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After 8 yrs. of Nexium, breakthrough symptoms

//After 8 yrs. of Nexium, breakthrough symptoms
After 8 yrs. of Nexium, breakthrough symptoms2014-02-02T22:51:44+00:00

Fast Tract Diet for SIBO Forum Heartburn and GERD After 8 yrs. of Nexium, breakthrough symptoms

Viewing 15 posts - 1 through 15 (of 22 total)
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  • mchurch314
    Participant
    Post count: 61

    Hi all! It looks like I have the honor of creating the first thread in this forum. I am a 52 yr old male. I was diagnosed with GERD (along with weak LES) about 8 years ago. I was prescribed Nexium around that time and have been on it ever since ( I expressed numerous concerns over the years with my doctor and he disregarded them). Recently, I have experienced considerable breakthrough symptoms that are not being controlled by the Nexium (prior to this I could break every GERD behavior/diet rule in the book without any consequence). The GI doctor that originally prescribed the Nexium no longer wants to deal with me now that I am not responding well to the Nexium. He deferred me to my MD which left me scratching my head. I have since sought out another GI doctor and he ran a battery of test, including an upper endoscopy, and found mild Gastritis. He instructed me to double my Nexium for 2 months (to let the Gastritis heal) and then he was going to have me stop the Nexium. He also had me follow a low fat and low acid diet (ie. citrus, vinegar, etc.). I’m at the end of week two (double Nexium) and I am still experiencing symptoms. While I like the idea of getting off the Nexium, I’m concerned about stopping it due to continued symptoms (even on two Nexium). Has anyone else ever gone through this?? How did you do it?? How long did it take?? What can I expect??

    JI
    Participant
    Post count: 180

    Hi,
    I was diagnosed with GERD back in April. Prilosec and Nexium did not work at all for relieving my symptoms. I tried eating very low fat and low acid foods and still had symptoms. The GI doctor kept telling me that the Nexium would work over time. That did not happen; instead I developed small intestine bacterial overgrowth. I told my doctor that I wanted to get off Nexium because low stomach acid can allow bacteria to thrive. She told me to take Zantac as a step down medicine. I quickly reduced the Zantac dose while following the fast tract diet. I did get some intense acid breakthrough but it subsided after about a week. It’s weird how the Nexium did not help me yet caused flare-ups when discontinued.

    I am no doctor and can only speak from personal experience. I suggest you read the Fast Tract Digestion Heartburn book and follow the dietary guidelines. By doing so, I finally have relief from my acid reflux! You will want to wean yourself off of the Nexium slowly. You can get some good advice on this topic by going to the People’s Pharmacy website: http://www.peoplespharmacy.com/ I take chewable DGL licorice tablets before meals and ginger capsules after meals. I believe that both of these supplements help me. Good luck! I hope that relief is on your way soon!

    mchurch314
    Participant
    Post count: 61

    JI…thanks for your response. I have read the book and plan on following the diet once my gastritis is resolved. I’m not following it completely right now because my doctor has restricted the acidic foods and the fats while the Gastritis is healing. If I restricted the sugars in addition to the acidic food and fats I have no way to get enough calories to keep up my weight (I tried it for about 5 days and lost too much weight — I’m already down from 180lbs to 158lbs). Not sure when to make the change back to the FP diet, I was hopeful to gain back some of my original weight so that I could afford to lose some weight when I try the diet again. I must admit that for those few day on the FP diet, my symptoms did seem to be better. The only problem was the additional weight lose. I’m not sure how the doctor plans to get me off the Nexium but I plan on some sort of weaning process (and I’m expect some level of rebound symptoms). I too have started taking DGL Licorice before meals and I have used Ginger sporadically though I need to be more consistent. Thanks gain for your thoughts and guidance. Wish me luck!

