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PPI Rebound Question

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Posted 8/7/2016 3:01 AM (GMT 0)
I'm 7 weeks off a PPI (I weaned slowly) and am still having acid rebound -- lots of chest burn. I never had this before going on the PPI. Someone told me it's from elevated gastrin levels causing more acid in my system. I was also told that actually gastrin levels return to normal after a couple of weeks and any rebound after that is from a weak LES that can get stronger only with time off the PPI. I'm on 450 mg Zantac too. Does anyone know WHAT causes the rebound for this long and about how long it lasts (I read it could be 3 or more months)?
Posted 8/31/2016 6:41 PM (GMT 0)
Hi LiveJoy - Like you, I too am 7 weeks off PPI. I was prescribed them for gastritis and duodenitis. I also weaned off slowly over a period of 2 months and I am also still suffering with rebound. I only took them for 5 months, including the 2 month wean, as they made me feel really ill. I tried to stop them 'cold turkey' after only one month but ended up in A&E with the most horrendous chest pain. Despite telling the doctor they made me feel ill I was prescribed a higher dose still which made me feel even worse so I decided to do my own wean and gradually went from 40mg down to 5mg and then stopped. I didn't feel well right through the wean and on stopping the tablets I felt much better. However, 3 days in I got terrible burning in my throat and naso/pharynx which lasted for 5 days and made it difficult to swallow. I eventually gargled with some sodium bicarbonate in water and that eased it so I knew it was acid. Since then I have continued to get rebound, I get a lot of discomfort in my naso/pharynx, stomach, bloating and a feeling of something being stuck in my oesophagus - symptoms I did not have before taking the PPIs. One scientific study suggests that it's not just gastrin which is the problem but that the parietal cell mass and ECL cell mass activity are involved in the mechanism of acid hypersecretion. This same study also concludes that acid rebound hyper secretion lasts longer than 8 weeks but less than 26 weeks so we may have some way to go yet. This is the link to the article. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2004.02271.x/full. I am trying to manage my rebound with Gaviscon and have today started taking Zinc Carnosine (PepZin Gi) which has good reports on gastric healing and is used as a prescription drug in Japan to heal the stomach lining. It is available as a food supplement in the UK and US.
Posted 8/31/2016 8:50 PM (GMT 0)
Thanks WelshWoman. Did the PPI give you GERD? It did give it to me. I was originally prescribed it for gastritis. I'm now 11 weeks off and am feeling slightly better, but now have daily pain mid-sternum that sometimes spreads to both sides of ribs, with occasional stomach jabs. I'm on 60mg Pepcid (an H2 antagonist) to counter the excess acid, but hope to wean from that when I'm stable. I also use Gaviscon Advance, Pepzin GI, DGL, etc. I read the same study about up to 26 weeks to recover. It says the gastrin was reduced at 4 and 8 weeks but I still felt pretty bad at that point. It's only the last few days I've felt slightly better. I totally believe and have read from others it can take 3, 4, 5, 6 months to recover. Any support from your doctors? My GI says this is not rebound, it's just lifelong GERD and I'll be on drugs forever, even though I told him I never had this before the PPI and this is way too painful to be just regular old GERD. I've pretty much given up on him.
Posted 9/1/2016 2:44 AM (GMT 0)
Hi,

I been off PPI for a year now. The acid rebound was not easy. You will get better. But first you have to know if you have low acid stomach or high acid stomach. We are different but the PPI gave me low acid stomach which my doctor did not want to hear. I go to this site below and had helped me figure out the acid rebound. Hope this will help you too.

https://www.inspire.com/CAGU/journal/ppi-warning-gastroparesis-delayed-gastric-emptying-proton-pump-inhibitor/

God bless.
Posted 9/1/2016 8:30 AM (GMT 0)
LiveJoy, I have GERD now which I did not have before PPIs and it is more uncomfortable that the original problem. No help from Docs. Like you I've been told I need to stay on a maintenance dose which I absolutely refuse to do as I did not have this problem before PPIs and I am convinced the meds have caused this added problem. I have given up with Doc as they don't seem to want to listen and have been doing my own research and trying to manage it with Gaviscon, diet (very bland and boring) and now the PepzinGI. I have tried the DGL but I find them so sickly sweet - can't seem to find any that aren't full of artificial sweeteners. My fear is that the additional acid slopping around is going to bring the gastritis back again. Hopefully you are coming through it now at 11 weeks, but what a long, painful and miserable journey this is. I did read one study which said it could last as long as 11 months!! Let's hope not.

Thanks Tu Wang, glad to know there is hope out there. What helped you?

Regards to you both.
Posted 9/1/2016 3:22 PM (GMT 0)
HI Welshwoman. I'm right there with you! The DGL I use is Vital Nutrients powder. I don't think it has anything else in it. I hope the Pepcid (and before that Zantac) I'm using will buffer the added acid -- I have the same fear. I don't want to get gastritis or esophagitis. But I also want off all these acid reducing meds. Hopefully soon I can start a slow taper off that. My body needs to function med free. It is a miserable journey! I haven't seen the 11 month study. I think we'll both be fine way before then. Here's to being returned to good health soon. And thank goodness at least we're free from the PPI! I will NEVER take one again!
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