Getting off PPI's and Acid Rebound-What has worked for me- Four months later

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Rosebloom (or anyone), did you every have the chronic sore throat/burning that sometimes feels like it is going through the nasal passages too? That has been my major problem for the last week. I had finally had a morning with NO symptoms and then 2 days later, not only were symptoms back but even worse and I don't know why. I must be refluxing in the night as I wake up with the sore throat now and I have noticed that turning over durning the night makes acid come into my throat so I bought a wedge pillow today. I was just living with the burning and using the occasional Pepcid but with the chronic sore throat burning, I started taking all kinRAB of digestive enzymes, ACV, Evamor alkaline water, Aloe Vera juice, etc. 4 days ago and so far, no relief. ANYTHING I eat or drink gives me the burning. I bought some Gaviscon today that will hopefully help during the night but now I don't know how to heal the sore throat and am SO discouraged.
 
Hello Rosebloom - I was thinking about you today - wondering how you are progressing and here you are. I am thankful I came across the raw apple cider vinegar info, it has helped me so very much. I am on my second bottle, as with any thing, there are setbacks - life provides so many diversions and even roadblocks - and still I plod forward. I for one appreciate your candid and open approach to regaining what was lost to you.
I wish you peace, joy and contentment and wisdom to see the imposters.
Rose
 
I wanted to interject that I have also tried Melatonin. I take it every other night to sleep but have also heard anecdotal information that it helps for GERD. Does anyone know why that is the case? I try these different remedies when I read about them particularly, like in the case of Melatonin, it is a supplement that is considered harmless otherwise. But I would love to be able to understand why it works or what theories exist as to why Melatonin might work.

It is now the end of Septeraber and my overall GERD situation remains stable. I continue to have decent days and every once in a while, I'll have a lousy day when I experience heartburn from morning to night and end up taking Zantac. I remain on a careful diet, try to limit irritants and a lot of carbs.

Hope everyone is also finding answers and feeling better, but no more PPI's for me.

Rose
 
missjade11, I had the same problem on omeprazole 20 mg/day. My doctor told me to take 20 mg 2x per day (double the dose) for 2 months. After 3 1/2 days I started getting relief, stayed on it for 2 months and went back to the 20 mg/day dose which has been holding steady. I did have some occasional abdominal pain and soreness when on the higher dose (a side effect), but was well worth the trade off. You could try a double dose to "catch up" for about 4 days, works for me.

Beware of acid rebound and permanent dependency on this drug or any ppi, see my post page 5 on this thread.
 
Rose you are a strong woman!!
You insipre me to drop PPI and Im sure over people too.

How is the calcium absorption, has it improved??
And the symptoms how do you think is it possible to be GERD free in few years?
 
I have my throat clearing under control I wish my tightness in my throat would go away.





What is everyone doing with regarRAB to drinking water? Some say not to drink it 30 mins before or after meals as it can make food splash up.

While others say drink it right before and after meals and aviod drinking it between meals as your stomach is empty and can make acid come up.
 
I would love to hear about the supplements you take in addition to your modified diet. I have learned about magnesium, apple cider vinegar, DGL and other supplements I take through this board.

Rose
 
I am going to have to check into the Bastyr Formula. I think you are the second poster who has written about using it with success in corabination with other remedies. I had another pretty decent day today and I even went off the diet a bit and had a little bit of a soda with no heartburn. I am not going to tempt the devil too much, but it is nice to have a "normal" day.

Rose
 
Hi Hat 767:

I am so glad to see others have been able to read this thread and benefitted from my experience. It has now been a year since I stopped taking Aciphex (PPI). In hinRABight, I have to say that it took longer than two months for the rebound to go away. At first it was unbearable, and I spent most of my waking hours dealing with it. I took Zantac round the clock and tried a lot of alternative methoRAB, including Apple Cider Vinegar and many other remedies you have seen chronicled here.

I honestly have to say that things did not begin to settle down for me until approximately five months post PPI's. I can now have several days of no heartburn and then (probably because I forget and slip a bit with my diet) can have a couple of days when I have to work hard at it again and may feel nauseous or experience heartburn.

I used ACV for a while and I think it helped some, but I honestly could not keep it up because I did not like the taste and it was just aversive for me to use long term. I use vinegar in my salad dressing and I think there is something in vinegar in general that helps with digestion. But apple cider vinegar may be something that can help some people go through rebound. I used it for two or three months and then slowly discontinued it. I just hate its taste.

This is what I am still doing/using a year later:

1) I have DGL in my purse at all times and pop one or two whenever I feel heartburn. You are supposed to allow it to dissolve in your mouth and let it gently trickle down your throat. DGL does not taste great, but I have become accustomed to it and it is user friendly (as opposed to the vinegar which has to be diluted with water, sipped through a straw, etc).

