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Old 01-11-2013, 11:33 AM   #1
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LPR/GERD annoying to out-of-control in 5 weeks??

Hi all. I have been lurking for a few days now absorbing lots of helpful info. Here's my deal: my throat got very irritated around thanksgiving 2011 and I developed globus sensation. Went to ER at Mass Eye & Ear. Doc took a quick look at my throat with a scope through my nose and said probably LPR. Prescribed 2x40mg Omeprazole per day + Ranitidine (Zantac) at night. Did that for 2 weeks...globus got a bit better, but still irritated throat. No other issues, except also developed some tinnitus, esp in left ear...which I understand is a potential (though not too common) side effect of PPIs. BTW, I had no idea about the dangers/issues with PPIs, and just blindly accepted his recommendation.

It turns out my insurance only covers 40mg/day of Omeprazole, so after 2 weeks I switched to 2x20mg of OTC omeprazole. Started noticing a little heartburn in my sternum...not much. But never had it before. In hindsight, maybe related to a little PPI rebound from dropping PPI dosage?? Have taken 2x20mg for last 2-3 weeks. No real improvement but no deterioration in symptoms. Also have switched to healthier low-acid diet...dropped all the bad food and booze.

Over the xmas holidays I did a bunch of online research. Have concluded that I want to get off PPIs ASAP and hope that all the aggressive diet / lifestyle changes will win the day -- in part because of all the long-term effects, in part because the ear ringing will drive me mad. So earlier this week I cut down to 1x20mg of Omeprazole for 2 days. But 2 nights ago I had brutal GERD/heartburn having never really had heartburn before and never had any sleeping issues at all in last 5 weeks since PPIs. Now I have alternating GERD and LPR type symptoms. Should I assume this is classic PPI rebound from cutting my dosage in half?? Is it odd to all of the sudden develop GERD from LPR-only symptoms??

I now plan to taper down to 1x20mg and 2x20mg every other day for a week, then 1x20mg per day for week, then 1x20mg every other day, etc...until I can get off...hopefully avoiding too much. Starting to supplement DGL, Aloe vera, slippery elm, etc to help with the GERD/LPR symptoms.

So a few questions here: does my assessment of PPI/reflux rebound from reducing PPE meds sound plausible/right? Should I get off PPI's now while I am only 5 weeks in? Or should I wait until my esophagus/throat more healed to taper?

Lastly, Should I get tester for "too low acid" before proceeding with anything? I have been too afraid to try the ACV approach for fear that my reflux is not because of too-little acid...don't want to irritate the issue further. BUt the theory makes sense.

This problem has gone from mildly annoying to out of control in 5 weeks!

Appreciate any sage advice that others can lend.

 
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Old 01-11-2013, 09:44 PM   #2
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

So I have been off PPI for 3 months now I had been on them for 7 years. What a disaster is was i am on 1 Zantac 150 mg once in the morning and again at night as needed with Gaviscon also as needed or Tums I have tried DGL chews apple cider vinegar ever supplement there is aloe Vera juice geezs I mean everything the thing is what works for me may not work for you hats why Gerds is so tuff to treat.but getting off PPj is the best thing way to many side effects more and more are found out all the time. The H2 blockers are much better. The lesser of the two evils.
Good luck

 
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Old 01-12-2013, 05:38 AM   #3
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

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Originally Posted by Stretch1one View Post
So I have been off PPI for 3 months now I had been on them for 7 years. What a disaster is was i am on 1 Zantac 150 mg once in the morning and again at night as needed with Gaviscon also as needed or Tums I have tried DGL chews apple cider vinegar ever supplement there is aloe Vera juice geezs I mean everything the thing is what works for me may not work for you hats why Gerds is so tuff to treat.but getting off PPj is the best thing way to many side effects more and more are found out all the time. The H2 blockers are much better. The lesser of the two evils.
Good luck
And how do you feel now? Glad you dropped the ppi's?

 
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Old 01-12-2013, 12:44 PM   #4
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Much better more normal now that I'm off them but it was a ruff trip

 
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Old 01-15-2013, 07:27 AM   #5
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Sounds very familiar as this is more or less just what has happened to me. I never really had true heartburn/acid reflux symptoms and very few episodes of the classic burning acid indigestion episodes in my life. When the rare episode would occur it could always be attributed to some overindulgence. Then back in late August 2012 I got sick with a virus that lasted about a week. Afterwards I developed a lingering dry cough and the need to clear my throat often. After about a month of it I figured I need antibiotics, so I talked my doc into giving me some. That didn't help. Then my wife, who is a nurse in a gastro office, suggested it could be reflux and try Prilosec. After 11 days that didn't help either so I stopped it. I then went to see the gastro she works for. He did and endo and saw no active reflux, but discovered the beginning stages of barrett's. That shocked the heck out of me I'll tell ya. He said let's be proactive and take Prilosec forever as a precaution. He also told me I was taking it wrong the first time. So I went back on it (had only been off my self-prescribed course for about 1 week) and took it for another 3 weeks. All the time I was taking 1x 20mg/day.

