I have been lurking around here for a while, I was recently diagnosed with GERD. I have some scientific background and access to most of the journal articles on pubmed, so I thought I would just take a second to talk about
proton pump inhibitors because there seems to be a lot of confusion on here about
them.
1) Many people do not take them correctly. You have to take them on an empty stomach, and you have to eat 30min after taking them. This is the only correct way to take PPIs unless you are on Dexilant MR. They are not absorbed well when taken with food, and will not block acid pumps unless the acid pumps are on. Acid pumps are turned on by food, especially protein. It takes time for the drug to get into your blood stream, hence the 30min. Taking them before bed is probably similar to not taking them at all.
2) It is probably best to not quit PPIs cold turkey. The acid rebound effect appears to occur in 40% of people that quit cold turkey. Talk to your doctor about
gradually weaning the dose down over 8 weeks or so and you shouldn't have acid rebound. It doesn't happen to everyone but it does happen to some people.
3) The evidence of PPIs being extraordinarily unsafe long term is not settled in the research. As far as drugs go, they are one of the safest drugs to take long term out there. However, surgery is certainly a much more permanent fix than popping pills forever. This is a hard decision to make, but I think it is important to not be too afraid of PPIs. PPIs most likely do not cause a litany of random side effects ascribed to them like headache, nausea, etc. In trials compared with a sugar pill, the sugar pill caused the same number of headaches, nausea, et al. They are not without risks, but the risks are small compared to the benefits.
4) PPIs can take a long time to start working. In some trials it takes as long as 4 months at double dose. You have to take them correctly as I described above, 40% of people do not take them correctly. If the PPIs don't help after 3 months or so at a double dose, then you need to see your doctor about
further tests. PPIs do not work for around 20% of people.
I see a lot of people trying to fight this awful condition with natural remedies and diet alone. If these two things aren't working well enough for you, don't be afraid of PPIs, surgery, and other mainstream medical treatments. Just find a good doctor that will work with you. It doesn't always have to be a specialist either, many primary care doctors are much sharper than they look if you find a good one.
A note on Zantac/Pepcid and other H2 receptor antagonists- your body builds tolerance to these very quickly when you take them every day or every night. They work okay when you take them on alternating nights or every once in a while, but a PPI is a much better choice if you need something every day. They also only work for about
9 hours, and it takes about
an hour an a half for them to start working.
Post Edited (343gs) : 12/18/2012 10:58:33 PM (GMT-7)