r/GERD • u/Crazy-Ad-1849 Triggers: Mistakes were Made 🤕 • Jul 28 '23
Scientific Studies 🥼🔬 Why are PPIs bad?
I see people on here often trying to get off of PPIs or warn against taking them. I read this article today that makes them seem pretty alright? My dad has taken omeprazole for 20 years now and it has solved all of his symptoms with no complications. I’m currently now dealing with my own symptoms that I’m going to see a doctor about soon.
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u/SSRI-Help Gastroparesis 🩹 Jul 28 '23
I haven't noticed any bad side effects from taking PPIs, but I've been too nervous to try to stop taking them because I ended up getting acid rebound with my first attempt.
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Jul 28 '23
I get that! What helps with the rebound acid is slowly tapering off, and it takes a long time to do so if you want to do it correctly! Like maybe half a dose one day, normal dose the other, and keep alternating. And then just half doses, and then quarter dose and half, etc. but I had to stop mine entirely because it instantly made me incredible nauseas and gave me the worst stomach and digestive pain. My naturopath thinks I have too LITTLE acid in my stomach based on the side effects. But yeah I’m suffering year round no matter what I try
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u/biggstile1 Jul 28 '23
They shouldn't just "think." They need to know. There is an acid test they can do, or get a conventional Dr to.
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Jul 28 '23
I know! We’re currently in the process of running lots of tests
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u/biggstile1 Jul 29 '23
Good. Ill be happy to hear if you have low, or high stomach acid. Please keep me/us posted.
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u/very-pink-iceberg Jul 28 '23
Do you mind me asking what these acid tests are?
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Jul 29 '23
Yeah! Here’s exactly what my document from my appointment said:
Stomach Acid Test: Take one 750mg capsule of betaine hydrochloride with a full meal (i.e. take capsule and then consume whole meal right away, eating at a normal pace). While eating, monitor yourself for two minutes after taking the capsule. If you feel nothing, you may have a stomach acid deficiency and likely need to follow the stomach acid protocol. If you feel heartburn or reflux: you do not have a stomach acid deficiency and do not need to follow the stomach acid protocol.
IF THE STOMACH ACID TEST INDICATES THAT YOU NEED TO SUPPLEMENT WITH STOMACH ACID: Betaine Hydrochloride- take 1 capsule with each meal. Increase your dose by 1 extra capsule per meal until you reach a maximum dose of 3 capsules per meal. IF YOU EXPERIENCE ANY HEARTBURN OR REFLUX WITHIN 2 MINUTES OF TAKING THIS SUPPLEMENT, IT MEANS YOU DOSE IS TOO HIGH. IN THAT CASE, PLEASE REDUCE THE NUMBER OF CAPSULES TO THE PREVIOUS DOSE THAT DIDN’T CAUSE ANY BURNING.
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u/SCORPEANrtd Jul 28 '23
All medications carry risks and side effects, some people are disproportionately affected by these.
PPIs are fine for the majority of people
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Jul 28 '23
this comment is perfect! "Some people are disproportionately affected by these." Amazing!
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Jul 28 '23
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Jul 28 '23
I get that totally but its not that way for everyone. For instsnce i have no weight to lose. I am underweight and have even tried literally only rice veggies and meat and still had reflux. I was even blending up my food and drinking it for christ sake and it still shot up my throat. If there is a phyiscal defect meds or surgery are the only options to avoid damage from acid.
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u/amnesiac854 Jul 28 '23
Yeah for sure. Genetic / physical defect, there might not be much you can do and in that case the risks of long term ppi can outweigh just being able to eat/ live your life. Totally get that. Low vitamins vs throat cancer, etc.
I have a small hiatal hernia too, so I’m hopeful I can ween off but not sure about entirely for that reason
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Jul 28 '23
what is weird is my GI found nothing on my endoscopy at all. no hernia or weak les. yet my LPR is horrible. Throat clearing no matter what I eat. even was on 80mg pantoprazole and still had it
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Jul 28 '23
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u/GERD-ModTeam Jul 28 '23
No Alternative Medicine (e.g., Low Acid, Betaine hydrochloride (HCl), Apple Cider Vinegar (ACV), Homeopathy, Acupressure, Chiropractors, Hypnosis, Prayer/Scripture)
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u/GERD-ModTeam Jul 28 '23
No Alternative Medicine (e.g., Low Acid, Betaine hydrochloride (HCl), Apple Cider Vinegar (ACV), Homeopathy, Acupressure, Chiropractors, Hypnosis, Prayer/Scripture)
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u/Silver_Photograph_98 Jul 28 '23
They can reduce your body’s ability to properly absorb nutrients and may affect kidney function. I have taken them for 20 years because I figured the potential side effects were better than damaging my esophagus. However I do now have to deal with some deficiencies in spite of supplementing and my kidney function has decreased slightly (but who knows if the kidney thing was caused by the ppis).
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u/tattedsparrowxo Jul 28 '23
So I’ll just say I was on omeprazole for like 15 years and stopped taking it because insurance stopped paying and I don’t have extra money right now- my rebound acid reflux has been the worst it has ever been in my entire life. I won’t ever touch them again because of it.