At first I felt great. The cough went away as did the mild, scratchy throat I started getting at night. But, during the 3rd week back on it the cough and sore throat started coming back. I also started having some GI distress issues like generalized discomfort and bloating w/lots of gas. So I started taking a 2nd Prilosec before bedtime. That didn't help at all so I read where taking an H2 at night proved better when combined with the a.m. Prilosec. That seemed to help. However, by this time I had learned how bad ppi's are and decided to stop them all and commit to lifestyle changes. So I stopped everything after having taken them a relatively short period of about 5 weeks (11 days on + 1 week off + 3 weeks on). This was enough to cause me severe rebound effect. The first 7-8 days was severe heartburn/acidy stomach like nothing I had ever had in my life. The moment that wore off it was replaced by mild nausea, loss of appetite, sever bloating and constant belching, and pain/lump in the throat sensation.

It's been almost 3 months since I stopped the ppi's and I've yet to get my digestive system back to where it was before I took them. All I had was a dry cough and night time scratchy throat. I've had a few good days here and there, but my digestion remains screwed up. I've tried too many things probably and nothing has worked really yet. I'm not sure if it's still my body trying to re-adjust itself from the ppi or all the stuff I've tried. My thought is that ppi's are evil things and if I'd have gone with lifestyle changes in the beginning I'd be much better off.

It's been frustrating because I believe my gerd/reflux is a symptom of underlying digestive issues I've obviously had for years. I've had a history of periods of "IBS" bloating and gas and I believe if I can get that under control I will solve my issues. If I have no bloating or abdominal pressure I have no reflux symptoms. However, it's been near-constant since stopping the ppi's.

 
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Old 01-15-2013, 07:46 AM   #6
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Quote:
Originally Posted by rednevac View Post
Sounds very familiar as this is more or less just what has happened to me. I never really had true heartburn/acid reflux symptoms and very few episodes of the classic burning acid indigestion episodes in my life. When the rare episode would occur it could always be attributed to some overindulgence. Then back in late August 2012 I got sick with a virus that lasted about a week. Afterwards I developed a lingering dry cough and the need to clear my throat often. After about a month of it I figured I need antibiotics, so I talked my doc into giving me some. That didn't help. Then my wife, who is a nurse in a gastro office, suggested it could be reflux and try Prilosec. After 11 days that didn't help either so I stopped it. I then went to see the gastro she works for. He did and endo and saw no active reflux, but discovered the beginning stages of barrett's. That shocked the heck out of me I'll tell ya. He said let's be proactive and take Prilosec forever as a precaution. He also told me I was taking it wrong the first time. So I went back on it (had only been off my self-prescribed course for about 1 week) and took it for another 3 weeks. All the time I was taking 1x 20mg/day.

At first I felt great. The cough went away as did the mild, scratchy throat I started getting at night. But, during the 3rd week back on it the cough and sore throat started coming back. I also started having some GI distress issues like generalized discomfort and bloating w/lots of gas. So I started taking a 2nd Prilosec before bedtime. That didn't help at all so I read where taking an H2 at night proved better when combined with the a.m. Prilosec. That seemed to help. However, by this time I had learned how bad ppi's are and decided to stop them all and commit to lifestyle changes. So I stopped everything after having taken them a relatively short period of about 5 weeks (11 days on + 1 week off + 3 weeks on). This was enough to cause me severe rebound effect. The first 7-8 days was severe heartburn/acidy stomach like nothing I had ever had in my life. The moment that wore off it was replaced by mild nausea, loss of appetite, sever bloating and constant belching, and pain/lump in the throat sensation.

It's been almost 3 months since I stopped the ppi's and I've yet to get my digestive system back to where it was before I took them. All I had was a dry cough and night time scratchy throat. I've had a few good days here and there, but my digestion remains screwed up. I've tried too many things probably and nothing has worked really yet. I'm not sure if it's still my body trying to re-adjust itself from the ppi or all the stuff I've tried. My thought is that ppi's are evil things and if I'd have gone with lifestyle changes in the beginning I'd be much better off.