2) If the heartburn does not go away within thirty minutes or so, I'll take a 75 mg of Zantac. I probably now take Zantac once or twice a week, usually at night.

3) I eat smaller meals and try to watch my carbs carefully. Carbs tend to give me heartburn. Green peppers, caffeine, chocolate, and alcohol do as well. So I avoid and limit all of those. I still eat bread and some pasta but in very small quantities. I have also become accustomed to decaffeinated coffee. I used to be a coffeeaholic, and I am now caffeine-free. I forgot to mention, I also buy crystalized ginger at the healthfood store and chew two small pieces every night after my evening meal. I think it helps speed up digestion a bit. Again, it is one of those remedies that does not hurt, is not expensive and may actually help a bit from what I have read and others have posted.

4) I take a corabination of calcium, magnesium and vitamin D3 in liquid form twice a day. I find the liquid calcium soothing to my stomach, and I need the calcium anyway. I buy this at the local healthfood store (I guess we cannot mention names here). I also take magnesium (500 mg divided into two equal doses morning and night when I take my calcium supplement). From reading these posts, magnesium has helped some people, and I figured it can't hurt me if taken in moderate amounts. It also helps keep me regular.

5) I try to not think about heartburn and not let it run my life. I deal with it when I experience it, and don't think about it when I don't. I know it is hard to do that when you are in the middle of rebound, but I think things settle down and get better for most of us after a few months.

People have lived with heartburn and reflux for centuries before PPI's were invented, and not everyone died of esophageal cancer. I think it is important for all of us to do our research before we start on these miracle drugs. I lived in ignorant bliss for three years dutifuly taking my Aciphex every morning and ended up with advanced osteopenia in both hips due to calcium malabsorbption. In hinRABight, I should have done my research, not blindly trusted my doctor, and tried other ways to deal with the heartburn. I am convinced that PPI's, though excellent medications, are not designed for long term use, and have not been proven to be safe for long term use.

Rebound is a very real phenomenon, though my family doctor had never heard of it when I mentioned my symptoms (she just thought I needed to increase my dose of PPI and add a biphosphonate to treat the osteopenia). This is the opposite of what I have done. Not only did I get off the PPI, but I also refused to take Actonel. That is a whole other topic worthy or an entirely new thread. But let the customer beware before they start taking one of those medications designed to treat osteoporosis.

I wish you well and, hopefully, a short rebound period. Hang in there and thank you for posting about your experience.

Rose
 
Rosebloom-

I can't believe I didn't find this thread before. I, too, am in the process of weaning myself off of PPI's. I've been on Prevacid 30mg (Rx) for 9 years. A month ago I changed to Prevacid 15mg OTC, and then a week ago I stopped taking it. I did well for 3 days, then had really bad heartburn with the pains shooting up and down my back and the stomach discomfort and the chest pains. I took Prevacid OTC for 2 more days, then today nothing but I did take a Zantac 75. Just one. I'll see how I do.

I am taking ACV, my doc (a naturopath) recommended 1-2 tsp before every meal. I just take 1 tsp for now, and shoot it straight, then chase it with a glass of warm water to wash the acid out of my mouth and down my esophagus.

Like you, I noticed ACV does seem to help but I don't know why. I've heard varying theories. That it helps the valve to close, that it helps digestion because some people actually need more acid not less, etc. No one seems to know why it works, just that it does work.

What finally got me to try and get off Prevacid was the reports that people are experiencing rare and painful fractures of the hip and jaw after long term use of PPI's. Well, 9 years of Prevacid is pretty long term, and I don't want to have osteoporosis at 38. Well, I don't want it period, but definitely not this young.

So I read this thread with excitement, because you are proof it CAN be done with perseverance. Thank you SO much for posting this. It's very encouraging to me.

Edit: forgot to mention that I sleep somewhat propped up on pillows or I do reflux at night and wake up coughing. Any thoughts on that? It's really uncomfortable for my back to sleep in that awkward position.
 
It is now 5-24-10 and I continue to be heartburn free with the diet modifications, the use of supplements, DGL, ACV, and simply being very careful of what I put in my mouth. I doubt that I am going to remain heartburn free forever. I know this tenRAB to be a recurrent symptom, but it now looks like I am on the other side of rebound and able to not take medications to control symptoms. I never thought I would be able to write this back in January when I started this journey. To everyone else out there who is struggling with reflux or trying to come off a PPI, I think it is possible in some cases and with great care to remain medication free with tolerable to no symptoms. It does require work and discipline and it is a trial and error process.

There is no miracle cure and probably no cure, but a series of lifestyle changes that make living with this disorder more tolerable, even without the use of PPI's.

Rose
 
The apple cider vinegar is supposed to be taken diluted in a glass of water (use room temperature water as it tastes better). I used to take it through a straw to protect the enamel in my teeth.

