PPI use and warnings - are most people switching to H2 blockers now?

Hello everyone,
I'm a long time GERD sufferer. Been on PPI's (mostly Nexium 40mg) 15 years to control it. It has worked very well in the past, but not as well nowadays. I haven't been too concerned over the warnings about using it until this second study on kidney problems. I've not had any of the reported problems with this drug (such as absorption issues-calcium and B vitamin levels are all great), but I admit I am starting to get more concerned about my kidneys. I do watch my diet (no gluten or hardly any grains, low fat), but still suffer with heartburn and gastritis. My doctor says my hernia is small,and that I am not a surgical candidate. I just make a whole lot of acid. is there anyone out there who is continuing on with PPI use despite these new warnings about the kidneys? I haven't seen the FDA put anything out on it yet. I'm very afraid to try anything else as my problem is severe. I have Hashimoto's disease which compounds the problem.

I believe many of the problems reported from long time PPI use are associated with the fact that we need stomach acid to digest our food. I eat my dinner around 5:00, the take my H2 blocker around 9:00. This allows time for much of my food to be digested in my stomach, and eliminates nighttime reflux, along with elevating the head of my bed. I take tums during the day if I need it, 1 or 2 most days. This gives my stomach and throat a rest from the acid, hopefully without long term harm.

Law and tracks, whatever direction you go, your first step is to step down from PPI to H2 blocker. Maybe that's all you intend to do, it would be an improvement for you I believe. You may likely experience rebound, and will need to tough that out. You may also want to look at the Fast Tract Diet, developed by microbiologist Dr. Norm Robillard. Though I don't really follow the diet, I got a lot of good ideas from it and by consulting with Norm. I have brief but daily heartburn, but I am managing it. People here have said that GERD always gets worse, but that has not been my experience.

Peabs, I absolutely agree with you. Reflux, Gerd, lpr, whatever your diagnosis, have diverse causes. Acid inhibitors only attemp to treat the symptoms. I have gastritis, caused by too much acid, and reducing acid with TUMS relieves it. Putting HCL into my stomach, as some suggest, would be a disaster. So we each need to experiment with what helps us. I am fortunate to be able to eat pretty normally, smaller quantities at a time, fewer carbs than previously. I ditched the "healthy" oatmeal and many other items that are harder to digest. Cooked vegetables are more digestible than salads, a small glass of milk relieves heartburn for a little while to enable my food to digest more, etc. etc. So many promoters want you to follow their program, but it really is up to each of us.

Post Edited (sunbeam48) : 4/26/2016 12:48:52 PM (GMT-6)

Thank you all for the most informative posts. It takes time to write these and I appreciate it so much.

tracks83 - Thank you for sharing. It is encouraging to know that the Nexium hasn't affected your kidneys after all this time. I haven't had mine checked, but probably will at my next yearly physical.

sunbeam48 - I have stopped Nexium and try not to take the Zantac 150 until after dinner, but honestly, at this point, I can't wait very long because I have stopped Nexium and I am suffering badly. I'm hoping soon it calms down and I can get to taking it at night if needed. Yesterday, I didn't take anything until after dinner and then was desperate at bedtime to take another 150mg. Tums for some reason has never helped me. It helps for maybe 1/2 hour and then I burn even worse. I have tried so many times. My doctor even tells me to chew on Tums all day, but I just can't. The rebound right now for me is very bad, and my esophagus was sore to begin with because the Nexium had stopped working like it used to. I am taking carafate which I hope is my saving grace from anything very bad from happening while my system calms down and I try and figure this out. I don't really want to be on H2 blockers for the rest of my life so I'm praying that one day, I can control this with minimal meds and diet. My doctor actually told me once that it was okay to take two 150mg zantac to give my body a break from a PPI. I don't understand since the PPI is so much stronger and there is no way 2 150 mg Zantacs compare. I saw you can take up to 4 150's a day. Is this safe? Lower carbs has helped me and gluten free. Some gluten free starches though can give me heartburn particularly those with too much potato starch. I have just given up the fact that the starchy kind of carbs (gluten free or not) have to be minimized. Milk products definitely cause heartburn for me. A small serving of lower fat ice cream I will have once and awhile, but I do feel the burn about 1/2 later. I am also interested in staying with the the low FODMAP foods as they are easier to digest?

