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Worried - omeprazole no longer effective

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Posted 6/22/2017 4:56 PM (GMT 0)
Hi all - I'm a 46yo male

I hope someone can offer me some advice. I have been using omeprazole regularly for the last 4 years or so with great effect.

I was diagnosed with a hiatal hernia after an endoscopy in my late thirties. Main symptom was nausea after eating lunch, but later this turned to stronger acid indigestion discomfort.

In April I suddenly got very nauseous after eating and the doctor recommended a switch the 30mg Lansoprazole in the morning. This worked for a couple of months but I had a flare up after taking some codeine for a back strain.

Since then I've had some globus / throat symptoms and intermittent nausea.

A week ago the doctor suggested Nexium twice daily but this has not eliminated the symptoms.


So.....

Anyone know what might be going on? Should I ask for another PPI or try H2 blocker? Should I push for another endoscopy?

Thanks in anticipation!

Phil
Posted 6/22/2017 7:47 PM (GMT 0)
Have you made any lifestyle changes, tried a GERD friendly diet, kept a food diary to see what your triggers may be? When was the last time that you had an endoscopy and/or barium swallow?
Posted 6/22/2017 8:41 PM (GMT 0)

SharonZ said...
Have you made any lifestyle changes, tried a GERD friendly diet, kept a food diary to see what your triggers may be? When was the last time that you had an endoscopy and/or barium swallow?


Funnily enough I've resolved to lose weight and I log every thing I eat. I've not fundamentally changed my diet though, just reduced the volume. I eat a lot of fruit and tend not to eat much bread.

I've only had one endoscopy and that was probably 18 years ago.
Posted 6/22/2017 9:46 PM (GMT 0)
In my own experience, fruit seems to have the potential to make things even worse. Despite what everyone tells you, fruit is concentrated source of sugar (its just tied up in fiber). There is just as much sugar in a large apple as there is in an 8 oz can of Coca-Cola. I would recommend to include more veggies, instead of ramping up your fruit intake.

Also worth mentioning - there seems to be some relationship between digestive problems (GERD, IBS, etc.) and the fructose : glucose ratio of the fruit. Fruit that has more glucose than fructose is more readily absorbed by the digestive system than one with more fructose than glucose (which can lead to digestive discomfort and other issues). For instance, a banana has much more glucose than fructose, but a mango has much more fructose than glucose. This could also be a potential explanation for why people claim to be sensitive to 'high fructose corn syrup'. There are a number of lists available telling you what to avoid. I would also recommend looking into the 'FODMAP diet' which includes this way of distinguishing fruit.
Posted 6/27/2017 7:29 AM (GMT 0)
In my experience with PPI, I had 2 rebound and have been in Emergency more than 5 times over 3 months. I now use famotidine or H2 blockers. What I want to share is I would try to go naturally with eating Chia Seeds, it has helped me over the weekend without any meds, I still need at night, I only eat a spoonful before and after meal. Whenever I feel I have heartburn or reflux I eat them.
Please mix with water before consuming as they expand into gel. It helps to reduce my gastric juice level.

I am still recovering but I can feel the difference.

Cheers,
Felix
Posted 6/30/2017 8:20 PM (GMT 0)
It has been about a week. How is the weight loss going?

I would second the EJohn's thoughts on fruit vs veggies. Veggies will do you way better than fruit and should be the main staple of your diet.

Have you had yourself tested for allergies?

I personally wouldn't bother with the endoscopy if you know you're refluxing. Just start implementing solutions. Dramatic diet change for a while, rebalancing gut bacteria, losing weight until you are at a healthy bmi.
Posted 7/2/2017 7:38 PM (GMT 0)
Hi all

Update - saw doctor who is testing me for H.pylori.

He said I have to be off PPIs for the next two weeks as they can affect the test. I've been on ranitidine 150mg twice a day - aside from a small acid rebound about 3 days in I feel much better and the nausea has now completely gone!

Phil
Posted 7/3/2017 1:55 AM (GMT 0)
Hi Phil,

Your story similar to mine, I was on omeprazolle PPI then switched to famotidine H2 blockers for 2 weeks it felt I got improvement. However the moment I tried to taper off meds, I got good and bad days. Sometimes I can sometimes I can't, I'm two week already into famotidine. Hope you could share you story once you have your endoscpy done. Mine scheduled on 28 July.

Cheers,
Felix
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