It's been frustrating because I believe my gerd/reflux is a symptom of underlying digestive issues I've obviously had for years. I've had a history of periods of "IBS" bloating and gas and I believe if I can get that under control I will solve my issues. If I have no bloating or abdominal pressure I have no reflux symptoms. However, it's been near-constant since stopping the ppi's.

Thanks for the reply. Far beit from me to diagnose you, but I wonder if all that bloating gas is a symptom of too-low stomach acid. I have read about that multiple places. Have you tried digestive supplments or DGL?

I continue to try to wean off the PPI's SLOWLY. The last week has been brutal. I read that if you were taking 8 weeks of Prilosec you shoudl wean off over a period of 8 weeks.

 
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Old 01-15-2013, 08:27 AM   #7
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Quote:
Originally Posted by khatadin View Post
Thanks for the reply. Far beit from me to diagnose you, but I wonder if all that bloating gas is a symptom of too-low stomach acid. I have read about that multiple places. Have you tried digestive supplments or DGL?

I continue to try to wean off the PPI's SLOWLY. The last week has been brutal. I read that if you were taking 8 weeks of Prilosec you shoudl wean off over a period of 8 weeks.
DGL and HCL yes. I have read a good deal about low stomach acid and a lot of my symptoms suggest it is possible or even likely. I have tried HCL tabs with meals and do not get the burning or warm sensations in the stomach, which is suggestive of low acid. However, about 1 hour after every meal I eat I start getting severely bloated and start belching. The bloating also brings along the globus sensation in the throat and some mild "sinus drainage/sore throat" type pain, which tells me I'm getting reflux. So while the HCL tablets don't bother my stomach, what comes up in my throat is more damaging when taking them. For me this has been a kind of a catch-22 situation. The HCL may be the very thing I need to get rid of the bloating, but I can't take it while I'm getting the reflux up in my throat. I've tried in numerous times and every time it takes 12-24 hours to get my throat feeling okay again. I'm sort of afraid to take more of it until I know for sure that is my problem. My desire is to get a stomach acid test and answer the acid question so I'm not experimenting and possibly doing more damage.

Last edited by rednevac; 01-15-2013 at 08:28 AM.

 
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Old 01-16-2013, 08:55 AM   #8
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

I did the baking soda/water test and did not burp until 5 minutes. So, I tried the HCL/Betaine and had similar reaction as you - bloating & burping for a couple of hours after meal with a bit of heartburn, then sore itchy throat and sinus throat drippage through the next day.

This makes me wonder if my reflux problem is actually excess acid, not low acid as many such as Kessler suggest.

Just ramping up in the past year, my 'normal'reflux symptoms are LPR (coughing, wheezing, sinus drip and shortness of breath) with very rarely heartburn. Even saw an allergist who determined it is not 'allergies' or asthma - but probably reflux. Needed an inhaler for SOB tho.

I am reluctant tho to start the merry-go-round with a GI doc and countless tests and meds... though that would be the only way to find out about the acid question...

I have a good diet (no dairy, low gluten etc) and supplements including DGL and probiotics.

Had been thinking about a trial of omeprazole 20mg 1x per day-14 days to see if it 'helps', but your experience (and others) with the rebound effect is troubling. Maybe something like Zantac...?

Last edited by Gerdee; 01-16-2013 at 08:59 AM.

 
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Old 01-16-2013, 08:57 AM   #9
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Repeat Post...

Last edited by Gerdee; 01-16-2013 at 08:59 AM. Reason: Repeat Post

 
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Old 01-17-2013, 05:31 AM   #10
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

If it were me I'd try and H2 blocker like Zantac of Pepcid AC instead. They are less powerful and don't seem to have the rebound effect that Prilosec and other ppi's do.

 
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Old 01-17-2013, 07:26 PM   #11
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Agreed H2 blocker Gaviscon start small then work your way up

 
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Old 04-03-2013, 11:31 AM   #12
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Quote:
Originally Posted by rednevac View Post
DGL and HCL yes. I have read a good deal about low stomach acid and a lot of my symptoms suggest it is possible or even likely. I have tried HCL tabs with meals and do not get the burning or warm sensations in the stomach, which is suggestive of low acid. However, about 1 hour after every meal I eat I start getting severely bloated and start belching. The bloating also brings along the globus sensation in the throat and some mild "sinus drainage/sore throat" type pain, which tells me I'm getting reflux. So while the HCL tablets don't bother my stomach, what comes up in my throat is more damaging when taking them. For me this has been a kind of a catch-22 situation. The HCL may be the very thing I need to get rid of the bloating, but I can't take it while I'm getting the reflux up in my throat. I've tried in numerous times and every time it takes 12-24 hours to get my throat feeling okay again. I'm sort of afraid to take more of it until I know for sure that is my problem. My desire is to get a stomach acid test and answer the acid question so I'm not experimenting and possibly doing more damage.
Rednevac, how are you doin at this point? It has been a few months and I am still struggling with many of the symptoms you cite above. You had any luck?