SC6789 - I may switch to famotidine 40mg instead of 150 ranitidine twice a day. That seems a stronger dose than 2 150's of ranitidine. What brand of papaya enzymes do you use? Does that have the HCL in it? I tried apple cider vinegar and I can't tell if it helps. It makes my esophagus hurt because it is so sore (I'm pretty certain I'm ulcerated) right now so that what I notice first!

Paulie B - Thank you. I will definitely look at the diet suggestions. I am open to anything. And I agree, that a lot of this is the push for the drugs which do not solve the problem. Your hernia is large! I will look at your link with the info.

Peabs - I agree with you. I started taking meds because of bad heartburn and ulcers they found in my esophagus, but I never focused on diet to the extreme. Now I'm convinced it is the only way. As you said, it is so different for everyone and by trial and error is the only way to know. I have already identified some foods that are worse than others. Right now, everything is causing the burn because I am coming off PPI's and only using H2 blockers. :( When you wrote about your pain at work, my heart broke. I know what you feel as many times I have tried to get off this stuff and it is always, always, excruciating pain.

SC6789,
I wish you all the best. I know it is extremely uncomfortable (actually miserable) to live with the pain and discomfort of this condition. Yes, I do know about the rebound. It is horrible. I'm feeling quite desperate today. How long has it been since you quit Nexium? I don't know if I could stand going 3-6 months like this. My esophagus is in very poor condition. But like you, I would rather try more H2 medication and keep trying diet changes to see if it calms down. That sounds like a good plan to try and drop to once a day. Did your doctor give you the famotidine or do you buy it OTC?

I have also given up caffeine, sugar (if I have any, it is once a week and only small serving), processed foodts and also gluten. I have just come off Nexium though so I don't know if any of what I do is helping yet. I was also able to eat anything I wanted on Nexium for years until recently, I developed pain in my esophagus and stomach pain. My doctor sent me for the gastric emptying test (still waiting on results) and told me to switch to Dexilant. I switched and it was not helping so I decided to go off PPI's since they were not helping 100% even with diet changes anymore. Everything is pretty bad right now which I expected. I just hope it doesn't last too long.

Thank you for the link. I like that they are chewable!

It's not only kidney disease that PPI users need to worry about, heart attack was reported as a side effect several months ago, I saw it on the news. I have been diagnosed with GERD and LPR by GI doctor, he prescribed Zantac twice daily and Prilosec, but I would never put Prilosec in my body with the risk of heart disease so I never went back to him.. My symptoms were sore throat, esophageal spasms, chronic cough, belching, burning in chest sometimes. I changed my diet to avoid trigger foods, drank alkaline water, gargled several times daily with alkaline water or baking soda, or aloe vera juice, use alklol drops in drinks to reduce acidity, took DGL, digestive enzymes, and probiotics. My first symptoms were chronic cough and chronic spasms, they disappeared within three months after diet change and Tums and Zantac use when symptoms are present (one or two tablets daily), but then I developed the sore throat and started the gargles and alkaline water. I tried Gaviscon Advanced, the anise flavor, but it burns my throat for two days, so I don't use it. The sore throat stays away unless I eat an acidic food, then I get it for three days. Don't be fooled by thinking acidic foods are just tomato, citrus, vinegar, etc. I purchased hamburger rolls and developed a sore throat so I read the ingredients, to my shock the bread contained 4 types of acids and vinegar! Another not so obvious acidic source is tap water, my filtered tap water registered ph 4.0 on the testing stick, that's very acidic!
It's been a year now since my symptoms started, and I am left with an occasional spasm and that globus in my throat sometimes and belching, but I am so much better than I was one year ago! I still take all the remedies I listed, but was able to cut out the daily gargling. I read that the U.S. gov. is to blame for the increase in GERD cases because of all the acid they allow in foods to preserve them.

