PPI s , lansoprazole, taking long term

The problem with PPIs is that it is easy to quickly become dependent upon them and they can have serious side effects long-term. I have used them, but only short term, and only when I had chronic GERD. I was fortunate in discovering the root cause of my GERD (Olive oil)and so that's the advice I give to you...look carefully at your lifestyle, and what you are eating, often people with UC will find that there may be a couple of foods that our bodies are struggling with, hence the GERD.

Poppie said...
The problem with PPIs is that it is easy to quickly become dependent upon them and they can have serious side effects long-term. I have used them, but only short term, and only when I had chronic GERD. I was fortunate in discovering the root cause of my GERD (Olive oil)and so that's the advice I give to you...look carefully at your lifestyle, and what you are eating, often people with UC will find that there may be a couple of foods that our bodies are struggling with, hence the GERD.

Chronic heartburn has its own serious consequences long term. So you MUST find a way to stop it. As Poppie said using PPIs as a short term fire extinguisher is OK but long term try to see if you have food triggers that can be avoided.

The problem with Proton Pump Inhibitors is that they perform as promised. Inhibiting stomach acid can induce Small Bowel Bacterial Overgrowth for some people. Not to mention that other bad bugs in your stomach and intestine such as C Diff and H. Pylori can run unchecked without enough stomach acid. PPIs also inhibit the absorption of calcium, iron and B12.

I am one of the lucky ones who can avoid heartburn by cutting back on caffeine and chocolate. Food triggers are a well known cause of acid reflux.

Long term PPI use can also cause osteoporosis. You need a slightly acidic stomach to properly absorb calcium and other minerals. So depending on your steroid use I wouldn't want to add that risk factor to IBDers already high risk.

The clinic I go to for my bones right now there is a woman who had no other major risk factors but PPI use and she now has osteoporosis.

Just a thought, have you tried Digestive bitters before you eat? Some people say it can help with similar issues.

You can try to not lie down and try to remain vertical after eating. I found that chewing 2-3 capsules of deglycyrrhizinated licorice root (DGL) can effectively relieve heartburn. Even though it is considered 'natural' I don't know how safe it is long term.

When the PPIs first came out, the data on them showed almost no side effects and no long term risks. Lots of doctors believed that, but in hindsight they should have known better.

Now that the PPIs have been heavily used for 20 years or more, lots of data has been collected. And the data shows increased risks of lots of things - c.diff infections, b-12 deficiency, bone density issues, etc.

It's important to keep in mind, however, that these increased risks are real but not huge.

It's also important to understand that acid reflux is not just a nuisance for some people. It is potentially a serious condition with long-term risks such as esophageal strictures, Barrett's esophagus, and increased rates of esophageal cancer.

So it's important to treat acid reflux disease. But it should be treated with as little medication as possible.

So it's all about balance, and to know the balance to strike, you need to work with your doctor and even have upper endoscopies now and then.

If you need PPIs everyday, you need them.

But if you can get away with lifestyle changes, by all means do so.

And if you just need antacid meds now and then, or even just a couple times a week (not everyday), then you can take the H2 blockers. That class of medication includes Pepcid, Zantac, and Tagemet (or their cheaper generic equivalents). These aren't as effective long-term as the PPIs, but they are cheaper, work faster, and have lower long-term risks.

Again, it's important to work with your doctor to make sure you're doing enough to control your reflux, while at the same time not over-medicating when you may not need to.

I've been on lansoprazole and Dexilant for about six years now (not at the same time). I haven't had any issues with them so far. I asked my doctor about PPIs causing people to be more prone to c diff, and he said that was, and I quote, "hogwash."

However, this was from the GI doctor that I have "fired" for misdiagnosis, so take it with a shaker of salt.