Intro & Med Question

I've been lurking here for a while but haven't introduced myself. I've been having mild acid reflux symptoms for a little over a month. I've been on Dexilant for about three weeks. I'm mostly symptom free with Dexilant and wholesale, rigid lifestyle changes, but I still experience mild heartburn or a bad taste in my mouth every three days or so. My symptoms are hardly ever painful (both before and after I started the PPI).

The GI did an upper endoscopy this week. He said everything looks good -- no damage, no hiatal hernia as far as he could tell, LES might be a little bit weak, but he wasn't sure and did not notice any obvious problems with it. The GI said to take Dexilant for another month and to come see him at that time. He mentioned the possibility of nissen but said it was too soon to talk about surgery (I agree, given that my symptoms seem to be getting progressively better, I have no damage, and the symptoms I do have are not painful).

I was a little bit concerned with the GI's instruction to take Dexilant for another month. I'm strongly against taking medication, especially a powerful one with documented long-term side effects. I'm only 32 and want to avoid being on this thing for life. The doctor's first instruction was to take it for three weeks. I did that, and now he wants me to take it for another month. I'm concerned that I'll come back in a month, only to receive the same instruction: take it for yet another month. I'm happy to take the PPI for another month, but I need to know that there's an end in sight, and I don't see one right now.

For those of you who have quit your PPI, did your doctors bless your decision, or did you have to take things into your own hands?

I was on ppis for nearly ten years. I had a weak LES and only surgery was my cure. It's not good to stay on them for a long time because one of the side effect of ppis is the growth of stomach polyps. In my honest opinion, if your not better after a few months of them then you need to consider having the surgery to strengthen the weak LES, because it will never get any stronger and in most cases it will get worse.

Usagihime: Your experience matches my suspicion is that I'd be fine without the PPI. My symptoms have never been severe, and I'd like to see how I hold up with lifestyle changes and full stomach acid.

couchtater: I tend to agree that surgery is preferable to a lifetime of PPIs. My biggest concern about surgery is the effectiveness. My GI told me that 40% of nissen patients are back on PPIs after five years. The surgery almost always improves symptoms, but not always to the point that the patient can do without medication. I'd probably prefer a lifetime of PPIs to a lifetime of PPIs and surgery, especially given that my symptoms are minimal.

Alice: I'm troubled by your advice: "Don't worry about taking them if they do the job." I'm 32 years old and hope to be around for another 70. We have no idea what the effects of PPI use will be over that term. We do, however, know that PPI use hinders mineral absorption and increases the risk of osteoporosis and stomach cancer.

Also, the choice between PPIs and surgery may be a false choice. My symptoms are about the same with or without PPIs: mild heartburn and a salty or sour taste in my mouth two or three times a week. I can handle the symptoms by taking a few antacids when symptoms appear. Moreover, my nutritionist claims to have "cured" numerous patients through nutrition and supplementation alone, and I've read several book by medical doctors who claim to have done the same. Because natural approaches cannot be patented, no one has any incentive to do -- and to my knowledge, no one has done -- rigorous testing of those approaches. But the clinical and anecdotal evidence is strong enough that I'd like to try natural approaches before submitting to a lifetime of untested drugs (untested over a 70-year interval) or surgery.

The nutritionist/naturopathic doctor I saw mid-last week said that he thinks my problem is related to heavy metals in my body. I'm pretty skeptical. He gave me some supplements and said that, if the problem is heavy metal related, my symptoms should go away in a couple of days. My symptoms haven't changed either way -- they're still mild and sporadic. I'm going to see him again this week so that we can try his next approach. He said that he's had excellent results with HCL supplementation. I'm not sure why he didn't start there. Perhaps because I'm on PPIs.

How was day #2 with no PPI?

That's was frustrated me about the experience. He knows a lot about nutrition, but he also dabbles in eastern medicine, and I'm skeptical about some of what he does. He gave me a digestive enzyme (the same one I was already taking), a calcium/magnesium supplement, and a supplement from a cow's salivary gland. I was already taking the enzyme and had been looking for a cal/mag supplement anyway, so I just went with it.

I've thought about going to an allergist about food sensitivities. I've ruled out dairy but might be sensitive to something else.

Congrats about being off of the PPI. It's encouraging to hear that you haven't had a rebound.