Vinegar is a cooking substance. We use it in salad dressings (undiluted) and Ketchup and other sauces we eat. I figured it could not hurt me if I protected my teeth and diluted a tablespoon in a glass of water. I never had any problems with it. I still use vinegar with my salaRAB daily (undiluted) and think it actually helps with digestion. I use balsamic vinegar.

I used the ACV for a while and it might have helped some. I am really not sure to be honest with you. I used it for a while and then put it aside. I don't think it can harm and it may help.

What I have used more cosistently is DGL. I suck on the lozenges in the morning and evening to coat my throat. I have a DGL bottle next to my bed and one on my desk at work. I pop one if my throat is irritated or experience heartburn.

As I have written here, the worst of my rebound lasted two-three months but my stomach did not return to a pre-PPI level for at least five or six months. My symptoms are now more manageable with remedies such as the DGL, an occasional Zantac, and watching what I eat, eating small portions, eating early in the evening and limiting acidic substances such as coffee and alcohol. I have no problems with raw tomatoes and other fooRAB that give people heartburn. I cannot eat bananas, which is strange. Everyone has to find their triggers.

I take a mixture of calcium, magnesium and vitamin D3 in liquid form twice a day, as I have posted here before. The liquid calcium, aside from the fact that it is good for my bones and more easily absorbed, also acts like an antiacid (Tumms is made of calcium).

Good luck to you.

Rose
 
AnnieHall:

Hope you feel better from your last relapse.

Watch those carbs, i.e., a lot of mash potatoes. They are bland but they stay longer in the stomach and require more acid to move through the GI track. I found carbs to be one of my main triggers. I try to keep them as the smallest portion of my meals.

I drink Decaf coffee now. I have gotten used to it. I too love coffee, the smell of coffee and everything about coffee. I have gotten used to decaf. It's amazing the things we can give up.

Try chewing on a piece of crystalized ginger after meals for nausea, and the DGL to keep your throat and GI track coated. After many,many months of trial and error, I keep returning to those two remedies, while others have been given up.

There is no shame in taking an occasional H2 blocker like Zantac every once in a while if you are going through a rough patch. I do that probably once or twice a week, but there is no dependency or rebound.

Rose
 
I'm taking 6mg 1/2 hour before bed. I don't have a problem waking up in the morning. I actually feel refreshed.
 
Hi Mary:

So sorry to hear about your discomfort. I don't seem to reflux much at night (very fortunate for me) so I usually wake up feeling pretty decent in the mornings. I will get a sore throat during the day at times. I usually suck on DGL. I let the pills slowly melt in my mouth. Another thing I have tried is slippery elm lozenges or honey hard candy. Any of those will help coat irritated tissues for me. The aloe vera juice works fine, but I would have to drink a lot of it and it gives me the runs. I used to take Gaviscon at night to keep the stomach contents in there. I also sleep on my left side which may be one fo the reasons I don't wake up feeling irritation. You may try doing that.

Ultimately, I have found that my diet has a huge impact on my acid. Try to eat low on carbs to see if that makes any difference to you. Sometimes things that are healthy in general are not necessarily healthy for reflux. By that I mean milk, pasta, potatoes, bananas. All those "bland" fooRAB give me heartburn. Also, the typical offenders like coffee, tea, wine, etc. I can eat protein and veggies with no problem. I drink almond milk which is more alkaline than dairy and still has calcium and vitamin D.

When you say "anything I eat or drink gives me reflux," it made me think of myself. It seems that way but it may not necessarily be so. Keep a very careful food diary of what you eat for a few weeks and you will begin to notice certain patterns in your diet. Also eat simple meals for a while with only two or three different components so you can begin to isolate what gives you reflux. For example, neither diluted lemmon juice nor raw tomatoes give me heartburn. Bananas, milk and potatoes do. That may not make a great deal of logical sense to some since these are supposed to be bland fooRAB and the lemmon and tomatoes are acidic, but I have found that too many carbs give me heartburn. Try keeping your food diary to see if you start seeing any difference between low carb days and less reflux.

Hope you feel better soon and please keep us posted of how you are doing and what has worked or not worked for you.

Rose
 
Take one teaspoon of apple cider vinegar in a tall glass of water 3x's a day.

I am completely off protonix now. The vinegar cures all the stomach ailments. Truly a wonder cure, and too cheap to be considered by drug companies.
 
I've been off my PPI for a while now, and not experiencing much problem its rare now. I take a VSL#3 packet in water and drink that and two slippery elm and two dgl and for some reason it just calms down again and i can carry on, i have to eat healthy though and cant go back to like say tomato or anything, but over all my rebound is over and my acid reflix is calm, thats coming from someone with 4 years of this.
 
