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Managing PPI Side Effects

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Posted 4/2/2005 11:09 PM (GMT 0)

Hi Everyone,

I have suffered from heartburn all my life. Over the years I had good results with H2 blockers and PPIs. About six months ago I was diagnosed with Barretts Esophagus and was told to stay on PPIs indefinitely. I had no problem with this. However, after a few weeks the side effects have become intolerable, i.e.: diarrhea, gas, lower intestinal discomfort. I tried lowering the dosage, taking them every other day or stopping for a while altogether. This would relieve the side effects but the heartburn would return and ultimately I would go back on the PPIs.

I was wondering if anyone had any experience with this and could help in me any way. I'm open to anything.

I've been on Prevacid, Protonix, Nexium, Aciphex and Prilosec all with the same side effects.

Thank you

Ron

Posted 4/3/2005 12:06 AM (GMT 0)
Your message caught my attention because i take prilosec,and i experience uncontrolable belching,and i read where acid deficiency can cause gas ..prilosec shuts off acid pumps,thus maybe causing gas.Have you ever experienced a lot of belching?
Posted 4/3/2005 1:42 AM (GMT 0)

I have experienced some increased belching while on Prilosec. However, lower gas is a much bigger problem for me. Every time I stop the PPIs for awhile the gas subsides as do the other side effects. I'm convinced that my gas is caused by the medication as it probably is in your case. You should stop the Prilosec for a few days and see if the belching lessens. Then, you'll know for sure. Have you ever tried Gas-X? I've used it with some degree of success for the gas. I can't use it too long because it adds to the other side effects that I mentioned.

Ron
Posted 2/22/2006 10:28 PM (GMT 0)
Ron, I need to be on PPIs indefinitely too. I have Crohn's Disease that is causing my reflux and causing esophagel inflammation. At one point I was biopsied for Barretts because of some odd irregularities. While awaiting the results, I read up on Barrett's and understand the reason you MUST be on PPIs.

Have you tried anythng to control the symptoms of that the PPIs cause? I suggest you pick the one that causes the least side effects and then try different things to control the side effects. Have you tried a fiber supplement to bulk up the stools and slow the diarrhea? That might help with the gas too. Calcium supplements are also successful in diarrhea control for those with irritable bowel and might work in this case. And finally, what has the doctor offered in terms of controlling the adverse side effects? Good luck.
Posted 2/23/2006 1:47 AM (GMT 0)

Ides, Thanks for the input. I'm currently on Zantac which also has side effects but not nearly as severe as those from the PPIs. The trouble with Zantac is that it wears off in about eight hours and symptoms return. I have to take it three to four times daily to remain symptom free.

I have tried medications to try to control the side effects of the PPIs. I've used Bentyl which is for irritable bowel and also otc meds like GasX. These work to some degree. However they too have side effects and after a few days on all these medications I'm unable to function. Fiber supplements sound like a good idea and are certainly worth a try. I would much rather be on PPIs for their longer lasting heartburn control and fewer doses.

My gastro doctor offers little in the way of relief from side effects. He's one of those guys that gives you the bums rush. It's a few words in his office and then a walk to the door while I'm still asking questions. I think it's time for a change in that area. I'll be trying someone new in the very near future.

I'm going to give the fiber a try and report back, hopefully with good results!

Thanks everyone for all the help.

Ron

Posted 2/24/2006 5:48 PM (GMT 0)

Have you considered surgical options for this?

Nancy

Posted 2/25/2006 1:18 AM (GMT 0)
Nancy,

I have considered surgery but my doctor advises against it. He says that 40 to 60 percent of those who have had surgery are back on medication within two years. There are aslo some new procedures, but again, my doctor doesn't feel that they have been around long enough to know what the long term results offer.

Have you or anyone you know had the surgery? If so, what was the outcome?

Ron
Posted 2/25/2006 1:53 AM (GMT 0)

No, I have not had the surgery.  I have known some who have and they actually had good luck with it.  I think the general statistics state that most people do not return to meds for about 5-10 years.

Have you looked into alternative treatments?  There is a lot of talk going around that heartburn is actually caused by too little HCL in the stomach, not too much.  If  you do some searches, you might find some things that are helpful.