 
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Old 04-04-2013, 10:21 AM   #13
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

[QUOTE=khatadin;So a few questions here: does my assessment of PPI/reflux rebound from reducing PPE meds sound plausible/right? Should I get off PPI's now while I am only 5 weeks in? Or should I wait until my esophagus/throat more healed to taper?

Lastly, Should I get tester for "too low acid" before proceeding with anything? I have been too afraid to try the ACV approach for fear that my reflux is not because of too-little acid...don't want to irritate the issue further. BUt the theory makes sense.


This problem has gone from mildly annoying to out of control in 5 weeks!

QUOTE]


It is an all too familiar story. Yes, it sounds like rebound. The telling thing is that you get worse than any pre-treatment symptoms that you had. Why would that be unless it was rebound. And the fact that it has gone out of control is the classic pattern of rebound - its an out of control thing!

I wouldn't taper while you feel the esophagus is inflammed. Wait a while for it to settle down. As I have said on other threads, trying to taper too quickly will end up taking longer.

The theory (about low stomach acid) does make sense, but it does not make sense when people get horrendous symptoms that they never had before, after stopping (or reducing) PPIs. It is highly unlikely, if not impossible, to have too little stomach acid having reduced PPIs, as this has to cause an increase in the secretion of stomach acid. (It is of course possible to have too little stomach acid whilst taking PPIs).


My own experience has been that waiting a week between large reductions is impossible. I therefore (since my initial jump from 40mg to 20mg) step down in tiny increments and wait a week between each reduction, or longer sometimes when necessary.

Hopefully you will find it easier as you have not been on PPIs so long. The less time you are on them the better. But trying to get off too quickly will not result in getting off them quicker, if you struggle with out of control rebound.

 
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Old 04-09-2013, 05:12 AM   #14
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Hi Guys I understand your PPI problems.
I got prescribed these things and and after heavier and heavier dosage I got heart arythmia.
It took a long time to get off them following LINX surgery. The titration plan was over several weeks to avoid rebound.
What I learnt over two years research was that our main LPR problem is Pepsin.
Pepsin aspirates from the stomach into the airway cells causing cellular damage.
PPI only reduce acid and then only part of the day.
Pepsin is not afected by PPI at all.
The good news is that you can now get tested for Pepsin aspiration in the post. Its called peptest..google it.
I've had several. it allows me to monitor the success or failure of any treatment
based on the amount of Pepsin in my saliva.(It should be zero)
Pepsin is hard to get rid of as it will bind to airway cells causing inflammation and damage which may lead to cancer.

Its worth googling and reading about Pepsin and remedies.

Reflux Revisited: Advancing the Role of Pepsin by Professors K D Bardhan & Dettmar

Potential Benefits of pH 8.8 Alkaline Drinking Water as an
Adjunct in the Treatment of Reflux Disease by Dr Jamie Koufman

Best Regards JPT

 
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Old 04-09-2013, 05:43 AM   #15
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Re: LPR/GERD annoying to out-of-control in 5 weeks??

Quote:
Originally Posted by JPT2013 View Post
Hi Guys I understand your PPI problems.
I got prescribed these things and and after heavier and heavier dosage I got heart arythmia.
It took a long time to get off them following LINX surgery. The titration plan was over several weeks to avoid rebound.
What I learnt over two years research was that our main LPR problem is Pepsin.
Pepsin aspirates from the stomach into the airway cells causing cellular damage.
PPI only reduce acid and then only part of the day.
Pepsin is not afected by PPI at all.
The good news is that you can now get tested for Pepsin aspiration in the post. Its called peptest..google it.
I've had several. it allows me to monitor the success or failure of any treatment
based on the amount of Pepsin in my saliva.(It should be zero)
Pepsin is hard to get rid of as it will bind to airway cells causing inflammation and damage which may lead to cancer.

Its worth googling and reading about Pepsin and remedies.

Reflux Revisited: Advancing the Role of Pepsin by Professors K D Bardhan & Dettmar

Potential Benefits of pH 8.8 Alkaline Drinking Water as an
Adjunct in the Treatment of Reflux Disease by Dr Jamie Koufman

Best Regards JPT
JPT, how successful has Linx been in treating your LPR/Pepsin issue? I had read that efficacy was low with LPR...was the surgery worth it?

 
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