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Acid rebound after PPI taper

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Posted 1/20/2021 2:17 PM (GMT 0)
I tapered off my PPI this past that I’d been on for a long time. I got off because I was diagnosed with SIBO, small intestine bacteria overgrowth for which there is a correlation with PPI use. I tapered off the PPI very slowly using a compounded liquid form of lansoprazole. I took 2 months to taper off 30mg. The taper went smoothly with no acid rebound. I was doing fine for some time but the gradually had little occasional bouts of Gerd symptoms. For them I took 20mg of famotidine. The need to do so has become more frequent to the point I’m now have frequent nausea and stomach pain. I’m thinking I have “reset” my parietal cells and that I’m having full blown Gerd symptoms again. I had an upper endoscopy yesterday and everything was normal. No gastritis or esophogitis but lots of nausea. So I’m wondering if I need to reinstate my PPI and do the taper all over again. I can’t handle this sick stomach feeling but I don’t want to remain on a PPI if it’s going to exacerbate SIBO. I’d appreciate any thoughts on this and the best approach to take as my GI doc has not been that helpful.
Posted 1/21/2021 1:04 PM (GMT 0)
Porkey49:

Even though you tapered of of the drug, your body is now experiencing what you probably experienced before starting the PPIs. We are not medical professionals on the Forum, so I suggest that you contact your doctor to discuss your concerns. I know that your GI doctor has not been helpful, but try again. If not, maybe it's time for a second opinion.

Sharon

Post Edited (SharonZ) : 1/22/2021 4:55:29 AM (GMT-7)

Posted 1/21/2021 3:48 PM (GMT 0)

Pokey49 said...
I tapered off my PPI this past that I’d been on for a long time. I got off because I was diagnosed with SIBO, small intestine bacteria overgrowth for which there is a correlation with PPI use. I tapered off the PPI very slowly using a compounded liquid form of lansoprazole. I took 2 months to taper off 30mg. The taper went smoothly with no acid rebound. I was doing fine for some time but the gradually had little occasional bouts of Gerd symptoms. For them I took 20mg of famotidine. The need to do so has become more frequent to the point I’m now have frequent nausea and stomach pain. I’m thinking I have “reset” my parietal cells and that I’m having full blown Gerd symptoms again. I had an upper endoscopy yesterday and everything was normal. No gastritis or esophogitis but lots of nausea. So I’m wondering if I need to reinstate my PPI and do the taper all over again. I can’t handle this sick stomach feeling but I don’t want to remain on a PPI if it’s going to exacerbate SIBO. I’d appreciate any thoughts on this and the best approach to take as my GI doc has not been that helpful.

Hi Pokey,
SIBO situation is tough. Based on my experience as I wean myself too from PPI. The first few weeks was not easy. I thought the same going back to PPI. My regular doctor did not like the idea of me weaning from my meds. But I had too because during that time it made me weak, meaning it did not make me better. Different effects on each individual.
I had my massage done and foot massage to relax me. I did small portion of food and a lemon (yellow kind) squeeze on my food, and it helped. The apple cider was too strong for me. Some people they can handle that. Eating Small portion of food also helps. Just remember when you have SIBO, food may take longer to digest. So the air goes to your throat area/esophagus. That's why there's discomfort and heartburn feelings. I did the SCD diet. You can research on what food to eat.

All the best.

As stated by Sharon, we are not doctors. I am not sharing my experience.
Be strong, you can do it. All the best to you.
Posted 1/22/2021 4:57 PM (GMT 0)
Talked to my GI doc yesterday. I don’t have H pylori. Celiac test results are not back yet. My Gerd seems to have come back full force. I just can’t understand why I did well being off my PPI for 4-5 months and now-WHAM!! But I guess it doesn’t matter why. It’s back causing great discomfort and I have to deal with it. My GI doc has recommended for now that I start with taking 40mg of famotidine at bedtime. If that doesn’t cut it I may have to go back on the PPI. Of course the PPI risks the possibility of exacerbating the SIBO again. It will be a case I guess of picking my poison. I’ve been working with a naturopath to try and get things calmed down and under control but the supplements she put me on seem to be having little affect. I’ve been to naturopaths in the past for other things and had similar less than stellar results from their treatment. I figure I can always try tapering off the PPI again. If not I guess it’s a life sentence having to take them.
Posted 1/24/2021 6:42 PM (GMT 0)
Hi Pokey49,
Don't loss hope. You can do it. Tapering with PPI when you are ready could be the best alternate I can suggest, (based on my experience). PPI does not help your SIBO. It's not easy and few times I really went back taking Pepcid then the Tums. Then I made sure I did it right, tapering it first, one day at a time. Good you are working with naturopath. They can direct you to heal naturally. Though it may take sometime and hopefully you will be ok soon. Remember your gut needs time to heal and that takes time depending on your diet, your medications and stress level.

This forum have helped me a lot knowing that there's a hope on this situation.

All the best to you.
Posted 1/24/2021 8:04 PM (GMT 0)
Thanks Tu Wang. Ive had 2 night now of 40mg of Pepcid and my stomach has calmed down considerably. I just hope the SIBO does not come back as a result. Im still on a low FODMAP diet. Ill give my stomach a rest for a while and try getting off the Pepcid down the road I guess. MY GI doc says its all about finding a personal balance that works for my gut. I guess if I had to be on an acid reducer the rest of my life, as long as it doesnt cause the SIBO to come back, there are lots of worse things one could have to deal with :o)

Pokey
Posted 6/22/2021 10:06 PM (GMT 0)
Pokey49

Any updates to your situation?
Posted 6/24/2021 2:25 AM (GMT 0)
Hi Pokey 49,

Getting better. Praise God, cat scan CT/scan, pancreas stool test, heart monitor came back normal. As it was I had discomfort galore. Having all test normal is a big blessing. To God be the Glory. Amen.

Now have to continue on the LOW FODMAP diet and per my gastro doctor. IBS or SIBO could happen after GERD. I was not even thinking that it could escalate to a different direction. But now feeling better with the new diet. Some of the GERD diet cannot work with IBS or SIBO. I did not realize that so I lost so much weight and felt horrible.

My suggestion (personal experience) is that, if GERD diet does not work try to go further and eliminate Garlic, unions, Gluten foods and dairy. If feeling better then probably LOW FODMAP diet is worth trying for 7 days and see how it works.
All the best.
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