If you have Barretts Esophagus, I would try and push my dr for the surgery (just my opinion and I am not a medical dr).  Thats a pretty serious condition and I would think that even if you had about 2 years of relief, that might be worth it.

Nancy

Posted 2/25/2006 2:30 AM (GMT 0)
Thanks for the input. I haven't really ruled out anything at this point I'm just not sure about any of the options. I wouldn't mind going through the surgery even if it meant only a few years relief. But, there are other side effects to consider. I don't want to do something that's irreversible and be sorry for it later.

I have heard about the too little HCL theory and find it interesting. I will be seeing my internist soon and will present that to him. Meanwhile, I WILL do some research and see what I can come up with.

There are also some new drugs on the horizon and I'm hoping that when they're available one of them will be more agreeable with me!

Thanks again.

Ron

PS. Do you suffer from acid reflux and if so, what works for you?
Posted 2/25/2006 2:34 AM (GMT 0)

yes, I have bad reflux!!  I havent found anything that helps.  The ppi's made things a whole lot worse-gave me gastritis.  Im still searching for answers too.

Nancy

Posted 2/25/2006 2:45 AM (GMT 0)
I'm sorry for your suffering. I've had gastritis and know how bad it can make one feel!

I know people who have taken PPIs for years with no ill effects. I actually took Prilosec for two months about ten years ago and it worked well with no side effects. I can't understand why my body doesn't tolerate it now. My doctor even gave me a prescription for a half strength dose and I still get a bad reaction after just one pill!

Ron
Posted 2/25/2006 7:16 PM (GMT 0)
i have gerd also with lots of acid and reflux i have been told to quit caffine choloate aspertame and booze ( dont drink anyways) i tried prilosec and it knocked out alll acid in my gut casuing bad D for 5 days. i went on flagyl as i caught something form not having any acid in my gut to be protective. you all need some acid to stop the bad bacteria from invading your GI so completely quiting acid is no good in the long run.

 

i eat yogurt with different cultures in it now, they have a new one out called activa by dannon which has a few different kinds of cultures taht your body need s to protect itself from germ invaders.

 

i need to lose weight about 30 pounds. this will hlep the gerd

i also cant eat much past 5-6 pm and expect a decent night sleep.

i am eating more fiber- fiber one cereal is low in calories ( but has the dreded aspertame) but highest fiber content of all cereals i think.

i am eating it small amounts twice daily to get me going again.

it doesnt help me thata i am on vicoden which is constipating. i want to eventually get off this altogether so that i can get back to normal

Posted 11/4/2008 12:42 AM (GMT 0)

Ron,

I noticed your post from April 2005 "Managing PPI Side Effects". I am curious if now three years later you have found a solution, or what was the outcome of your situation?

I have been on PPIs for 5 years and they have always worked find with none (or very little) side effects. However, three months ago I developed side effects: Ringing in ears, then light headedness, then shortness of breath. The side effects stopped after I ceased the PPI.

Working with my doctor, I have tried all the current ones, in standard and 1/2 doeses. And the same thing happens, when I start the side effects start, when I stop the side effects go away. And like you when I stop the PPI the symptoms of GERD return.

I am currently starting 40mg Famotidine PM with 20mg AM, and may increase to 40mg Famotidine 2X daily. All these trials, starts, stops, symptoms, side effects are driving me crazy and greatly affect my livelyhood. (It's hard to go to the gym when acid is creeping up my esophgus).

Several years ago, the PPI (Aciphex) I was taking suddenly did not work as well, and I also had severe gastritis which took me to ER but no diagnosis. Now thinking back, I think it was the PPI that caused the gastritis, as it re-occured several times after that.

At that time I did see a GI specialist who was hell bent on surgery. But thankfully (I think) the endoscopy showed good splincher and no Barrett's. So I was instructed to continue PPIs. And I have until now where my body can't seem to tolerate them.

So I am hoping you can share what was your outcome? Did you find a solution? Thank you.

Posted 11/4/2008 6:23 PM (GMT 0)

Max,

Hello and Welcome to HealingWell.  the last time Ron was seen was February of 2006.  He may still be reading and if he is I hope he sees this post.

Otherwise we have many current members with a large knowledge base that will be along and help answer your questions.

Again Welcome.

Kitt

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