Concerns about pantoprazole....

1) Is the long-term use of pantoprazole safe? How long is usually recommended by a doctor? Is it typical to be on it "indefinitely"?

>>>8 weeks is the usual course of treatment. If the symptoms continue, then another 8 week course is prescribed. Doctors began using them longer to keep symptoms in check. It is not unusual to find people who have been taking PPI's for decades. However, keep in mind that the drug company only did research for a year, so there is no data past 12 months - this information is on the Protonix web site. PPI's were never intended to be used long term; they were meant for short term acid relief to allow the esophagus time to heal.

2) Should I be having any sort of testing to determine if any damage has occurred to my esophagus? Is treating based on symptoms alone typical?

>>>Treating based on symptoms alone is usually where a family doctor would start. You've just started the course of treatment so give it some time to work. It might be a good idea to find a gastroenterologist if you find that you are taking the medication longer than a few months. They will most likely do an endoscopy. That is the only way to know if there is any damage and if the medication is working - taking a look is worth it.

I trust my family doctor but he does seem a bit "casual" about this issue and I'm just not sure if that's normal or not. Any advice or thoughts appreciated!

>>>My family doctor was also casual for many years and I'm not surprised - after all, look at the commercials on TV. Acid Reflux is now a household word and it seems like everyone has it. I like my family physician and trust him a lot, however, family doctors are not specialists. While I was taking the prescribed Protonix regularly over several years, my esophagus was still being damaged. I finally consulted a gastroenterologist who started really looking into the problem - testing was done to determine the cause of the reflux; endoscope and barium swallow test were two of them.

Sometimes the 8-16 week course is all that is needed. Sometimes the cause of the GERD is a mechanical problem with the lower esophageal sphincter that surgery is needed to correct. In my case, surgery was the best option after many years of taking PPI's.

Every person is different so treatment for me may not be the same for you. I'm now 5 1/2 months post op from a Nissen Wrap. I have no reflux at all and take no meds. The surgery is not for everyone, but depending on what the specialist finds it could be an option later down the road.

Good luck.

Thank you for the replies. I've become resigned to using a PPI long-term since even missing a day seems to provoke a serious attack of GERD. I will look into a referral to a gastroenterologist.

I have one other question, though. A few days ago I missed my dose of pantoprazole and had horrible symptoms. The next 4 days I took it as scheduled and all was fine. The 5th day I took it but "fell off the non-GERD inducing diet wagon" and had horrible symptoms again (even though I'd done that before and had no symptoms). Could it be that the day I missed the PPI was enough to irritate my esophagus and make it extra-sensitive to the foods I ate a few days later, even thought I took my PPI? Any thoughts are welcome....