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Old 09-05-2012, 05:47 AM   #1
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How long does acid rebound after PPI's last?

I've taken 2 x 2 week courses of Omeprazole, one early July, and then another early August. I realise now that when I started the second course I was probably suffering rebound from the first (it was about two and a half weeks after finishing the first).

And now, two and a half weeks since I finished the second course, I'm still having bad days, though once or twice I have managed a 2-3 day period without having to take anything whatsoever.

How long does anyone think it will take for my system to get back to normal given that I'm not a long term taker of PPI's?

 
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Old 09-05-2012, 07:39 AM   #2
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Re: How long does acid rebound after PPI's last?

When people take them for a long time, it takes at least 1-2 months for acid levels to return to normal. Since you were only on them for 4 weeks, it shouldn't take that long. Still, I'd allow up to 4 weeks.

 
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Old 09-05-2012, 08:12 AM   #3
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Re: How long does acid rebound after PPI's last?

It is possible you are just suffering gastritis/reflux issues and not rebound. Some folks never have rebound. I was on Nexium and Prevacid for 10 weeks in 2010 and had no issues at all getting off them. It isn't a given. Being on PPI's for just two weeks it may be you haven't resolved the original problem you started taking them for.

 
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Old 09-05-2012, 08:20 AM   #4
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Re: How long does acid rebound after PPI's last?

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Originally Posted by janewhite1 View Post
When people take them for a long time, it takes at least 1-2 months for acid levels to return to normal. Since you were only on them for 4 weeks, it shouldn't take that long. Still, I'd allow up to 4 weeks.
Thanks for replying When you say 'it shouldn't take that long' do you mean it shouldn't take two and a half weeks or it shouldn't take very long?

 
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Old 09-05-2012, 08:30 AM   #5
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Re: How long does acid rebound after PPI's last?

That's a possibility I guess, Johnah; all I know is that although I had issues before I started taking them, they weren't as bad as I feel now, after having taken them.

I should have stuck with my antacids (calcium carbonate/magnesium carb/alginic acid) but I began to worry about the long term effects of taking a couple of them most nights. I'm now trying to do without anything other than natural remedies to allow things to get back in balance but it's very hard, and at times very worrying.

 
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Old 09-05-2012, 08:32 AM   #6
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Re: How long does acid rebound after PPI's last?

I mean it shouldn't take very long.

Unfortunately, acid rebound just isn't very well studied, and it varies from person to person. As Johnah said, some folks don't get any rebound at all. Do keep taking antacids as necessary, and look into dietary changes to reduce reflux. If that doesn't work, you may have to see a doctor for further testing.

 
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Old 09-05-2012, 08:47 AM   #7
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Re: How long does acid rebound after PPI's last?

Thanks Jane. I see on some threads that people are using Zantac to get through rebound periods. I assume this is the same as Ranitidine. I have some OTC Ranitidine tablets (75 mg) but on the packet it says do not take for longer than 6 days, and do not buy a second packet without seeing a doctor. What's all that about?

And are there rebound effects from Ranitidine too?

 
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Old 09-05-2012, 02:21 PM   #8
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Re: How long does acid rebound after PPI's last?

You won't get rebound effects from Ranitidine it is a H2 not a PPI, different class of drugs. They are very safe to take. Surprised your doc wouldn't start you on something like that or Pepcid instead of a PPI. I have taken Pepcid at prescription strength for 15 years, it is similar to Ranitidine. Just went to PPI's this spring again after some reflux issues. Usually the prescription strength form of these drugs is twice the recommended dose as the over the counter dose. The warning on the package is standard fare, if your seeing a doc already no need to worry. They put these warnings to prevent people simply self diagnosing.

The issue with Ranitidine is that it will suppress about 50% of the acid in your stomach and is effective for just a few hours, perhaps 6-8. Omeprazole will suppress up to 90% of the acid and once taken for a few days the medication effect lasts 12-16 hours. Of course all that varies with the individual to some degree.

 
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Old 09-05-2012, 02:35 PM   #9
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Re: How long does acid rebound after PPI's last?

Hi Minx, the clue as to whether you are suffering from rebound or an unresolved original problem, is whether or not you are worse than you were before you took the ppi.

Rebound causes symptoms that are worse than your pre-treatment condition, so if you are worse after stopping ppis then it is probably rebound; if you are the same as you were before taking the medication then it is more likely the unresolved original problem.

As to how long it lasts, it varies from person to person, but it can be 2 months or even up to 6 months. It will take longer for the body to right itself, the longer you were taking the medication, so you should be ok in a few weeks if you only took it for a couple of weeks.

Many people do use ranitidine/zantac whilst weaning off ppis, but it can also cause rebound, though some say less so than ppis, as it has a less powerful action.

Personally I have tried to avoid replacing one harmful drug with another potentially harmful drug, but you have it there to try if you want to.

 
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Old 09-06-2012, 12:52 AM   #10
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Re: How long does acid rebound after PPI's last?

Quote:
Originally Posted by Johnah View Post
You won't get rebound effects from Ranitidine it is a H2 not a PPI, different class of drugs. They are very safe to take. Surprised your doc wouldn't start you on something like that or Pepcid instead of a PPI. I have taken Pepcid at prescription strength for 15 years, it is similar to Ranitidine. Just went to PPI's this spring again after some reflux issues. Usually the prescription strength form of these drugs is twice the recommended dose as the over the counter dose. The warning on the package is standard fare, if your seeing a doc already no need to worry. They put these warnings to prevent people simply self diagnosing.