Law - if you're not on any medicine the rebound will be significantly worse. In most of the posts I've read people who went off cold turkey had to go back on the PPI. I would definitely call your doctor about famotidine or speak to the pharmacist asap. I believe the OTC is the same is just comes in 20mg so it would be just more pills.

I've "only" been on PPIs for little over a year, but for me it's the only thing that works even a little. In my case the risk of cancer, inflammation, and just the general everyday suffering associated with GERD is more of a cause for fear than any possible side effects of PPIs.

Got a question on this one. I stopped taking lansoprozale 30mg a day on 4/30/16. Still feeling rebound at a little over 3 weeks. 150 mg Zantac twice a day has helped out. My chest and throat has stopped burning up but I still get the post nasal mucous in my throat and hot fumy feeling in my nose sometimes which tells me its not over. I just need to know when to gauge when its safe to start tapering off Zantac. Zantac is starting to give me headaches which is one of the reasons I had to stop the PPI. I wish my GI would had just said to eat better and lay off alcohol instead of pushing these nasty drugs on me.

Thank you everyone for your input.

I am still struggling but am determined to stick it out until I am beyond 8 weeks post PPI. I am at 5 weeks now. I have good times and then bad again. I can still feel the ulcers in my esophagus especially if I drink something very cold. I agree that foods have a lot to do with it and I am finding that the more I experiment.

Peabs - good for you and I agree about going as natural as possible. I read everything on the label now if I do buy something not 100% in natural state. And you are right that the GI docs aren't much help with the diet.

Jagged - I am with you. I was scared when they told me I had ulcers so I went right to medication. Maybe try 75mg Zantac and 150 mg for the second dose and see how you do? If well then drop to two 75's? I think the only way to know is to try it and see.

SC6789 - that is terrific news. It gives me hope to wait it out. I've not been good though taking an H2 blocker. My doctor still says 300mg max for the day, but I,thought I was doing okay until the last couple of days. I think the rebound is still coming and going. I am very happy for you and hope you can wean down more. I should get the enzymes. I think I am hesitant because I have purchased and tried so many things! The reviews are very goo so I may just try it. My poor husband has to pay for all of my trial remedies!

Bella01 - I hear you 100%. After 15 years for me though, they stopped working completely. I am scared of esophageal cancer, but I think also equally scared of the side effects which become more alarming to me as they release more information. It is a risk verses benefit scenario and everyone has to decide for themselves. For me the meds stopped working and caused severe stomach discomfort. For years I did very well, but is like my body started rejecting them.

Nicholebug1 - I have not heard of that wedge, but I am going to look it up. The one I have is probably standard, and I wake up at the bottom of it so basically off the wedge by morning. Not very effective. Let us know if you get it!


My best to everyone!

Jagged - we are neck and neck! Have you tried famotidine? I didn't realize rebound could last up to 6 months? I am worried about having serious problems before it is over with. The foods you mention I would be so scared to try! The turkey burger sounds fine but not onions. Isn't lime acidic and carbonated beverage a huge no? If it helped though, that's great! Do let me know how you are doing! Right now I am in pain and trying to ease it with Carafate and I also take Tylenol for the pain. It can be very, very painful and I have felt dizzy as well.

I get straight 20mg famotidine at BJs pretty cheap. My dog takes it so I tried one last night in desperation. It worked pretty well. I don't want to take anything, but when it is this bad, I have no choice. I definitely get froggy and mucous in the throat. For me, it has always been like that even on the PPI. This period though of going off has definitely made it worse. The liquid carafate is really good. I don't understand the use of a pill form if it is supposed to coat everything. Didn't know that about lime. I may try some.