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Old 08-16-2012, 07:43 AM   #1
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H2 Blockers or PPI's

I was originally prescribed omeprazole 20mg by my G.P. which did not help with my acid problem (I have been diagnosed with hiatus hernia). The doctor then changed it to pantoprazole 40mg, but still no success. He then told me to take 2 40mg a day for a week. However, after the week my acid problem seems to have got worse. I seem to be forever visiting the G.P. and I think he does not know what to prescribe me or thinks I am overreacting.

I was wondering if anyone has had more success with H2 blockers then ppi's or if they could suggest something else which they have felt more successful

thanks.

 
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Old 08-16-2012, 07:53 AM   #2
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Re: H2 Blockers or PPI's

H2 blockers, like ranitidine (Zantac) are OTC and do help. They can be taken with PPI's for stubborn cases. I also like a RX drug called sulcralfate. It works differently, by coating the inflamed/ulcerated tissue, and comes in pills (large) or liquid. If none of those help, I would ask for a scope to be sure there is nothing else going on in addition to the HH. Have you been tested for H pylori and pancreas inflammation (amylase, lipase)? You might consider seeing a gastroenterologist instead of GP for this.

 
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Old 08-16-2012, 08:10 AM   #3
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Re: H2 Blockers or PPI's

Thanks for your speedy reply. I am going to see the G.P. tomorrow and will mention that I would like to try zantac probably with a lower dose of the ppi. However, I don't think that they like being told what to prescribe as they probably think we know too much. Yes, I had an endoscope and I also have Barretts as well as the hiatus hernia so maybe this makes the healing process more difficult.

Thanks for your help

 
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Old 08-16-2012, 01:33 PM   #4
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Re: H2 Blockers or PPI's

If you have Barrett's, then you definitely need to get this under control. Sucralfate is a good suggestion. Also try the Zantac, see what happens. Sometimes folks who don't respond to one PPI do better on another one, or sometimes none of them help.

I assume you are already following some lifestyle measures: No caffeine, alcohol, mint or smoking, as all relax the lower esophageal sphincter. Avoid greasy or fried foods, as they increase acid secretion. Beyond that, use trial and error to identify your dietary triggers.

Also, posture matters. You get more reflux when lying down than when sitting or standing up straight, so remain upright during and after meals. Try to avoid bending over or putting pressure on the abdomen. Try elevating the head of the bed at night.

If none of this works adequately, you might want to consider having the hiatal hernia repaired.

Oh! I almost forgot. If you are overweight, losing weight often helps a lot. Of course, there are some normal weight people with reflux, also.

Last edited by janewhite1; 08-16-2012 at 01:36 PM. Reason: Add more

 
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Old 08-17-2012, 12:25 PM   #5
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Re: H2 Blockers or PPI's

Thanks for your help. My doctor said he does not think I need to take zantac or sucralfate and has given me Peptic. I mentioned that I was worried about the Barretts but he did not seem too concerned. I am doing all the things you suggest except losing weight. I have not had much of an appetite for months and have lost quite a bit of weight so would like to put some back on. As far as surgery is concerned they seem reluctant to do this over here 'except in extreme circumstances' so at the moment there is not much else I can do except pray that things will improve.

 
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Old 08-17-2012, 01:40 PM   #6
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Re: H2 Blockers or PPI's

You need to get your symptoms under control. Your GP should be concerned about your Barretts, I would consider changing GPs if I was you. I would expect you to be considered for surgery in your circumstances. Don't put up with being fobbed off, you need to get sorted out.

 
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Old 08-17-2012, 01:45 PM   #7
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Re: H2 Blockers or PPI's

They don't like to do reflux surgery anywhere except in extreme conditions, because it's a permanent change to the digestive system and most of the time it's not necessary. Here in the US, I had GERD for 6 years and severe uncontrolled GERD for 15 months before I finally got referred to a surgeon.

Barrett's isn't horrible news, but it does mean you need to stay on top of your reflux. If the latest medicine doesn't work, go back.

 
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