Reflux & PPI's not working - Please help!

Hi,

I'd really appreciate your advice/help/guidance.

I'm a 30 year old male who has suffered from reflux for about 3 years now. I initially started off on PPI's with lansoprazole but eventually that just decided to stop working!? I have since found that Esomeprazole (40mg) is the one I can get good relief from day to day and generally symptom free. However over the last few years it seems like every 9 - 12 months the Esomeprazole stops working and it feels like I am not taking anything!? It's as if a switch is flicked and the medication just stops working and I get pain and heartburn symptoms all day for weeks. It seems like if at this point I stop taking them for 3-4 weeks completely (which is horrendous) my body seems to reset itself and then the Esomeprazole starts working again.

However recently I had my most recent rebound and I stopped the meds however since coming back on them they seem to not be working still!?! I've had the 24hr PH manometry test and it has come back with clear results that I have reflux and my consultant Dr recommends Nissen Fonduplication to completely eradicate the acid reflux (of which I'm terrified about as I'm and active person who is not overweight goes to the gym and exercises/lifts weights, never smoked and hardly drink alcohol).

My questions are:

Is it normal for PPI's to stop working? As I thought they were supposed to suppress the acid production in your stomach?!

What do people do to get them working again? My doc just says keep taking them and it should eventually get better and back to normal??

I'm just so sick of it which I'm sure a lot of you guys can relate to.

Thanks for reading and any input

Hi neo_4789

Both Low stomach acid and too much stomach can cause GERD/LPR. The problem is the GI doctors do not check which one you have before they prescribe a PPI. PPIs only mask the problem, they do not treat what is actually causing GERD.

I developed Low stomach acid after being on a PPI. This caused serious GERD/LPR issues. I no longer had enough stomach acid to break down my food. So both food & the remaining stomach acid kept coming back up the esophagus causing intense burning. The PH in the stomach needs to be somewhere between 1 and 3.5.... or this will cause delayed gastric emptying (food staying in stomach too long).

Google: low stomach acid

Thanks for your replies. My symptoms are mainly a pain in my chest behind my sternum, sometimes it is just a slight burning pain and sometimes it is worse where all my sternum area is really painful. I never seem to get the feeling of food coming up but just the main pain in my chest.

I guess I'll have to keep an eye on my trigger foods but I can't really seem to put a finger on anything specific. Could someone explain to me why they have been working and then seem to stop working? I don't understand as I thought PPI's were meant to suppress stomach acid!?!

Thank you

I can't stress the importance of keeping a food diary, and trying to pinpoint what your trigger foods may be. What you think is eating healthy, may not work with GERD. With some people, they need to switch medications periodically - some medications work better than others, everyone is different. Are you on prescription esomeprazole or O-T-C? I've had the NF surgery, and I tell people that it should be your last resort after you have exhausted all other options. It is a major surgery, and some people still need medication afterwards.

Hi Neo_4789,

I was diagnosed with GERD a year ago. PPI might not work with you cause you might have low acid. As mentioned by CAGU long term taking of PPI can cause Low Acid stomach. For me it did damaged my Gut flora. My experience might be different from yours but I battled it with diet and pro biotics (live). Some food supplements like Boost had helped me during the time that i become so weak as I was not able to eat anything. When i felt a bit better, I take down notes on what I ate and made sure I only eat little amount of rice and fish. Small portion helped. Since I developed low acid, putting ACV (Apple cider Vinegar) on my food helped me. ACV was too strong for me when taken as a drink. Only it suites me if mixed with food. Having a lemon on my water half an hour before my food helped too. It's been almost a year now that I wean from PPI. I think that's the best thing i did. Still being careful on what I ate but been eating most foods now.

Hope you feel better. God bless. God is my healer.

Yes for my Gerd this time doc insisted that I take an anti anxiety medicine as he said PPIs alone are not going to break the acidit reflux. He explained that it's a vicious cycle - more acid reflux more stress more stress more reflux. So he said in order to break that cycle we need to bring down anxiety and stress. Today was first day I took an anti anxiety medicine. Will give this a week and then see. Have been having issues with acidity since a year but since a month pretty bad attack with reflux. Never had noticeable reflux before this. Stomach burning, fullness, no appetite is what I am facing. Also my doctor has given me nexium in morning, anti anxiety at breakfast, and ranitidine tablet at bed time.

Can someone tell me if GERD causes a lot of burping and inconsistent motions as well?

this could be an H Pylori problem. I've had it before.

Hi Panudh

Your naturopathic doctors here in the U.S. are familiar with low stomach acid and the problems associated with low acid and why it causes GERD. However, the GI doctors in the U.S. continue to treat reflux the old fashion way by throwing PPIs at the problem. It's no surprise that PPI stops working. Then they switch PPIs and eventually that one stops working as well.

Thought I should mention low stomach acid has been associated with H.Pylori, because there is no longer the correct stomach acid to sterilize the food before it enters the small intestines. So bacteria can live in the stomach. This article below explains this much better. You will want to make sure to scroll down to the end of article.

http://www.bewellnaturallyguide.com/is-low-stomach-acid-the-cause-of-h-pylori/

Yes, stress can always seem to make GERD worse. However, one of the side effects of PPIs can be anxiety. I was lucky I did not have this side effect. One of my friends was not so lucky. Much like you, her GI doctor told her to take anxiety medication, which she refused.. The problem fixed itself when weaned off the PPIs. She no longer has anxiety. I can have her reach out to you if you like...I've included an article below concerning PPIs & anxiety:

http://rxisk.org/if-anxious-check-drugs-ppis-and-diuretics/

Thank you CAGU, SsjGogo,

Your experience and post had helped me.

I had silent GERD at firts then when I took antibiotic it flared up last June 2016. My doctor had me on PPI, she told me it might be forever I have to take it. Wohh that was comforting. I took it for 6 weeks and I just lost weight like crazy and I cannot eat due to too much discomfort. I was prescribed with Anxiety medication too, but only took it twice. It made me relax but it did not help my GERD. I think it made it worst. I was sleeping on a reclining bed since then and this had helped me sleep at least 6 to 7 hrs. When I was sleeping 2 hrs a day, my anxiety issue got worst. I prayed hard and relaxed my mind. This had helped me a lot. Diet and taking notes on what I ate made me figure out what I can and Can't eat. I read CAGU's site and I realized that due to the antibiotic and PPI I had low acid stomach. So far it's been 11 months I'm off on PPI meds. I'm eating healthy now and I'm still avoiding those triggered food. Due to the damaged done by PPI and antibiotic taking probiotics helped the process.

All the best to you all. God bless.

Hi SsjGogo,

Yes you are right a lot a rare cases of low acid stomach and I was on of them due to antibiotic I took. But my doctor said it just happen, it's not the antibiotic. (A big pharma business).

Depending on the situation, some people are taking PPI for longer period of time. I have friends that are taking it for years and some have to resort to surgery since it does not work long terms on most cases. Different on each individual. I just did not have a good experience on PPI. Who would have known as my doctors kept telling me to take it. It was thru prayers, understanding my body and changing my diet as to when my healing started. To recall it was a tough situation and I was so scared. One day, I was so desperate that i was eating the fresh aloe vera from my garden. Of course it did help long term but all remedies I tried. The healing is a process and to all out there just take it, one day at a time. You get better.

Thank you very grateful on all experiences and sharing, learned a lot from it.

God bless.