The issue with Ranitidine is that it will suppress about 50% of the acid in your stomach and is effective for just a few hours, perhaps 6-8. Omeprazole will suppress up to 90% of the acid and once taken for a few days the medication effect lasts 12-16 hours. Of course all that varies with the individual to some degree.
That was helpful, thanks. We were going out for a meal with friends last night and I'd been suffering all day, so in desperation I tried a Ranitidine about 4 pm (despite my intentions to try to stop all forms of medication till I strike a normal balance). By midnight I was in full acid reflux, though I'd had a reasonably comfortable evening, which ties in with what you're saying. Two antacids did the trick at that point.

When I'd collected a prescription for PPI's the doctor told me that if I needed long term medication Ranitidine was now the drug of choice for chronic sufferers due to side effects of PPI's, so I couldn't reconcile that statement with the warning on the OTC packet.

Thanks again.

 
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Old 09-06-2012, 01:01 AM   #11
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Re: How long does acid rebound after PPI's last?

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Originally Posted by kacyc View Post
Hi Minx, the clue as to whether you are suffering from rebound or an unresolved original problem, is whether or not you are worse than you were before you took the ppi.

Rebound causes symptoms that are worse than your pre-treatment condition, so if you are worse after stopping ppis then it is probably rebound; if you are the same as you were before taking the medication then it is more likely the unresolved original problem.

As to how long it lasts, it varies from person to person, but it can be 2 months or even up to 6 months. It will take longer for the body to right itself, the longer you were taking the medication, so you should be ok in a few weeks if you only took it for a couple of weeks.

Many people do use ranitidine/zantac whilst weaning off ppis, but it can also cause rebound, though some say less so than ppis, as it has a less powerful action.

Personally I have tried to avoid replacing one harmful drug with another potentially harmful drug, but you have it there to try if you want to.
My symptoms are definitely worse than they were before. Before I took PPI's the issue was night time reflux, usually around 2.00am. If I didn't take antacids as a preventative and the reflux had chance to get a hold, I would then, and only then get a kind of oesophagitis where I would be in discomfort throughout the day, for a day or so.

Now, in this post PPI period, I am in day-long discomfort on the days when I'm bad. I have however had two periods of 2/3 days when I've been symptom free, which is the light at the end of the tunnel so far as I'm concerned. You just get so discouraged on the bad days and I keep looking at the PPI packet remembering the discomfort-free days they can offer, which is, of course the reason why I embarked on the second course. Thanks for responding.

 
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Old 09-06-2012, 06:49 AM   #12
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Re: How long does acid rebound after PPI's last?

I have never seen any studies or information that suggests H2's like ranitidine/zantac cause rebound unlike PPI's. Not sure where you might be finding that information Kacyc.

If you are having rebound from quitting a PPI it makes sense to dampen that impact with H2's rather than suffer.

 
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Old 09-06-2012, 07:15 AM   #13
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Re: How long does acid rebound after PPI's last?

Quote:
Originally Posted by Johnah View Post
I have never seen any studies or information that suggests H2's like ranitidine/zantac cause rebound unlike PPI's. Not sure where you might be finding that information Kacyc.

If you are having rebound from quitting a PPI it makes sense to dampen that impact with H2's rather than suffer.

There are only small studies, as with ppis, but if you search medical publications the studies are there. I also discussed with pharmacists the effects of H2 blockers vs ppis.

Not sure how to do a link, but type "Rebound intragastric hyperacidity after abrupt withdrawal of histamine H2 receptor blockade" and you will get to one such article. Other articles are available!

I think we all have to find our own solutions. I probably would take H2 blockers if they made any significant difference on rebound, and if I knew I would not simply end up addicted to another drug!

 
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Old 09-24-2012, 07:52 AM   #14
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Re: How long does acid rebound after PPI's last?

Went to the docs today after cutting short our holiday due to GERD symptoms. I'd taken some Ranitidine with me just in case, and decided five days ago that I would have to start taking them as I wasn't getting any sleep due to reflux. They've cleared the acid really well, but I began to experience chest and back ache and the belching continued. Then I started with yellow stools which have now returned to normal.

She's ordered an endoscopy, but told me the tube would go down my nose, which I thought was something different. She's doubled my Ranitidine to 300mg per day, but the Ranitidine dosage I've been taking so far doesn't seem to have any effect on the chest/back ache. She's also said I'll need to stop taking the tablets for two weeks prior to the endoscopy as they can mask conditions.

Foolishly I googled Esophageal cancer, saw the reference to chest/back pain and I'm in real panic mode now, losing weight and worrying because my uncle died of that. I feel as though I've been messing about for two months since the situation became worse, trying to convince myself the symptoms were PPI rebound when I should have gone straight to the docs. And the thought of the endoscopy terrifies me. Can I insist on a sedative for the procedure, do you think?

 
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Old 09-24-2012, 09:11 AM   #15
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Re: How long does acid rebound after PPI's last?

When I have had a endoscopy they have always sedated me. They spray a freezing spray in your throat, get you to the point of putting the tube in, ask you to swallow (this facilitates the scope going in) then hit you with the sedative. Next thing you know you wake up in a recovery room. Pretty easy thing to have done, better than a colonscopy as you don't have the prep stuff to take. I wouldn't fret about it.

Having the tube go down your nose is nothing that I have seen, not sure what that is. I have had a ENT check my sinus out that way with a small scope. My endoscopy's were always done in hospitals

Last edited by Johnah; 09-24-2012 at 09:14 AM.

 
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