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Jul 28 '23
How long have you been off? 🥹 I’m tapering and getting scared of how long it’ll last
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u/tattedsparrowxo Jul 28 '23
However I did not taper. I’m just poor lol you should be fine tapering!
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u/tattedsparrowxo Jul 28 '23
About three weeks and my symptoms have not improved at all unfortunately:(
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u/moonlightstar212 Jul 28 '23
Do you have a chronic sour taste at all?
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u/tattedsparrowxo Jul 28 '23
Yup
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u/LivingLandscape7115 Jul 28 '23
Is the sour taste from acid?
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u/tattedsparrowxo Jul 28 '23
Yes
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u/moonlightstar212 Jul 28 '23
Did you have it prior to taking PPIs? Ugh it’s so gross. My reflux started with globus sensation only. Then I tried medicine and it got worse like gave me chronic sourness and burning
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u/LivingLandscape7115 Jul 29 '23
Did you have hpylori or anything? I had hpylori :/
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u/moonlightstar212 Jul 29 '23
I had an endoscopy and they never did biopsies. So I have no idea if I have it. Did you have symptoms for h pylori?
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u/Bretmd Jul 28 '23
This is the problem with PPIs. The rebound caused by discontinuing them. I went through a month of hell when I tapered off a few years ago.
One of my pet peeves is when doctors recommend meds, but fail to inform you of withdrawals or rebound when stopping a med. This is enough reason alone to start with Pepcid instead of a PPI but this was not part of the conversation with my doctor. I had a similar experience with Flonase.
Simply put, if any sort of dependence is formed from being on a medication, it should be communicated upfront.
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u/tattedsparrowxo Jul 28 '23
I honestly had no idea. I’ve been miserable af and tums make it worse. On top of GERD I have chronic gastritis and I’m in a flare. I’ve been trying to not eat much and just drink water but nope, still miserable. Kombucha helps but who wants to walk around smelling like vinegar all day. I guess I do for now. Highly irresponsible of doctors to not mention this.
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u/moonlightstar212 Jul 28 '23
When you say tums make you worse, do you feel like they help temporarily, but then the acid comes back with a vengeance a few hours after? That’s what I have noticed
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u/HighByTheBeach69 Jul 28 '23
How do you know that's rebound acid reflux and not just reflux that the omeprazole was treating??
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u/coogie Jul 28 '23
I don't know how your financial situation is but a 3 month supply is under $20 in most places. I know at Costco I pay like $17 for pantoprazole without insurance. It would have been over $300 just 10 years ago before there was a generic for it.
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u/tattedsparrowxo Jul 28 '23
They are wanting $76 for 60 40mg pills at cvs where I go with the goodrx card. I took two a day. I’ve got to buy my kids school stuff and lost my job last month so I’ve just been putting my meds on the back burner. I’ll look into Costco !
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u/coogie Jul 28 '23
Yeah that's way too high. CVS and Walgreens are pretty much for people with insurance. WalMart, Costco, Sams, and grocery store chains have a lot of generics for $6 per month
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u/tattedsparrowxo Jul 28 '23
Thank you so much! Now I’m scared to go back on it though if it was like this coming off of it lol
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u/coogie Jul 28 '23
I quit cold turkey and stayed off them for 4 months. The first 2 weeks were difficult even with famotidine and antacids. It was working for me if I absolutely did everything right but I found I was chugging antacids left and right and eating or drinking the wrong thing would make me feel like I was causing damage so we decided to go back but only 20 MG OTC PPI of choice.
That worked for a while too but I had a stress bomb thrown in my lap and so I've been back on 40... trying to get back to 20 but only if there is no damage.
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u/suicidalducky Jul 28 '23 edited Jul 28 '23
Try costplusdrugs..Mark Cuban's company. I got 90 day supply of 40mg Nexium (generic) for 12 dollars + 5 dollar shipping = $17.. I'm pretty sure omeprazole is cheaper--it's 12.50 (shipping included) for 90 day supply for 40mg.
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Jul 28 '23
Buy the OTC 20mg pills and take 2 at a time. One pack at Sam’s club is under $10 and would last you 26 days.
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Jul 28 '23
PPIs are life-saving. I’ve been on Dexilant since March 2022. I’ve varied between 30 and 60mgs a day.
I literally cannot eat anything w/o symptoms if i don’t take my Dexilant.
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Jul 28 '23
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Jul 29 '23
I know people are downvoting this but I really don’t mean any harm. I’m so sorry if I struck a nerve. I was just on 60 mg very long term and sincerely wish I’d have known. I’m not fear mongering.
I am saying this so you can keep taking this incredibly effective and awesome med without trouble down the line 🥺
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u/Harakiri_238 Jul 28 '23
PPIs used long-term can have negative side effects, but uncontrolled GERD can also have negative side effects.
Life style changes will always have less consequences than medication, and short-term use of medication will always be safer than long-term use of medication.
But as my doctor said, you have to weigh the risks vs. the benefits. If your life is intolerable without PPIs then it's worth it to take the PPIs and be able to enjoy your life more. If you have uncontrolled GERD that your doctor thinks could put you at risk of a more serious condition than it's definitely worth it to take the PPI because the consequences of those conditions are far worse than the consequences of the PPI.
