Acid rebound phenomenon

[esimpkins]

To all

I recently stopped taking PPI's (about 4 days ago) after taking them for 4 months (single does and double dose). While I never had bad heartburn before (my symptoms were more in the LPR world), in the last few days I have had brutal heartburn. It occurs more often after running. Does the stomach start to produce huge amounts of acid when one comes off these PPI's

Thanks

[The Pard]

Hi E,

If you told that to your doctor he would tell you
that "if it hurts to do it....Don't DO IT"

If you have a loose les the jostling of your stomach and pounding on you diaphragm is enough
to foam up the stomach acid and if nothing else, the fumes will iritate your esophagus and lungs.
Do you have any coughing spells after running?

Maybe you should take up the bicycle and save your knees as well as your innards. (Go ahead and tell me that runing causes you knee pain, but you keep on running anyways.)

There is a rebound effect when you stop PPIs and
the body starts producing more acid than it would
with no meds to suppress it.
Try going back on a half strength PPI for a few weeks and then cut that in half again.
Supplement with pepto-bismol, gaviscon, tums as needed when you are tapering off and afterwards.

Pard

[Rebecca]

Hi es,

Pard is right about the running....but as a distance runner since my teenage years I know how addicting it can be. I haven't been able to give it up either, although I think at this point I could probably be off PPIs by now if I wasn't running. My GI explained it to me this way -- he said imagine running with a milk jug with the lid loose , as you ran the contents would push up out of the bottle. In the case of a loose LES it means your stomach contents are spilling up into the esophagus/lungs and make the GERD/LPR symptoms worse. If you continue running, make sure you don't eat or drink anything at least three hours before your run. I take my PPI 1 1/2 hours before running, but since you're off PPIs now you might want to think about at least taking an H2 (Pepsid or Zantac) before you go out. Also, make sure your strides are smooth and not jarring (this is also better for your back). I had a physical therapist help me with this and it's made a big difference in my GERD while running. Just focus each step on hitting the ground with your heal and rolling through smoothly to the ball of your foot and try to minimize the "up and down" motion of your stride as much as possible. Also, Pard's right about tapering off PPIs slowly instead of going cold turkey. I know some people don't have a problem with acid rebound, but why take the chance. Hope you feel better soon. --Rebecca