Prilosec doesn't work any more?
Been on Prilosec (Losec in UK) for over five years, but it's gradually losing its desired effect. Seem to belch frequently during and after eating, and get sharp burning pain just below shoulder blade. Anyone else get these symptoms or found losec to be losing its efficacy?
Many have reported that their PPI has seem to fail after a few years. I am not sure if it is the medication or just the fact that the reflux is just getting worse.
I was on Prilosec 20mg a day for seven years or so when I noticed that my symptom of being short of breath was returning. The doctor increase the dosage to 40mg but it did not seem to help. The doctor then switched me to Nexium 40mg a day and the symptom resolved.
Others have found that switching to one of the other PPPI's has helped. Some doctors have prescribed a PPI for the AM and a H2 blocker like Zantac for the PM.
Same problem here....tried all the others with no luck.
Doctor is trying to wean me off the PPIs to see what happens.
Been on the PPIs for 9 years now.
This is pretty common. I guess our systems get used to the drug. Ask your doctor to switch you to another PPI. (He should already be quite familiar with this aspect of GERD, by the way.) You might have to try several, if the first alternative doesn't do the trick.
Or you can be like me and try all of them with no success.
Remember that it can take several weeks for a PPI to take effect, so give a new one a month or so before you give up on it.
After 9 years of being on this junk I am 11 days into no PPIs at all and I'm feeling pretty good.
I've had my rough spots over the past 11 days, but I've tried to counter it with DGL tablets, Acid Soothe and an occasional Pepcid Complete.
My GI doc suggested 300mg of Zantac in the morning and at night to get through the rebound stage, but I haven't needed it.
I like hearing stories like yours... I would love to get off this 'purple crack'.. (Nexium)... I go back for follow up on Wed... new GI doc... gonna see what he thinks... I've never tried Zantac... but am willing to try... the Nex doesn't seem to be working as well as it did anyway... but I've tried going off 4 times now and YIKES! I tried just about all the other PPI's before Nex... none worked like it did... but maybe now...hmmmmm
I hope you are able to kick the habit ... :P please keep us posted...
I figured I would try to give myself a month off the stuff to see what happens. I've read accounts of people experiencing the rebound situation for 14 - 30 days.
I was put on the PPIs 9 years ago when I checked off the symptom sheet at my family doctor saying that I experienced heartburn more than twice a week. Back then I had just graduated from college and was starting a new job. They had done an upper GI and said that I was having a lot of reflux and considered me to have GERD. I was then sent to a GI doc who did an endoscopy which showed no signs of esophagitis or Barretts, but he told me to stay on the PPIs indefinitely to control the symptoms.
Fast forward nine years and the stuff isn't working anymore and I'm having all kinds of crazy symptoms...lump in the throat, ears hurting at times, terrible burps, etc. A lot of this has diminished once I started weaning off the PPIs.
Over the course of 9 years I have tried:
I am convinced that this whole issue in my situation is caused by a combo of the PPIs, stress, not enough exercise, eating habbits and lousy sleep. I refuse to buy into the whole mysterious transient relaxing LES theory.
It's all a big journey so we'll see how it goes. I'm also seeing a Christian counselor to try to learn new ways of coping with stress and anxiety. My GI doc actually recommended that I try this since all of the tests they have done with the exception of the upper GI have come back normal.
Your story sounds familiar... I'm REALLY thinking most of my troubles is caused from stress... I didn't have ANY digestion troubles til my oldest son joined the military! it's been downhill from there... lets just say UPPER digestion issues...LOL I've had constipation issues all my life... but sternum pain started about 3 yrs ago... then my gallbladder went wonky on me... I'm much better since that came out but I would love to be what I was sayyyy 4 yrs ago... I know my weight has a lot to do with it... but this crap causes me to feel so icky at times it's hard to really work on that part of it... excuses excuses.. I've been at this weight for 5 or 6 yrs... but STRESS has made things much worse... a good friend of mine was put on Ativan for anxiety and she says it helps tremendously... I really don't want to rely on that but I'm about ready to give it a try! I know when I take 2 mg of Valium I DO feel better....
I'm beginning to have some ear pain... hmmmm didn't relate that to my GERD/PPI issues... now ya got me thinkin...
Schwinn I just can't beleive you were on PPIS for 9 years without any proof of GERD . You can't diagnose GERD with a barium swallow. You should have been given a ph test years ago .
There are different types of GERD with varying severity. You can't lump it all into one. There are those who have all negative tests . This is beleived to be the stress related type.
These disorders are all episodic by the way . Symptoms tend to come and go. If your symptoms come back it would be smart while you are off of PPIS to ask for a ph test , that way you will have a definitive diagnosis . Take Care and good luck
I did have a Bravo PH test done back in January 07 and I hit the symptom button 42 times in the 48 hours I was wearing the monitor and it showed no signs of dangerous acid levels.