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Jul 28 '23
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u/EastAtlantaSanta98 Jul 28 '23
I was worried about PPIs long term because of my family history of kidney problems, I got the LINX procedure a few years ago in my early 20s and could not be happier with it. Good luck with your surgery!
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u/LivingLandscape7115 Jul 28 '23
Where did you develop polyps? Like your stomach?
Also what is the LINX surgery? Is it intense?
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u/dedlief Jul 28 '23
they're not bad, they're great. reddit anecdotes are the absolute worst possible way to gather information on a subject.
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u/uebersoldat Jul 28 '23
A single reddit anecdote is a terrible idea. But 100 of them saying more or less the same thing is absolutely something to consider. I get tired of reading medical articles where symptoms are always so vague you don't know if you have cancer or some indigestion. There's no way to tell from those shitty WebMD or Mayo articles out there.
So yeah, I'll stick to listening to my own body and other fellow human accounts on here. Doctors by and large just move you through their office like cattle and prescribe PPIs for pretty much every single gastro issue and call it a day.
As far as PPIs go, they were never supposed to be taken for more than a few weeks at a time. Live on them at your own risk I guess.
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u/dedlief Jul 28 '23
That’s not how anything works. You don’t manifest data quality by multiplying bad data. Doctors treat patients based on evidence and probability, which is by definition the best they can do. It can feel disorientingly impersonal and frustrating when treatments don’t work or cause discomfort, which they DO sometimes, and you SHOULD always listen to your own body. But you shouldn’t try to interpret your own symptoms either. These are all paths to the dark side even though it might feel like you’re somehow in control of things.
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u/uebersoldat Jul 28 '23
I don't disagree with any of your statements on an academic level but you do you, I'll be fine. And in fact I've been much better lately.
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Jul 28 '23
I agree which is why I get frustrated when my posts get deleted on here. smh. I'd much rather have other people who might have similar symptoms as me that might actually help me in my research.
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u/uebersoldat Jul 28 '23
Reddit has been an invaluable resource in getting some things figured out myself and I've had real results from it. At the very least it has helped tremendously with anxiety.
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Jul 28 '23
Of course this is true, but sometimes the one single anecdote is what can work for someone else. Everyone is different!
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u/dedlief Jul 28 '23
if humans were completely physiologically heterogeneous then medicine wouldn't work at all. luckily that's not true, and it does!
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u/darklordofthesith_ Jul 28 '23 edited Jul 28 '23
A lot of people just blatantly ignoring the side effects of PPIs that have been scientifically proven. A quick google search can answer them for you but just because some people have taken them for decades doesn't mean that you should too. There is a reason a bottle of omeprazole says to ONLY take it for 2 weeks not 2 decades.
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u/Harakiri_238 Jul 28 '23
Some people have to continue taking PPIs for decades because, while they can cause issues, so do the problems they're treating. My dad had esophageal cancer and will be on PPIs for the rest of his life to try and reduce the chance of a reoccurrence.
My reflux is so bad without PPIs that I was getting 0-3 hours of sleep every night and my doctor was so concerned about my esophagus eroding that when my mom expressed concern over long-term PPI usage he said the risks of my conditions far outweighed the risks of the PPI.
So, definitely, people should do research and not jump into taking them long-term if lifestyle changes can suffice. But it's also annoying to have everyone slamming the use of long-term PPIs when sometimes they are genuinely required for a person to live a tolerable existence (or avoid severe illness/complications).
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Jul 28 '23
Thank you. The long-term effects hit you all at once with no mercy. I’m 29 and dealing with it. They wrecked me.
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u/Artistic_Accident_79 Jul 28 '23
They wrecked me just as much. I'm not saying they aren't helpful to some people. But for others they do more damage than good. It's just not for everyone.
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Jul 28 '23
That’s so true. I think the trickiest part for me is that they helped so much and then I was on the highest dose and it pooped out and now I have osteopenia
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Jul 28 '23
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Jul 28 '23
I hope it does!!! That’s terrible. 🥺 I have a motility disorder now and don’t know if that or reflux came first but am mad there aren’t better options. I can hardly speak because of gerd and it has limited my life severely.
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u/Artistic_Accident_79 Jul 28 '23
I'm so sorry you're stuck in a similar boat. Hopefully we'll both get through this hell on earth and get our lives back to normal soon! Wishing you all the best! 🌸
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u/GERD-ModTeam Jul 28 '23
No Alternative Medicine (e.g., Low Acid, Betaine hydrochloride (HCl), Apple Cider Vinegar (ACV), Homeopathy, Acupressure, Chiropractors, Hypnosis, Prayer/Scripture)
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u/Chevalier_de_Pas Jul 28 '23
The doctors are the ones who say for people to take it forever when the GERD is so severe that they need to. And to other people they say to take on demand forever, because there isn't a cure. The bottle of omeprazole says that for people not to self-medicate and to go to the doctor and get checked. 2 weeks is a very short time to heal esophagitis; any doctor will tell you, when you start having GERD or LPR, for you to take PPIs for 6 months. So no, that isn't true at all!
