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Need advice for Omeprazole for newly discovered Barrett's

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Posted 7/11/2013 6:00 PM (GMT 0)
Hello everyone I am glad to have found this site. I'm in my late 30s and had an endoscopy done yesterday which found what the doc believes is early Barrett's. I am an RN and requested to have one because of heartburn that wakes me up in my sleep from time to time. I have no heartburn issues at any other time, just when I lay down within an hour or two of eating. Anyway, the GI doc says he wants me to go on Omeprazole for life because he said it definitively stops Barrett's from developing further. That sounds well and good.

However, I have studied proton pump inhibitors quite a bit in my schooling and have done a bit more research on them of late and I am struggling mightily with the thought of taking the med long-term for the following reasons:

- there are no studies beyond 6 years in length of long-term consequences of omeprazole use.

- the acids that Omep stops are also crucially needed to break down proteins before their arrival in the small intestines. when these proteins are allowed through, it often leads IgE-induced food allergies. Some people report becoming allergic to all sorts of foods from nuts, dairy products, anything with gluten in it, some develop Celiac's Disease

- Omep also can lead to anemia and hypoxia because it interferes with Vitamin B12 absorption, Vitamin D absorption, and therefore Calcium absorption, all of these interfere with red blood cell production and can lead to bone density loss

- Also, I have seen that many people online have complained they cannot come off Omep because of crazy rebound acid spikes and heartburn that doesn't go away, forcing people to go back on Omep.

As with any med, you must weigh the benefits with the risks. This sounds a bit too risky for me. A couple of months ago, I began to wonder if maybe I had night-time GERD, so I put the head of my bed up on blocks and stopped eating or drinking within 3 hours of bedtime and I really don't wake up with heartburn anymore.

What I want to know is, in your experiences, do you think what I've done enough? I really don't want all the problems with Omep, but I also know that if I develop esophageal cancer, there is a less than 10 percent chance of living 5 more years. I really want to hear from all of you.

Thanks.

Posted 7/11/2013 8:22 PM (GMT 0)
gospa, i'll try and give a reply to part of your enquiry, but I am open to correction. I have Barretts and take 20mg Omeprazole twice a day.

Unless you are on a major dose of Omeprazole, there is still some acid production. I have heard in the region 15%. So digestion carries on. Supplements are thought to help. B12 and Calcium+D3 are part of my daily intake.

Acid rebound can be reduced by titration, ie weaning off your dose.

Your lifestyle mods seem very sensible and will help.

Cancer is more of a worry for those who have 'silent reflux' and have not been picked up in regular screening.

I'm sure there will be others along to comment soon.


When are the results of your biopsy?

phil

Posted 7/11/2013 8:48 PM (GMT 0)
Hi

I had IgE mediated food allergies before I got GERD or Barretts. The food allergies predate my GERD by over 20 years. I've been on a PPI for 3 years now and my food reactions haven't changed. However, there is a detrimental effect on my eczema, in that my skin is far more reactive than it used to be. I have been concerned about the allergy risk, but so far things have been OK and the PPI, despite the undesirable effects, allows me to function day to day.

MMM
Posted 7/12/2013 1:34 PM (GMT 0)
gospa

Welcome to Healing Well.

If you are able to control your reflux with diet and sleep changes that would be better than a PPI. I still developed barretts even while on high dose of PPIS. I eventually went the surgical route and now only have to have my barretts checked every 3 years.

As long as you can control the reflux, whether with diet, meds, natural, or surgery, with monitoring the chance of it advancing is very low.

My self I would use a non PPI approach if it works first.


Take care,
Bill
Posted 7/12/2013 5:00 PM (GMT 0)
hi opn,

did you get the nissen fundo? after reading up on it, it's something i'd consider if things get worse for me. as for ppi's, i have decided to take them for only 2-3 weeks to allow the esophagus time to heal, and use bed blocks, and no eating within 3 hours of bed. and i plan to supplement with aspirin, going to talk to the gi doc bout strategy, dosing, etc. at this point in my life, i cannot justify going on a ppi.

Posted 7/13/2013 12:01 AM (GMT 0)
gospa

I did have to go the nissen route. My LES wouldn't close and I was already taking double dose of PPIs and had the choice of 4x PPI or surgery. This runs in my family so I went the nissen route and for me it was a great decision.
you have a very sound plan in place.

Take care,
Bill
Posted 7/13/2013 6:31 PM (GMT 0)
I would take the ppi's and see about surgery as things develop. In my opinion, for now, EC is the main goal to avoid. There is the LInx and nissen. But, MRI and the LInx plus other issues and then the nissen you can't ever throw up. I have decided to stick with the ppi's and not worry about it. All the numbers are in your favor with ppi's. Unfortunatly, long term ppi's use is necessary. You could not take them. Some do. However, I'd double check your Barrett's and have a second. Wish I had. My new GI will be looking at my old slides. I did have it ablated and suggest the same to you, if it is Barrett's. I look at ppi's as not a life long thing. I give myself and the LInx a 5 to 10 years to observe findings then I may do it. I believe my stomache acids got to hot or acidic and thus I need the ppi's. I have the impedance test and my acid levels are very much in the safe zone. My pain has stopped and I get very few episodes. For now.......it sounds like you are doing everything keep up the good work and things will improve.
Posted 7/13/2013 7:28 PM (GMT 0)
teacherman, i wasn't familiar with LInx that u mentioned. so i looked it up and it appears interesting. at what point do most people consider LInx? i never have heartburn really. i blame my condition on the weightlifter's philosophy that we should never go too long without calories, so I would eat before bed, so there was always acid coming up while i slept. with the bed on blocks now, and not eating for 3 hours before bed i havent' woken up with heartburn once. if i find out there's no dysplasia, these steps are all i will take for now and have yearly endoscopies to monitor. did you have tissue ablated because you have known dysplasia or u just did it anyway?
Posted 7/13/2013 7:51 PM (GMT 0)
Teacherman


Actually not everyone who has the nissen is unable to vomit. Quite a few can. I am not one of those, but with anti nausea meds I control it. I just have to be mindful of food poisoning.
The development of the "floppy wrap" has helped rid a lot of the post nissen issues that were common. I can burp quite well also.

Take care,
Bill
Posted 7/15/2013 3:23 PM (GMT 0)
Hi go spa, I had it ablated. It was small length but felt better ablating it. I too went to bed every night with a full stomache. Very full. For 30 years plus. Even as a kid.
However, I should have had another endoscopy to double check. I don't get typical heartburn anymore as I don't eat before bed. I try to wait 3 hours. Small portions as best I can. I used to sleep raised but doc checked my acid levels with an impedance test and I have very low acid while on ppi's . So I started to sleep horizontal again. No issues and its been about a week. The only issues I get now is throat irritation. But, astepro and nasal finches work very good. I wondered if it was reflux causing throat because why would astepro work? However, a few weeks ago I tried holy basil and got throat issues so I think it is . Went to two allergist and I do not have allergies. Just non allergic rhitis. I still stress a lot but that too may be why I got Barrett's....stress and anxiety. Mixed with bad eating habits. Either way, the LInx does seem Lilly but I'd like to wait 5 to ten years. I would like to try and stop ppi's but that is the right choice for me right now. I might call the doc and see what he the thinks about one a day or cutting the strength in half for morning and night dose. ??????
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