Trouble with PPI's

Hello to my fellow Crohn's sufferers, my name is Ryan.

I was just curious as to how many of you have been on proton pump inhibitors for longer than 1 year and if any of you have had adverse effects from them.

I was on them continuosly for 4 years from 2003-2007. Started out with nexium (horrible D experience), then quickly moved to prevacid which I stayed on for a year until it stopped working for me. I've been on protonix as well which also seemed to become less effective with continued use. Finally, I was on achipex for several months and then something happened and my stomach hasn't been the same since.

The only way I can describe it is I started feeling hungry all the time, even after pretty large meals. At first I couldn't figure out what was going on, I told my doctor who didn't think it was too serious and brushed me off. After experimenting with my medications I discovered that this feeling was mostly relieved by stopping the aciphex. I also lost a few pounds during this time even though I was eating more food.

I've been having to manage my gerd since then with OTC acid blockers and antacids (and these make the hungry uncomfortable  feeling come back if I use them too much). I just couldn't tolerate how those drugs were making me feel. During bad attacks of acid reflux I've tried to go back on other ppi's with the same result, feeling hungry and weight loss. I have told my doctor about it but they don't seem to have any answers and sometimes act like they don't believe me.

I've heard that staying on ppi's long term can be dangerous. I'm just curious if anybody knows anything about what may be going on with me, I had another bad attack of reflux last week and I need some other way to control this besides ppi's.

I have been on PPI's for probably 3-4 years and have not had any bad side effects from them.  Just keeps my GERD in check.

My dad has Barrett's Esophogus and I have bad acid reflux. I have been on PPI's since I was 13 and I am 27 now. I did prilosec for 7 years, twice a day and then it stopped working. I went on prevacid and it never worked. I was then on Nexium twice a day and then when my diarrhea got worse put down to once a day nexium. When that stopped working I got put on a combination of protonix in the morning and zantac at night. It works great for me. I do often feel hungry and feel awful if I don't eat when hungry but I just thought i had some blood sugar issues. I won't be stopping my PPI's anytime soon.

Hi Ronyan,

I have a weak valve (the valve between the esophagus and stomach), and thus have had GERD my entire life.  I've been on different types of acid reducers since my teens; then progressed to the H2 blockers (Zantac etc.); then progressed to PPIs.  I've probably been on PPIs for at least a decade.

It seems that after I've been on a particular PPI for a long time, after awhile it doesn't seem to work as well.  So then I switch to a different brand of PPI and I again find some relief.  (Currently I'm on Zegerid and it works well for me.) 

I have a fantastic GI doc, and he's not at all concerned about long-term use of PPIs.  He is aware of the osteoporosis link, and suggests regular use of calcium supplements.  He also had me do a Dexa scan in 2007 to check for osteoporosis.  At the time I had the scan, I didn't have osteoporosis, but had some PRE-osteoporosis in one hip.  That doesn't necessarily mean that the PPIs caused it though.  ALL the women in my family had osteoporosis, so it tends to run in my family---and they weren't on PPIs.

Definitely paying attention to what foods cause you reflux, and then avoiding those foods, helps!!  And don't eat 3 hours before bedtime.

Good luck!

Crohn's causes gut permeabitity due to regular inflammation. This permeability allows food allergens to enter the blood stream and cause antibodies to that allergen to form. Thereafter, upon eating that food, the mast cells in the stomach react to the food. One of the products released by the mast cells is histamine. Histamine causes more stomach acid to be released. As well, the mast cells release a host of other inflammatory agents and the stomach is inflamed as well as hyper-acidic. As you know, inflammation can cause gut blockage due to swelling. Similarly, stomach swelling causes the stomach valves to leak. Avoiding food allergies can avoid all this.

On the other hand, taking PPI's reduces acidity. Reduced acidity changes the pH of the stomach enough so that your digestive enzymes don't work. This results in undigested food entering the small intestine. Undigested food slows down peristalsis which allows bacteria to over-grow in the SI (SIBO). Moreover, if your gut is inflamed (as can happen with SIBO), the resulting permeability will allow any food allergens from the undigested food to pass into the bloodstream and create new food allergies, or just inflammation from existing food allergies.

There are several long-term problems associated with PPI's as well. If you go to Google and start typing PPI's into the search, you will see several choices in the auto-complete box to do with heart attacks, osteoporosis and others that are known complications of long-term use of PPI's.

The older H2 blockers target histamine and would be preferable if you cannot manage your problem by diet control.

Link for anyone interested: Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients

Post Edited (Keeper) : 9/7/2009 2:38:47 PM (GMT-6)

Hi Ronyan

Hope you get things sorted soon.

I'm on PPI for acid reflux and I can't help but feel it had a lot to do with my current flare-up.

(((HUGS)))