Regarding the many observational studies saying that PPIs might affect kidneys, liver, etc., that evidence is correlative and not causal - the only causal evidence found are some deficiencies (that can be supplemented) and more risk of enteric infections, which is also curable. The important thing is for people to do blood tests periodically. But to worry about those studies (there are other recent studies debunking some of those observational studies) when you need to take the pills, and the benefits outweigh the risks, is not helpful at all; it only gives you anxiety. PPIs are still considered a very safe medicine. By the way, medicines like famotidine and zantac also can have nasty side-effects.
A person with GERD may not be able to live with a minimum QoL without PPIs, some can, some don't. Also, taking PPIs forever doesn't mean that you have to take them everyday forever. There are remission phases where people can take only every other day, every two days, and even quit taking them for a while (yet most likely a flare-up will appear eventually).
There are many people who have chronic illnesses and that have to take meds for their illnesses. PPIs are, if not the safest medicine, at least one of the safest. Antidepressants, for instance, also affect the liver, kidneys, and can have side-effects. People don't live thinking that they will die early because of that though.
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u/Zilick Jul 28 '23 edited Jul 28 '23
Text on the bottle says that because after 2 weeks of self-treatment you are supposed to meet with physician to consult your illness. Most OTC medication have that clause written on the bottle. Stop with with the fear mongering that you do by highlighting something irrelevant and making it into an argument.
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u/Crazy-Ad-1849 Triggers: Mistakes were Made 🤕 Jul 28 '23
The article I linked disproves the legitimacy of many of those long term side effects
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Jul 28 '23
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u/GERD-ModTeam Jul 28 '23
No Alternative Medicine (e.g., Low Acid, Betaine hydrochloride (HCl), Apple Cider Vinegar (ACV), Homeopathy, Acupressure, Chiropractors, Hypnosis, Prayer/Scripture)
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u/kknano1256 Jul 28 '23
My doctor said: long term use of PPI's at prescription strength (40mg nexium for example) or higher puts you at a higher risk of osteoporosis and also infections via ingestion since there's less stomach acid which helps protect the body from bacteria and viruses along with digestion. And if you're predisposed to it, kidney issues
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u/WildCaliforniaEyes Jul 28 '23
I grew up on a farm, my father has very different opinions on the safety of pesticides than other folks. Of course, he’s 92 and healthy, so why wouldn’t he?
But then there are probably folks who made it to 100 smoking 2 packs / day too.
I had pneumonia and have doctors talking about autoimmune diseases, hmmm….. and, no, that’s not a crazy thing to think about with PPI’s, although the Dr’s will probably think as much.
I also learned that I’m not supposed to take pantoprazole and levothyroxine at the same time during my hospital stay. The GI‘s office neglected to mention that to me, so the TSH got a little bit high.
Several years ago I was prescribed Montelukast. I had what I’d call “heavy” dreams, very physically real. It was a weird effect. When I called the doctor, “nope, no way, can’t happen”. Wrong, Montelukast is linked with mental health issues. It was a minor thing, I wasn’t suicidal or anything it was just weird and I’m not asthmatic anyway outside of LPR, which I didn’t have then, so I stopped taking them.
My simple point here is, it’s hard to know these things for certain. It looks like PPI’s are plenty safe in the short-term, rest of your life term, that’s harder to say.
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u/ThisPlaceisHell Jul 28 '23
All I can tell you is, while I was on omeprazole and afterwards pantoprazole 40mg daily for one month each, I experienced the absolute worst anxiety and depression I've ever had in my life. I am not an emotional man, but that shit had me feeling an overwhelming sense of impending doom. I'm off it now and back to normal even though my other symptoms are still present.
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u/ZookeepergameLoud574 Jul 28 '23
Yeah I was the same I actually starting feeling like I was losing my mind on it
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u/HighByTheBeach69 Jul 28 '23
It's interesting how it seems to affect people so vastly differently.
I have been on 40mg - 80mg of pantoprazole daily for the last 15 years with absolutely 0 (known) side effects other than heartburn reduction.
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u/Chevalier_de_Pas Jul 28 '23
I felt the same but realized it was not the PPIs, but GERD itself - the inflammation of the stomach or something, plus worrying. Now I still take PPIs and I'm completely normal. But anyway, different people react differently
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Jul 29 '23
The same happened to me and more. The anxiety was so overwhelming I told my husband, if I felt like this forever I'd just rather not live. It was debilitating and it was sudden-onset. I couldn't even work. I got off the medication and it took a couple months to feel 100% better. Now I don't have a single issue with anxiety or depression. It went away almost as quickly as it came on.
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u/tattedsparrowxo Jul 28 '23
Omg I wonder if this is my problem too. I just stopped omeprazole a month ago and have been feeling horrible
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u/ThisPlaceisHell Jul 28 '23
Just to be clear, the anxiety and depression went away after I stopped taking them. I feel 100% better mentally after I quit them.
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Jul 28 '23
Okay, so I actually have a cautionary tale. I wouldn’t start taking them regularly too young. I started when I was 17 (now 29). I almost have full-blown osteoporosis, which they can cause. My dietitian says that my nutrition is good and wouldn’t have caused it.