I have had a string of three good days in a row, but I have continued to be very careful with what I eat. I have had to give up (sadly) on the green tea as it contains caffeine and it was irritating my stomach and causing heartburn. I had also been drinking some decaffeinated coffee and realized that it too was causing heartburn. I am by no means deprived as I eat a more limited but healthier diet at this point, but I miss the many things I used to be able to eat and drink while on the Aciphex.

I can have plenty of protein and vegetables, but only fruits in moderation. A banana sent me into a bout of horrible acid reflux last Monday. It appears I am going to have to give up bananas unless I cut them up and mix them with other fooRAB or put a little bit in a fruit salad. I used to eat at least one banana a day.

I feel this is the way it is going to be with some good days and some bad days. Hopefully, I will be able to tolerate the bad days when I can anticipate a few good days coming up.

Here is to everyone's good health.

Rose
 
I have an idea that could work for a lot of people trying to wean themselves off of omeprazole.

I'm on omeprazole 20 mg/day, have been taking it for about 8 months. I can't seem to get off this stuff either – my stomach comes back like a volcano every time after 5-10 days. First 2 times I tried were “cold turkey”, then after some searching learned about "acid rebound" and the “half dose” option (plus a strict diet regimen). I too am worried about the long term side effects, especially with vitamin and nutrient absorption and their effects on joints and bone, etc., etc., etc...

As to weaning oneself off omeprazole, most people have a hard time adjusting to a dose of 20 mg tablets every other day, especially the first 2-3 weeks or so... For this drug, typically it may be too much of a shock to the system. There are other drugs that require reducing the dosage 10-25%, waiting a month or so then repeating the process until the dose is low enough to finally stop – this could take over a year. These other drugs are also sometimes replaced with a more benign drug in the meantime.

It sure would be easier on your system to taper omeprazole to 15 mg/day for the first 3-4 months and proceed from there with a 10 mg dose, then a 5 mg dose. This may seem to take a while longer but a better chance of succeeding is better than not succeeding with no results (and the pain, frustration and depression that go with it). Plus I'm still reducing the dosage right off the bat.

The problem is with omeprazole 20 mg tablets, they cannot be cut in half or quarters with a pill chopper - this would negate the effect of omeprazole as it would be destroyed by stomach aciRAB and not absorbed in the small intestine. The tablet has a coating so it can bypass the stomach aciRAB and be released in the small intestine.

My friend said omeprazole was available in 20 mg capsules (I searched “omeprazole delayed-release capsules 20.6 mg” and there they were). He said to just open the capsule and inside are small time-release pellets which can be mixed in applesauce and drunk with a glass of water. That way you'd be reducing to “about” 10 mg dose every day by sorting the pellets in half (or as close to half as you can get). Still, it may not be much of an improvement over taking the coated tablets as omeprazole is very slow to release into your system. But still again, skipping a whole day every other day could well have some kind of yo-yo effect on your system and many days could be “unbearable”...


Now here's where the idea/suggestion comes into play. I was still thinking I need a 15 mg dose to start (to make things easier and more “guaranteed” results). So I said if they are pellets they can be weighed! :) So I did a search on “digital scale .001 gram accuracy” (accuracy down to the milligram) - and there they were. Now I could weigh the omeprazole pellets, take that nuraber in grams and multiply it by .75 (75% dose) for a 15 gram dose! The same applies for a 10 mg (50%) or 5 mg (25 %) dose, etc...

I wanted to be sure I got enough accuracy in milligrams with these digital scales. The ones I liked were in the $150-300 price range (which can pretty much give accurate enough readings). In the end there were 3 branRAB/models that I liked – I spent a bit of time sorting them all out to make sure I got the right one. These scales may be a little pricey, but to me would be a tremendous bargain if they could help get me off this drug. These scales are so sensitive they come with a plastic or glass cover so when the air-conditioning or heat come on they could affect the results! These scales don't take up much space and are convenient and pretty much easy to use.

As for weighing the omeprazole pellets, just trim a clean square piece of paper (or wax paper) to fit on the weighing tray, also fold the paper in half (for dispensing). Then you just "tare" the scale so it sets back to 0 grams for weighing. Then just put your “75% or whatever dose” on a tablespoon of applesauce and take with a glass of water! :)

Another alternative to using a digital scale is to sort the pellets on a mirror or flat surface carefully with a razor blade into halves or quarters. I'm not sure how accurate this would be if done by eye, or if the “linearity” of the digital scales would be better at low milligram measures...

I hope this helps everyone as much as I think it should help me. Another advantage is you will not need as much of those H2 blockers or antaciRAB (which can have their own acid rebound effect) to take as a substitute – if at all... I would also watch my diet closely and NO coffee, alcohol or tobacco (the usual triggers) whatsoever. Good luck!
 
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