Discussions that mention aciphex

Allergies board


Dear Boddy,

I can't believe you've suffered like this for over 25 years. I was ready to meet my maker after 6 months of this crummy disease - and you've survived over 25. Amaxing.

I truly believe that every one of your symptoms is actually that of GERD, gastro-esophageal reflux disease. The chronic cough is a manifestation of GERD called LPR - larygopharyngeal reflux. Though most people think of GERD as heartburn, LPR occurs when the acid rises higher in the esophogous into the throat and irritataes the UPPER linings. Heartburn is usually localized in the lower esophogous. But over time, most people who start out with GERD or LPR will usually develop symptoms of both.

Luckily, it's treatable, and highly so for most GERD/LPR patients. Second, while it's distressing to hear that your doctors have been pretty hapless, the medical community has only recently begun giving attention to laryngeal manifesions of GERD and realizing what an impact it has on throats and sinuses. In fact, they now believe that most cases of asthma are actually linked to acid reflux.

Unfortunatley, you are in England, which has a slightly different medical system. It seems that doctors there are sometimes a little slower to embrace new medical findings.

Let's talk treatment. First of all, I need you to be willing to go out right now and get yourself this prescription. You need to suspend your disbelief that anything can help you. You're here asking for help - but I know all to well how easy it is to let your mind think "well, this simple solution can't help me -my condition must be more complicated". I was in the same position 4 years ago, but swallowed my disbelief along with a double dose of Nexium, on a top doctor's orders. My coughing stopped 30 minutes later.

There are 2 classes of acid reducers. The first is called an H-2 blocker, of which the generic form ranitidine is the best known. H-2 blockers were the first generation of reflux drugs and were sold in the U.S. under names like Pepcid and Zantac. Ranitidine is awesome for people with occasional heartburn, but it's not going to help anyone with LPR, which for some reason is much more stubborn than basic heartburns. Ranitidine and it's fellow H-2 blockers are now sold over the counter in the U.S. - no prescription required.

The 2nd generation of acid reducers were launched 19 years ago. They are called PPIs - Proton Pump Inhibitors. You are on lansoprazole - which in the U.S. is sold under the brand name Prevacid. PPIs are much more powerful than H-2 blockers. However, while 1 dose of a PPI is sufficient for treating most cases of chronic heartburn, LPR treatment requires 2 doses of a PPI per day. And that is the most important thing that I can tell you.

Equally important is that you find the right PPI for you. In the U.S., there are 6 prescription PPIs on the market:

Nexium
Aciphex
Prevacid
Prilosec
Protonix
Zegrid

All of them (except for Zegrid) can be taken 2x per day. I recommend that you start with Nexium. Nexium is the latest PPI to have been introducted in 2002. It is more structurally unique and typically is the most effective for patients with LPR. It is very expensive here is the U.S., but it is worth every penny. It may also help you, in that it is better metabolized by more patients - seems to cause less side effects (I don't have any side effects at all). In addition, other LPR patients have had success with Aciphex and Prevacid. There seems to be less success with Prilosec and Protonix.
Zegrid is being used as a supplement to a double dose of another PPI. For instance, I take 2 doses of Nexium in the morning, then 1 dose of Zegrid before bed. Zegrid is just a new combinatin of Prilosec and sodium bicarbonate - 2 existing drugs that have been put in 1 pill together.

The Ranitidine you are taking is not going to help you with LPR. And when you begin 2x daily PPI therapy, you shouldn't take the Ranitidine with it, because Ranitidine can counteract the PPIs.

I also want you to take the 2 doses of a PPI together, at the same time to start with - and I want you to do this in the morning. If after a few weeks this timing doesn't work well - switch to one dose in the morning and one dose before dinner. Most people with LPR need the large dose together.

You can choose to add Zegrid at bedtime, but I don't know if it's available in the U.K.

As I mentioned earlier, I felt better in 30 minutes after taking my first double dose. However, I had been on a single dose for the previous 4 months and I don't know if that contributed to my getting better so quickly. Some people take 30 days to realize significant improvement.

You also need to post on anoher board - there is a forum set up for us called the "acid reflux" forum here on healthboards. You will find many other individuals there with the same problem. However, it's worth noting, that when people really begin feeling better, they tend to stop posting as much. I'd also ignore all the rubbish about natural treatment. LPR is so severe that we must have our pharmaceuticals.

Just in case you are bowled over in disbelief, I'm providing you with links to a U.S. government hosted research database called pubmed - which contains citations of all medical and scientific research articles. You just pop in "laryngopharygeal reflux" or "LPR" and you get abstracts of all the cutting edge research. you can bring these citations to your wonderful doctors, seeing as they'll probably not believe you without them. You can access it yourself by going to [url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed[/url] .

I'm allowed to post this web address because it is a U.S. government web address.

To make your first foray a little easier, here are links to some of the most relevant citations on pubmed for you:

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16598989&query_hl=17&itool=pubmed_DocSum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16189367&query_hl=37&itool=pubmed_docsum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15995512&query_hl=37&itool=pubmed_docsum[/url] (NOTE THAT "BID" means "2 pills per day")

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16615600&query_hl=17&itool=pubmed_DocSum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16817916&query_hl=1&itool=pubmed_docsum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16787744&query_hl=1&itool=pubmed_DocSum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16778364&query_hl=1&itool=pubmed_DocSum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16816932&query_hl=14&itool=pubmed_DocSum[/url]

[url]http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=11593175&query_hl=37&itool=pubmed_docsum[/url]


You will get well!