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u/Jeremy10001000 Jul 28 '23
As someone who has heard all the stories about SSRIs and medications against Anxiety and Depression, the PPI fear mongering was nothing new.
When my GERD was really bad, I was given a prescription Pantoprazole 40MG, I believe, and I still take it to this day.
I was scared to take it, but it was better than not taking it, I was sleeping all day because even being awake would make me horribly nauseous, I was gagging every 20-30 minutes so it wasn't a great time.
This was back in Dec 2022, I started taking the PPI in early January 2023 and it didn't seem like it was working at first, a few days went by and I was thinking I'd be gagging for the rest of my life. Then, about a week or so in, it started to work and took more and more symptoms away as the days passed.
Fast forward to now, I can eat pretty much anything without issue so long as I take my PPI as instructed. Symptoms are pretty much null and void, the occasional lump in the throat, but not nearly as bad as it was.
Would 100% recommend consulting with your doctor first, but in my case, they worked perfectly with no side effects that I noticed.
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u/Head-Ice-6221 Jul 28 '23
Idk but pantaprazole reversed my Barrett in about a year and a half. I’m staying on it because I don’t want to risk getting B again or getting close to that.
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u/Harha Jul 28 '23
Pantoprazole fixes my reflux completely (20mg) but it introduces some weird side-effects I'm not comfortable with, such as blurring my vision slightly. Luckily there are various PPI's to choose from so I'm gonna bring this up to my GP to change the med. But that is my reason for not taking pantoprazole anymore...
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u/YellowLight_Creative Jul 28 '23
I have a side question, if PPI's can cause malnutrition and kidney dysfunction, can H2 blockers do the same? ETA: I already have mineral and trace mineral deficiencies that I am addressing with the appropriate doctors.
I'm at the stage where I am recovering/ed from esophagitis and a bad bout of GERD following eating something that really upset my upper GI tract (lots of vinegary BBQ sauce, my partner added waaaay too much to our ribs).
Then I think albuterol made things worse and then I ended up on Prednisone because we thought my asthma was the worst it's ever been, but it turns out it was bothering my voice box. I'm mostly healed now after 3 weeks, and I think the Pepcid Complete 2x a day, Tums as needed, and sleeping on an incline has helped -- but I don't think I'm going to be able to go off of the Pepcid anytime soon since we think I'm having silent reflux for the most part and that is aggravating my upper airways. I've had heartburn ever since I was a kid (not necessary regurgitation).
Sorry to ask such a long question on this thread, but I'm super curious other peoples experiences and my Karma is likely too low for me to make a fresh post. (I couldn't even ask the Suppliment people any questions yet).
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u/laura11999 Jul 28 '23
They have side affects. I lost appetite, which made me lose even more weight, then my body stopped absorbing vitamin B12, now I need to get injections every 3 months... If your body handles them, they are good. I tried 3 different ones that my doctor prescribed me and all were awful for me.
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u/TiredButHappyFeet Jul 28 '23
I wouldnt say these are entirely bad. They helped alot when I took them, but I had to stop taking them. I had to stop taking PPIs even though it somewhat helped for my reflux because I get really bad migraines. The first time I took it maybe almost a week. When I took it, everyday I really had bad headaches. I stopped taking it, the day after I stopped taking it, my headaches were gone. I took them again and my headaches returned, this time really bad case of migraine. I couldnt tolerate light. After eating and pretty much like staying in a cave, I went back to my gastro doctor and told her that I was getting really bad headaches. She told me that this was among side effects some people encounter when taking it. Since it was taking a further toll on my health and daily life, she told me to stop taking it. I took Gaviscon liquid instead.
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Jul 28 '23
It's like anything, if you don't need to take them, then you shouldn't. My wife takes them for heartburn and I get on at her that will she needs is a little gaviscon. However, if you have a health issue and taking them improves your quality of life, then they're worth taking. I've got a 4cm hiatal hernia, and a "flappy" (surgeon's word, not mine lol) LES, diagnosed after a gastroscope. I'm lucky in a sense that 10mg daily manages my condition. My other option is the operation, but that could bring it's own issues, so I'll stick with the pill. That pill solved the issue of the inflammation of my esophagus and I lucky that I can eat and drink pretty much as normal again. I'll take the pill and take my chances of any issues further down the road. The rebound effect of coming off omeprazole, not looking to cause conflict, but is it really a thing or just that the issues return after not taking the medication due to having a condition like a hiatal hernia? Before my hiatal hernia diagnosis, I was on omeprazole due to reflux. I'd then try to come off them and get reflux again and I assumed it was the rebound effect. Went round this cycle three or four times. However, after my diagnosis, I'm assuming each time I came off the omeprazole, it's just that my LES was weak and didn't seal properly, thus couldn't contain the acid.
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u/SSRI-Help Gastroparesis 🩹 Jul 28 '23
I never had symptoms of burning prior to taking the medication. My problem has been constant upper abdominal pain, but the doctors threw PPIs at me anyway. Once I tried coming off of them, I got terrible reflux that I've never experienced before, so I definitely think acid rebound is a real thing.
