now, I am still taking it, and in two weeks will try to go down to one pill a day.

I specifically asked the Doctors, that I never had heartburn, now that I stop PPI I experienced it. I asked about acid rebound, they agreed it's possible, but they told me when I was off PPI I should not have had to take Zantac twice daily.

They said my symptoms were still not in control, hence zantac was not working properly.

I'm 31, and am frustrated at the fact that I went in exactly one year ago for pain in the stomach, but now seem to be in a worse position.

Would appreciate any feedback as to how I can get back to where I was and to possibly get off the PPI.

Both GI said I may have to take this long term and one said if taking it every other day was working for me, i should stick to that regiment.

I was wondering if there are any non-invasive test that can be done to figure out if it maybe something else, anything my PCP can write. Also, I am taking vitamin D prescription supplements to ensure I have enough calcium.

 
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Old 07-13-2012, 09:44 AM   #10
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Re: Too Much or Less Acid plus getting off PPI

PPIs are a good drug not a great drug for a lot of stomach problems, but unfortunately they are the only game in town. Sometimes people get relief from things like Zofran or Domperidone, but most of the time not.

American doctors are very reluctant to believe that rebound is, at least for some patients, a real and significant problem. I mean, would you want to believe that every upper GI patient you've seen for the last 30 years was potentially harmed rather than helped?

You're now on it every other day, right?

If you want to taper further, realize that every time you decrease your medicine, it will take your body a month or two to adjust.

 
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Old 07-13-2012, 12:12 PM   #11
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Re: Too Much or Less Acid plus getting off PPI

Right now, I'm on it twice a day. I plan on taking it for two more weeks on this schedule and then move to one per day.

I mean it's no use pondering for me what may have been if i had not started off with a PPI for the stomach problem, but I need to shift my mind to what I can do get off of it and back to normal, as the more I think about it the more I get depressed and stressed, adding to the problem.

Any suggestions on what regiment i should do when i try to go one pill per day. I was thinking of taking 2 pills one day, then one pill next, for one month, see how that goes.

Any other products that could help me heal and get back to normal that you would recommend? Initially I was taking DGL supplements the day i would skip the achiphex and that worked well.

I guess what bothers me is why i get these bout of heartburns when i never had it before, my only thinking is it's due to stopping the PPI.

The doctor i went to the said symptoms change but the core cause is acid reflux.


Quote:
Originally Posted by janewhite1 View Post
PPIs are a good drug not a great drug for a lot of stomach problems, but unfortunately they are the only game in town. Sometimes people get relief from things like Zofran or Domperidone, but most of the time not.

American doctors are very reluctant to believe that rebound is, at least for some patients, a real and significant problem. I mean, would you want to believe that every upper GI patient you've seen for the last 30 years was potentially harmed rather than helped?

You're now on it every other day, right?

If you want to taper further, realize that every time you decrease your medicine, it will take your body a month or two to adjust.

 
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Old 07-13-2012, 01:55 PM   #12
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Re: Too Much or Less Acid plus getting off PPI

DGL is a good option. Small, bland, frequent meals helps me. And taking Zantac twice a day during the rebound period is a perfectly reasonable taper protocol.

 
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Old 07-13-2012, 01:57 PM   #13
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Re: Too Much or Less Acid plus getting off PPI

Thanks, this is my fourth week taking 2 X 20mg Achiphex twice a week on a regular basis, i will continue it till the capsules run out and in about two weeks, then switch to Achiphex for one per day for a month. Then take it every other day the next month.

Here is hoping/praying the symptoms stay away so I can get back to normal.

Quote:
Originally Posted by janewhite1 View Post
DGL is a good option. Small, bland, frequent meals helps me. And taking Zantac twice a day during the rebound period is a perfectly reasonable taper protocol.

 
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Old 07-15-2012, 02:28 PM   #14
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Re: Too Much or Less Acid plus getting off PPI

Thanks DGL works great for me too, i was actually taking it when trying to get off ppi. i was taking zantac too during the taper protocol, i probably should have added gaviscon to it too, but then for the first time experienced heartburn and panicked, after being 30 days free of ppi in april, then went running back.

will start to taper off and try again soon.

Quote:
Originally Posted by janewhite1 View Post
DGL is a good option. Small, bland, frequent meals helps me. And taking Zantac twice a day during the rebound period is a perfectly reasonable taper protocol.

 
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Old 07-16-2012, 08:36 AM   #15
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Re: Too Much or Less Acid plus getting off PPI

Jane did you beat the rebound yet?

 
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