Of course, the doctor kept me on 80mg of Protonix during the test.
I questioned this and he said that it kept him from making take the test twice. Apparently if you take the test without PPIs and it shows bad acid then they have to run the test again while on PPIs to make sure the acid levels are reduced.
For me, I was having trouble while on 80mg of PPIs a day so I guess he was checking to see if acid was the culprit.
After that he put me on Carafate for a week to see if it was bile reflux. Apparently it wasn't because it didn't help either.
So far I have had:
* 2 Upper GIs - Both showed reflux
* 2 Endoscopies - No esophagitus or Barretts
* Gastric Emptying Study - Normal
* Bravo PH Test on PPIs - No bad acid
* Sonogram of Gall Bladder - Looked Good
The only test I'm lacking is the manometry/impedence test. My GI doc says that they just got the new model in with the thinner wire that also detects the presence of liquids. Still not sure if I'm ready for that one.
I also laughed when my doctor asked if they made me drink liquid when I was laying down in my upper GI test. I said yes and he rolled his eyes and said that it wasn't good for them to do that because it's not a reliable way to test during the upper GI.
BTW...How do the doctors prove GERD? Seems like my doctors labeled it GERD after I complained of heartburn more than 2-3 times a week and the Upper GI with barium swallow showing reflux.
Hi Schwinn Well if the person complains of heartburn more that 2-3 times a week, or whatever it is exactly..... i forget, the AGA reccomends a trial dose of PPIS rather than tests initially to see if symptoms resolve .. ( cost effectiveness ) and then eventually try to ween the patient down to H2 blockers or off of the medication.
But when symptoms don't resolve, it's unusual to increase the dose and allow the patient to stay on PPIS for 9 years without at least confirmation of diagnosis.
There are only 2 ways to diagnose . (1) Biopsy proven esophagitis on endoscopy. ( 2) If endoscopy is negative than a ph test off of medication . This is important because half of all people with GERD symptoms and negative endoscopies also have negative ph tests.
You need to know if your symptoms correlate with acid reflux episodes....
People who have no damage on endoscopy ( it's called NERD, or non erosive reflux disease ) are beleived to have a less serious form of GERD anyway. The prognosis is better .
Anyway , the object with treatment is to at least scale down .... or get off of PPIS. unless you have Barretts or some refractory case of GERD .
A barium swallow is not meant to be a diagnostic tool for GERD. It's more to look for hernias , ulcers , tumors, and the anatomy. . A quick, cheap, non invasive test. You cant use a barium swallow to prove GERD . It has a very low accuracy rate. You will get both false positives and false negatives.
The reason is everyone refluxes , A person without GERD can have up to 50 reflux episodes a day . This is perfecrtly normal . This might be what the radiologist sees . Normal reflux. GERD is more than 50 reflux episodes a day , and acid exposure is often longer.
Hmmm, so Tricia, do you think that I need to have the Bravo PH test done again while off the PPIs?
I guess there was a time when I was symptom free while on 20mg a day of Prilosec and that seemed to last for a couple of years. Of course, that was before I had two kiddos and started my job 22 miles from home.
My latest GI Doc is wanting me to do a manometry test...not sure what that will prove. He says it's the last test to perform and he was suprised I had not had it done already. Still not sure I'm realy crazy about this one.
I have seen 4 different GI docs over the past 9 years so that probably explains some of the lack of feedback on the PPIs. Whether I was unsatified with their practice or had a change of insurance, I've switched around a lot. I give the new doc all my info each time, but it seems like they can only spend so much time going back over everything.
I'm on day 14 of no PPIs and I'm not doing too bad, but I have had a few symptoms in the past couple of days. I was off of work all last week and felt my best due to the ability to relax and not be stressed. This week I'm back at work again and I've noticed a twinge of heartburn again. The crazy part is that my job isn't all that stressfull.
Thanks for your input Tricia!
Hi Schwinn Hope you are still doing pretty well off of the PPIS . A tough thing to kick after 9 years.
Well i didn't mind the manometry at all. I suppose your doctor wants to check for esophageal motility problems to see how bad your GERD is. Also check for other motility disorders like alachasia for example which has similar symptoms to GERD but isn't GERD . Sort of to make your file complete.
I sure would consider doing the Bravo off of PPIS. When you had the bravo test on PPIS , you pressed the symptom button 42 times , but acid levels were normal. So what were the symptoms from ? Most surgeons will not touch you unless you have a ph test off of PPIS anyway, if you are considering surgery down the road. Manometry is mandatory too.
By the way , carafate doesn't work well in a lot of people with bile reflux , so that wouldn't rule it out. ... Not saying you have it, just saying not responding to carafate wouldn't rule bile out, just like not responding to PPIS wouldn't rule GERD out.
Hope you're having a great night . It's very hot here , getting ready to watch American Idol.