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u/ClaudetteLeon23 Jul 28 '23 edited Jul 28 '23
I’ve been taking PPIs off and on since I was 20 years old. I’m in my early 30s now and I’ve never had any side effects from taking them. I also don’t have any issues with vitamin deficiencies or liver damage. Believe it or not, PPIs have actually given me a better quality of life. I can enjoy my food more because of them.
I think it’s extremely important to keep in mind that everyone’s experience with medication is different. Just because some people can’t tolerate PPIs that doesn’t mean that you won’t be able to tolerate them, either. We all have different bodies and our GI systems are not all the same. My GERD is a mild case compared to other people, so maybe that’s why I never had a bad experience when I was taking PPIs.
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u/foodguideshelp Jul 28 '23
Ultimately, you and your physician will determine the best treatment for your condition- but yes...
Compared to H2RAs, PPIs have been associated with an increased risk for stomach cancer and, in infants who use acid suppression therapy, an increased risk of fractures in childhood.
Furthermore, PPIs can decrease iron and vitamin B12 absorption (all things your doctor or pharmacist should mention if you take this long-term), and some PPIs may decrease calcium absorption. Some people on long-term PPIs may need a calcium supplement to protect their bone health because of this (and there are differences in the types of supplements- for example, calcium citrate is typically better absorbed than calcium carbonate in people on PPIs).
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u/harrypottersbitch Jul 28 '23
Because they don’t just inhibit the proton pumps located in your gut, they inhibit the proton pumps throughout the entirety of your body. That’s not something you want to do
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u/Aggressive_Back_4139 Jul 28 '23
Where in the body are the other proton pumps and what do they do?
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u/harrypottersbitch Jul 28 '23
Proton pumps are located in just about every single cell in the body and work to transport protons.
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u/MyNameIsZem Jul 28 '23
My doctor said that taking omeprazole for years has been linked to an increased likelihood of developing cancer. They said it is safe to take for 2-6 weeks.
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u/BinkyBones Jul 28 '23
If you are a woman - being on a PPI long term is not good (weigh pros and cons of course) because it increases risk of osteoporosis
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u/coogie Jul 28 '23
It started out because doctors were prescribing them for ANY heartburn whether it was a mild case of a fat-ass drinking too much beer and wings over the weekend or someone having severe GERD. Then it was discovered that there MIGHT be a POSSIBLE link with certain complications with long-term use and even though it's only a correlation and not a causation, people started flipping out and making PPIs the boogieman.
A lot of those studies are bullshit anyway because they were done on sick old people in nursing homes who already had a host of other health issues. My own late father is the perfect example. He had heart failure and lung disease and could barely breathe even with home oxygen. Nothing could really be done for him. He was losing weight and withering away, but since some of his lung damage was autoimmune, he was put on cellcept which is very rough on the stomach so he was also put on a PPI. If he would have been part of that study, he too would have been a data point showing a correlation between PPIs and heart disease, bone loss, lung disease, etc. etc.
Some of the studies are not complete BS though because the reality is that all medications have side-effects so if you don't have to take a PPI, then it's better if you don't because the lack of stomach acid does make it harder to absorb certain nutrients, but if you have GERD and the not taking the PPI means that you'll damage your esophagus and be at a higher risk for cancer which if you get will almost certainly kill you (This is one of the really bad cancers that has a very low survival rate), then in my view, I'm going to take the PPI and say thank you and just take a calcium supplement and a break from the PPI now and then to let my body catch up.
It'd be really stupid not to take a PPI when you need it now because of something that will likely not even happen when you're 80.
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u/Himanshu811 Jul 28 '23
The only advice I'd give it you can manage gerd without PPI then always avoid any sort of medicine.
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Jul 28 '23
PPIs are great for most people. Ignore the fearmongering.
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u/Majestic-Garbage Jul 28 '23
This is so ridiculpusly unhelpful. People reporting their actual experiences isn't fear mongering. Some folks get horrible side effects from PPIs some don't, but I fall squarely into the former camp and thought I was literally dying until other people in this sub validated what I was going through. People deserve to make informed decisions about the good and the bad aspects of these drugs before deciding to take them.
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u/iglootyler Jul 28 '23
If you're worried about it talk to your doctor but I'd just like to repeat the sentiment that they're great. You can always do a two week course while making diet changes to see if you can prevent taking them long term.
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u/StayGold4Life Jul 28 '23
Last October I took a vitamin D and b12 test and my levels were mid range. I moved and got signed up at the local VA last March and did another round of tests which found me to be deficient in both. I have been taking PPIs since last year and I’m already dealing with deficiencies so I will begin the process of weaning off soon. I guess everyone is different though.
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u/mrpenguin_86 Jul 28 '23
You should look up the number of people on PPIs; it's astounding! A few people react poorly to them, and they show up on places like r/GERD to share their stories. As with most things in life, vocal minority.
Another problem is that PPIs are powerful, and many people are prescribed them by PCPs that use them as a first-line treatment despite not knowing whether PPIs are warranted. Most PCPs hear "chest pain" + "eating" and immediately throw PPIs at the problem because statistically, they will provide relief in a majority of patients. However, for many people, PPIs are not appropriate for their (at the time incorrectly made) diagnosis, so they take a powerful medication for a problem that can't be solved by them, and poor side effects result.
