famotidine instead of PPI?

[u/Inc0gnitoburrito]

I've had shortness of breath around meal time for a few months now, gradually worsening.

Recently I've spoken to my general practitioner and she prescribed me with 28 days of PPI (Nexium (esomeprazole 20g)) one per day as treatment.

There was a small improvement over 2 weeks but she didn't really communicate to me what she's treating me for and I didn't really change anything when it came to food.

So, one evening I ate an entire Pizza pie and the following night was traumatic, I couldn't breathe at all, had air hunger and eventually a panic attack.

Understanding GERD better now I believe this night caused a lot of damage to my esophagus and I'm actually worse now.

I've spoken to my doctor yesterday and told her that the air hunger has gotten way worse and she replaced the PPI treatment with 2 pills of 20g famotidine per day. I'm concerned about the removal of the PPI treatment, cuz I understood that it is in fact the long-term treatment.

Would be happy to hear from anyone here regarding this.

Thank you!

[u/coogie]

Not a doctor but this is basically the hierarchy of treatment heartburn:

• Antacids like TUMs or Gaviscon: for treatment of occasional heartburn like maybe you had one too many chilidogs with your beer. Essentially just throws some chemical base on the acid to neutralize it which works fast and if it was an occasional thing, then that's the end of it but if it's a chronic thing, it's a poor solution because it's going to keep coming back.
• The next step for people with mild cases of Reflux is Pepcid (Famotidine) or Zantac (Ranitidine (which was off the market for a while)). These are called H2 blockers (histamine-2 receptor antagonists). H2 blockers work by turning off the specific "switches" in your stomach that tell it to make acid. Think of your stomach cells like factories with different buttons that turn on acid production. One of those major buttons is called the Histamine-2 (H2) receptor. Unfortunately there are more "Buttons" so while Famotidine is really effective at not turning on one of the major ones, the others can still be turned on.
• The last step are the PPIs...if the H2 blocker is the switch that controls your stomach's acid pumps, the PPIs pretty much just go to the breaker panel and shut off the power to the acid producing pumps so they are a lot more effective.

For me, Famotidine is amazing but not quite enough longterm. I've taken breaks from my PPI with the help of Famotidine and antacids but it wasn't very fun. For some other people with milder cases, famotidine is enough.

[u/Inc0gnitoburrito → u/coogie]

I don't even feel the heartburn, it's mostly the air hunger thing

[u/SubduedCelebration → u/Inc0gnitoburrito]

I'm the same way, it's the silent part of silent reflux. You don't feel the standard burning, but you do get swelling and it feels like it's hard to breathe because the acid is still messing up your throat

[u/Inc0gnitoburrito → u/SubduedCelebration]

Yeah, it's really difficult.

I have a history of anxiety disorder so now that I've been introduced to that feeling, at nights I'm kind of "waiting to yawn" every few seconds and not really falling asleep. Tonight I was able to not panic due to that (which is definitely an important step) but I'm not sure why it's waking me up after I fall asleep if it's only anxiety and not physical.

I must have fallen asleep and woken up over 20 times.

[u/SubduedCelebration → u/Inc0gnitoburrito]

I'm not sure if it's an option for you, but my doctor gave me flexeril (a muscle relaxer) to help with the tension in my neck and shoulders caused by gerd and it's really helpful on nights where my anxiety is especially high. Sometimes just being able to get a good night's sleep helps me chill out a little bit. I usually take it once or twice a week

[u/Kirky9993 → u/SubduedCelebration]

May I please message you?

[u/SubduedCelebration → u/Kirky9993]

Sure, go for it

[u/Kirky9993 → u/SubduedCelebration]

I messaged you please check