    Norm Robillard
    Keymaster
    Post count: 436

    MC, I tried to get to the bottom of why doctors might recommend limiting fats for gastritis. All I could find was one unconvincing publication on mutant (LDL receptor-negative (LDLR(-/-)) mice. http://www.ncbi.nlm.nih.gov/pubmed/11397709

    Did your doctor happen to share any other information / publications with you supporting this idea?
    Also, were you diagnosed with H. pylori and if so, was it treated successfully?
    Thanks.

    mchurch314
    Participant
    Post count: 61

    Norm…I don’t know why he restricted the fat. I assumed it was because fat takes longer to digest than some other foods therefore it may cause excessive stomach acid secretion. I’m just guessing. He said no marbled meats, no ribs, no ground chuck, etc. He even said no to butter cookies, butter, ice cream, etc. That obviously really restricts your diet. You can see why I could not manage enough calories when I tried to blend the two diets (yours and his). He also said no alcohol (I really miss my evening glass or two of wine). I’m following his advise until I get this Gastritis healed (supposed to take about 2 months with 2x a day Nexium). I don’t want give him any reason to say that I did not follow his orders and therefore that is why things did not go as he planned. The reason that I’m giving him a chance and doing what he says is because he is the first doctor to tell me that he wants me off the Nexium. I’ve wanted off these for years. It scares the heck out of me but I want to be Nexium free. The big question for me is when do I switch over to your diet. Your diet makes so much logical sense to me that I know it will work in the long run. And I am very disciplined and can stick to it. I’ve gotten my sister, who shares my GERD as well as has IBS-C, on board and she will be starting your diet as well. I instructed her to order your IBS book in addition to the Heartburn book. If you have any additional thoughts on the fat restriction or alcohol restriction (or tea for that matter) please let me know. Thanks for your help!

    Norm Robillard
    Keymaster
    Post count: 436

    I see MC. I can’t fault you for listening to your doctor. The other reason I believe doctors limit fat in this case is the reported effect it has on gastric emptying. I do think getting off the PPIs and limiting SIBO with Fast Tract is an important goal for addressing GERD. Hopefully you can share the book with your doctor and keep a discussion going to reach that goal. Best of luck to you.

    mchurch314
    Participant
    Post count: 61

    Thanks Norm…looking forward to a better tomorrow!

    Jaeme
    Participant
    Post count: 348

    Hi Norm & MC,

    Doctors told me that fat causes more acid because it is too hard to digest and weakens the LES – so no fats for reflux/GERD/LPR. Their response is to replace all fats with whole-grain carbs and low-acid foods. According to Norm, this is a recipe for more GERD/LPR and other gastro problems?

    I have only been on the no-fat, low-acid, high-carb diet for a week and a half, and I have already lost almost 20 pounds (which I did not need to do). I feel terrible, and am worried about nutrient levels/balance and the extreme weight loss.

    I consented to one Zantac 150mg at night to prevent nighttime reflux, but I think it is causing daytime breakthrough when it wears off mid-day. I have read that H2 blockers like Zantac quickly become non-effective due to body getting used to them (same goes for nasal anti-histamines like Claritin).

    That is why I am here on this site – looking for a better way.

    Norm Robillard
    Keymaster
    Post count: 436

    Hi Jaeme,
    You’ve come to the right place and stated my belief clearly. I don’t think fats have anything to do with reflux and are actually the safest food you can eat for GERD. The reasons are all explained in Fast Tract Digestion Heartburn. I am also working on a blog article on the underlying cause(s) of acid reflux.

    As for H2 blockers becoming ineffective, I don’t think they are very effective to begin with. There is an idea that the body may adapt to both H2 blocker and PPI drugs by producing more acid pumps, but I am not aware of any proof of that concept.