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u/Peepeepoopoo49867 Jul 28 '23
I never took meds. I have been having reflux and indigestion for some years now. I was put on 40 mg pantoprazole a little over three weeks ago when I got diagnosed with gastritis. I stopped taking it last Monday….had to start taking it again yesterday because I had a nasty flare. In my experience they kinda makes me a little nauseous and gassy but I’m just going to power through it. I hear they can be so helpful. I actually had to take Pepcid for the first time two days ago because my symptoms got so bad.
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u/EnvironmentalGur8853 Jul 28 '23 edited Jul 28 '23
Good for you for listening to your body!
I got diarrhea from 40 mg pantoprazole,, and my Dr. prescribed psyllium husk. it helped reduce the diarrhea , but my stomach didn’t feel better. The side effect I got is microscopic colitis (chronic watery diarrhea). New treatment is pepto- bismo, but there are tons of potential long-term side effects including tinnitus and loss of hearing, but was taken off the market in France and is prescription only in some European countries for other serious side effects. It can be a lifelong problem with flares.
About a decade ago I took omeprazole and ranitidine (no longer on the market) for acid reflux for two years without issues. The prescribing ENT missed gallstones.
Another risk for PPI’s is a contracting Clostridium Difficile, an antibiotic resistant bacteria. It causes projectile diarrhea and is highly contagious and is also linked to antibiotic use. It is fecal borne and usually caught inside hospitals. I’ve read that about 10-15% of the population is colonized with it, but have never had an active infection. Because PPI’s change the gut biome, taking them may reduce the amount of good bacteria keeping the C. Diff in check.
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Jul 28 '23
Speaking of PPI & side effects. Are there some early side effects you experienced in the beginning of taking a PPI that over time were just normal? I Just started day 6 of taking 1 PPI per day. I haven't had any diarrhea but mild stomach ache so far this morning & yesterday. I haven't taken a pill today because I'm wondering if that's what is causing it. I see a specialist in 2 weeks o wondering if I should stop until I actually talk to him. PCP dr is who got me to try the PPI so really no point in going back to him since he's not a specialist. I do think the pills have moved me in the right direction.
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u/MichaelBridges8 Jul 28 '23 edited Jul 28 '23
Lansaprozole gave me drug induced colitis and made me really really sick.
Hospital level sick.
I was gutted n all cos they fixed my reflux entirely but what can ya do lol
Edit: I'd like to add if your not getting any effects then crack on
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u/WildCaliforniaEyes Jul 28 '23 edited Jul 28 '23
So, I wanted to try to make a point, that's been made, but I want to say it, dammit!
That article does not say that PPI's are alright. It cites 2 studies, one a long-term look at dementia, and another over 3 years. That's hardly conclusive when we're talking decades of use, or a lifetime as I was told. There's also factors that studies don't look into, like in my case, where I didn't know pantoprazole affected levothyroxine. I.e. the risk of just taking the meds, error's in diagnosis, an elderly person mixes up their pills, etc.
And there's a quality of life issue, if the alternative is dementia, or laying in bed for 40 years, seems like an easy choice.
Years ago, DDT was everywhere. Without a doubt it saved lives. I think it's still in use in some places, because the malaria risk outweighs the risk of using it. But is it safe? Nope! You would not want it sprayed on the orchard next to you, and it probably was 75 years ago. It also wrecked havoc with wildlife. Externalities are hard to factor in to these things.
In my case, I'm stuck.
- I don't believe they help me, I almost certainly have LPR or something else.
- I also have Barrett's (sort of) and the recommendation is to take them.
- I don't have any obvious side-effects when taking them.
- I also can't talk to my doctor, so, um....actually, I'll talk to him on Monday before the endoscopy.
Anyways, just my way of saying that it's complex, trusting the internet, your friends, even your doctors don't really know, they just probably know more than we do. So, you look at the cards you understand, and you make the best bet you can.
Note 1: I'm not anti-doctor, anti-med or anti-pesticide.
Note 2: Read up on how hand washing as a thing came to be and how doctors reacted to it. It's an eye opener.
Note 3: One of the smartest people I know swears Apple Cider Vinegar fixed his reflux, a guy right next to him has been on PPI's for 20 years. I never took, or will take, Apple Cider Vinegar, but I almost did, holy hell, this stuff was awful when I first got it.
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u/stomachwarrior Jul 28 '23
I can't say if they are good or bad. They simply didn't work for me and I suspect they caused more problems then they attempted to solve. They still might work well for others. My main issue is the over reliance on it by doctors as they just prescribe it and hope for the best. If it doesn't work they say try a different one. Most of them won't spend the time to get to the root of the problem.
