PPI Rebound Question - please help!

tk44 said...
Hello. I have GERD and I recently stopped using a PPI I have been on for the last few months as I don't want to be on it for the rest of my life. Planning to try alternate treatments.

It's been about 10 days now since I stopped and I have severe heartburn pretty much all day long, much worse than before I started the PPIs.

I trying to figure out if this is rebound and I can expect it to ease off in a couple of weeks, or if my underlying GERD is now so bad that I have permanent heartburn.

Can anyone who stopped PPIs and successfully went through the rebound tell me what it was like and how the heartburn was? Was the heartburn constant or just after eating? How long did it take to get over it?

I should mention my GERD was diagnosed as being caused by hiatal hernia and seems not so related to diet.

Many thanks.

It does sound like a rebound to me. I have been through a rebound. The heartburn wasn't all day long, it happened before and after meals. How long to get over it? 3 months.

How big is your hiatal hernia? You shouldn't go off the PPI if it's big because no alternative treatment can close the opening caused by hernia. If the hernia is caused by overweight, perhaps losing weight can reverse it. Here are a few tips for you if you plan to go off anyway.

1. Make sure you have been following lifestyle modifications like GERD diet, raising height of bed, proper eating habit etc, and you respond well.

2. Tapering off, do not quit cold-turkey. 2PPI / day -> 1PPI / day for 2 weeks -> H2 blocker for 2 weeks. Use antacid on demand. if you have severe heartburn, go back to the original regimen.

3. Use a natural agent that protects your esophagus, like manuka honey or slippery elms.

Then the hernia is not the cause. Medical journals say <2cm hernia should not matter. Usually if not hernia, GERD is caused by some metabolic reason. LES is not contracting tight or relaxes too often.

If you have all-day heartburn, you need alternative pills like Zantac (H2 blocker), and antacid, to help you avoid getting into esophagitis (inflammation to esophagus) which is bad.

I am doing fine now. My GERD is mostly under control without taking pill. I have heartburn about once or twice a week only. I have to constantly watch what I eat though. I have daily heartburn when I need to take PPI.

The best diet is the one that suits you. Start taking note of what sorts of food will trigger a flare-up. Usually it's oily food, food that irritate stomach such as spices, food that is hard to digest such as brown rice.

Thanks for the replies. Much appreciated.

I have been off PPIs now for about 3 weeks and the rebound seems as strong as ever. I'm using an H2 blocker at night and tums during the day. I can feel a burning sensation in throughout my stomach most of the day (not heartburn which I have quite badly at the moment) which I assume is the excess acid.

One benefit of a rebound I discovered is it really allows you to see what helps your reflux. I found keeping good posture and using a standing desk for work helps a lot.

Forgot to mention about Paleo diet.. Paleo works great except stay away from the fruits that are high in aicd: berries, oranges, etc.. and I would stick with water to drink