    JI
    Participant
    Post count: 180

    Jaeme, my current Gastroenterologist told me to start eating full fat foods when I was losing too much weight. She actually asked why I was eating fat-free cheeses. She is more concerned about me eating too many carbohydrates and sugars because I had a bad case of SIBO. Her advice meshes well with the theory behind Fast Tract Digestion. I know it is confusing because every doctor has told me something different. I have weaned myself Nexium and Zantac, my next step-down medication. Everyone is unique, but I only suffered from acid surge for a few days.

    mchurch314
    Participant
    Post count: 61

    Hi Jaeme…I had the same thing happen. I tried to cut out all fats and I just couldn’t get enough calories unless I added sugars back into the mix. Sugar is obviously not a good trade off because it feeds the bad bacteria and it’s not healthy in general. Before adding the sugars back into my diet I lost 22 pounds (maybe 10 pounds that I could afford, the rest I could not). I’ve recently seen my GI doctor and explained the problem and told him about Norm’s theory and diet suggestions. He generally agreed with the approach but he prefers to take it a step farther by eliminating animal proteins from his diet (a bit outside of mainstream but there is some evidence to backup his theory — Googles, “The China Study”). I’m not sure that I’m ready to eliminate animal protein but I am definitely ready to remove the sugars (ie. cane, fructose, etc.) while including what I would define as mostly healthy fats (ie. fish, chicken, lean meats, olive oil, coconut oil, etc.). As you likely read in earlier posts, I will be starting the Nexium weaning process in about 5 weeks. I have already started minimizing sugars and have accumulated a few tools to help with the process (ie. Sucrolofate, baking soda and water, digestive enzymes, Prelief, DGL Licorice, etc.). Regarding your comment about doctors giving conflicting advise, it has happened to me too many times to count. The best thing that you can do is educate your self and then follow the advise that feels the best to you. My new GI doctor seems to line up pretty well with the Fast Track approach and since I can see the logic in the Fast Path approach, that’s the way I’m going. PS. Since adding fats back into my diet (about a week ago) I have gained about 5 pounds. I also started simultaneously cutting back on the sugars. I’ll post my progress on this thread.

    Jaeme
    Participant
    Post count: 348

    Thank you for your quick responses, Norm. Your site is giving me hope!

    Here is a link to a Copenhagen study that links PPI’s to causing heartburn/GERD:

    http://www.npr.org/templates/story/story.php?storyId=112564382

    Jaeme
    Participant
    Post count: 348

    Thanks JI & MC! Wishing you success with adding the fats back in – please keep us posted! The idea of loading up on sugar to keep weight on is ludicrous, and makes me feel even worse.

    I started adding a little fat back in today (some olive oil, a whole egg – surprise, no reflux/LPR symptoms) and stepping down on the whole grain carbs, so as not to completely shock my system at once. Since I have only been on the nighttime Zantac for a few weeks, I am hoping it will be easy to wean off.

    The ENT I went to for LPR, while on the side of the low-fat/low-acid camp, did consent to say she was not against using Apple Cider Vinegar since so many of her patients have had success with that (so she said she had a “foot in each camp” and couldn’t argue with success). So minds can be changed. I will tell her about Norm’s approach – based on researching many forums, people are having success with the Fast Track diet (many who were on the low-acid/low-fat diet ad gave it up).

    One thing I have found to be extremely helpful (suggested on several forums) is chewing gum for at least 30 minutes after eating. This keeps things moving in the right direction and neutralizes throat acid/pepsin with saliva. There was a research study done on this, and it showed success as well (especially if you can find bicarbonate gum). The problem I am having is finding a gum without mint/chocolate/cinnamon/citrus and no sugars or sugar alcohols, and with the bicarbonate.

    I have also started the DGL (which is prescribe in Europe more than PPIs). Chewing food very thoroughly with no liquids until after meal has helped as well (again, adding more saliva). Keep liquids sparse during mealtimes also keeps stomach from over-filling.

    mchurch314
    Participant
    Post count: 61

    Jaeme…try a gum called “Ice Cubes”. It is made with Xylitol( a sugar alcohol) and comes in Wild Cherry and other non-mint flavors. I know that it is not ideal but it seems to be the best of the bunch. As a side benefit, Xylitol is suppose to help strengthen your teeth. If anyone else has a better suggestion pleas let us know.

    Norm Robillard
    Keymaster
    Post count: 436

    It’s great to see an active discussion on reflux and PPIs. Good stuff and some progress too. MC, on the China study, you might be interested in Denise Minger’s analysis of this study. http://rawfoodsos.com/the-china-study/

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