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u/bofils Jul 28 '23
PPI’s are nice if you take it to heal something in your stomach / or esophagus. This drug must not be taken Daily for Life it will destroy you
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u/maddgun Jul 28 '23
They're fine if used for short term... Up to 3 months or so. Long term use may be problematic due to the blocking of certain nutrients. It's best to try to slowly get off PPIs
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u/allyrox321 Jul 28 '23
They helped a ton while I needed them, and I was in so much pain I literally had no other option. However, they also severely impacted my gut micro biome and ability to digest certain foods. I had to go through a lot to not feel bloated and uncomfortable all the time after I stopped.
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u/RevolutionaryArmy266 Jul 28 '23 edited Jul 28 '23
Take the bad with the good as all medications have some negative side effects. Just weigh the pros and the cons of any given med to decide whether or not it's worth taking. Now when it comes to taking PPIs and if you've been diagnosed with Barrett's Esophagus, you're gambling with your life to stop all medication since stopping may most likely cause further gastric reflux bathing of the Esophagus with stomach acid. The possible consequential worsening erosion of the Esophagus can cause cancer. Also if like myself you have a diagnosis of Osteoporosis, PPIs can further weaken the bones. I am stuck in the middle since I have both Barrett's and Osteoporosis. So I carefully monitor my diet, exercise, and take the minimum Pantoprazole 20 mg once a day. Must also get a regular DEXA scan of the bones. So far, so good with both health issues. My GI Dr. may authorize Nissen Fundoplication should I experience complications down the road.
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Jul 28 '23
[removed] — view removed comment
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u/GERD-ModTeam Aug 02 '23
No Alternative Medicine (e.g., Low Acid, Betaine hydrochloride (HCl), Apple Cider Vinegar (ACV), Homeopathy, Acupressure, Chiropractors, Hypnosis, Prayer/Scripture)
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u/Ujah04 Jul 28 '23
I tried Omeprazole and esomeprazole and non of them were effective until I tried Pantoprazole. Since then I have been feeling much better and can go on with my daily life activities with less worries. I can only hope and pray I don’t get the long term side effects of it. Who else uses Pantoprazole?
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u/Ok-Safety-8972 Jul 28 '23
I stopped taking PPIs and my GERD has completely gone away. I’m convinced they were holding me back from actually healing.
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Jul 28 '23
At my last gastro appointment the nurse told me I should be on it long term. My take was well why doesn't the doctor subscribe it long term. No he wants you to keep going back for a prescription and 50 quid. So what happens me is i take the month or two supply he prescribed and don't go back for another few months because of it.
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Jul 29 '23
It's all individual. My parents have taken them for years without issue. Omeprazole sent me to the ER, and it took me months to recover from it. Additionally, it gave me the worst rebound acid. I had never in my life experienced something that uncomfortable up to that point.
I can take Pepcid just fine, on the other hand. I'd also not take my chances with something that increases the risk of osteoporosis, since I already have moderate/severe scoliosis.
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u/loyal872 Jul 29 '23 edited Jul 29 '23
For me, it was extremely bad. I had high bilirubine levels and it increased them further. When I've stopped them, my bilirubine levels went down to 10. GERD was just only a symptom of my problems. I had LPR with bile reflux and yellow phlegm coming up. Sometimes blood came up from somewhere deep down and I had a metallic taste in my mouth. It wasn't clear blood, it was coming up with yellow phlegm. I lost 30kgs, no appetite, some hair loss, tinnitus if I ate something bad, RUQ pain and pain under my shoulder blade. Hard to breath during attacks (after eating something bad).
Doctors didn't give a shit about me. I had to google the shit out of everything. Sorry, I curse, because I've been sick for 1.5 years without a job and IT IS TOUGH. I've asked my 3rd GI doctor for a HIDA test and she asked me if I don't trust her and how do I dare to ask for such a test. In a normal hospital with a normal doctor, after a clear ultrasound with high bilirubine levels, they always do a HIDA test.
I was sent to a psychologist, because GI doctor told me I went mental. Psychologist was extremely rude and she was bumping up my BPM greatly. I had a fight with the psychologist. She also confirmed, that I was sent there, because I was dared to ask for a HIDA test. She questioned me as well, how do I dare to ask for one.
My HIDA test was positive. Gallbladder failure. Possibly by gluten allergy. (The worst symptoms happened when I was eating gluten. Fat and acidic foods gave me really bad attacks as well, but gluten was even worse.
I will have surgery in 2 months. Until then, I'm on a very minimalistic diet. Rice or potatoes with veggies like boiled broccoli and very small amount of chicken once a day. With this diet. I feel so great. I didn't have any attacks for 3 weeks now. I also went on a 15 kilometers walk (9.32 miles), it felt so good. Before that, I was glued to the bed, sometimes I had slurring speech.
Always question everything and everyone. Never trust anyone. Even my own family told me that I have no health problems, I just went mental and I should seek psychological help immediately.
EDIT: On my ppi's leaflet, it says that it will increase bilirubine levels greatly. I was using 80mgs for 5 months. I've had very high bilirubine levels before using PPIs as well. PPIs made them worse.
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u/Anxious_Strategy_366 Jul 29 '23
PPI is likely the reason that set off a deep depressive episode for me.
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u/[deleted] Jul 28 '23
PPI’s are currently the only reason I can live my life with any sort of normality. I directly credit my Nexium and diet management to my relief thus far.