Tagged: PPI rebound
- JulesParticipantFebruary 18, 2015 at 3:28 amPost count: 14
I thought I’d add my story to this interesting forum. I’ve been taking Nexium 20mg for 7 years. Last September I saw my doctor about an intense throat prickle, dry cough, limitation of voice range and feeling generally unwell. He advised me to double the Nexium to 40mg. At this point I had no GERD symptoms whatsoever. After 3 weeks of taking the Nexium 40mg I was having very uncomfortable oesophageal pain after each meal, often lasting the whole distance between meals. LPR was subsequently confirmed by an ENT man who also wanted me to go back to the double dose of Nexium.
I started researching the internet about getting off this medication. I found that low acid can be a culprit as well as excess acid. With the help of organic apple cider vinegar before each meal my aim is to get off this medication. It’s quite possible I had low stomach acid before taking Nexium as I’m in my 60s and it appears low stomach acid is not uncommon in the older population.
In early December 2014 I put myself on a strict diet, one that eventually helped me overcome chronic candida problems back in my 30s. I recently discovered it’s along the lines of Norm’s suggestions and pretty well everything I eat I would consider has a low FP according the to FP tables in Norm’s book. Essentially, breakfast is buttered puffed ricecakes with varying vegetables (cooked or raw) or an egg. Lunch is a little bit of meat and raw salad veges. Dinner is a little bit of meat or fish and cooked vegetables. I also eat unsweetened yoghurt with a very small amount of low FP fruit. I have been having a cup of Rooiboss tea with a very little milk each day. I dropped all grains apart from the puffed ricecakes. I have not measured the total FP of my daily diet but the meals aren’t large. Needless to say I’m losing weight, weight I don’t really need to lose which is concerning, and the diet is extremely repetitive.
Getting off the Nexium is very difficult. I’m down to taking a third of a tablet with rebound symptoms all the way. Rebound for me is an acid stomach and varying degrees of heartburn/throat burn/larynx irritation after most meals. I’ve stopped drinking water overnight because it results in a rush of stomach acid at this point in time. It’s taken me from December until now to get down to a third of a tablet because of the rebound. I’ve read on other forums it can take up to a year in some cases to get off a PPI. Right now I’m plying myself with Gaviscon after each meal to give my throat a break from the vinegar/water drink I usually have before eating. When I use the vinegar before a meal I can sometimes escape having to take Gaviscon afterwards.
Recently I tried a teaspoon per day of some expensive organic fermented red cabbage. That created a lot of gas in my stomach/small intestine region so I don’t think fermented veges are going to be a healing tool for me.
The unsweetened yoghurt I eat has live cultures of Lactobacillus bulgaricus and Streptococcus thermophilus which appears to give me no problem and even helps with rebound to an extent.
Some days I get quite discouraged but I am hoping that my ongoing GERD/LPR symptoms are being caused by the rebound effect and from what I’ve read, this will continue for a while once I manage to get off Nexium completely. So far though I know my large intestine has definitely benefited from the diet. It would be lovely if one day I can say the same for the rest of my digestive system. Have to not let go of hope.ftderParticipantFebruary 19, 2015 at 3:10 pmPost count: 210
Glad you posted your story! Don’t let go of hope! From what I have read, Dr. Robillard encourages people to go off the PPIs completely if possible. Did you read Fast Track Digestion:Heartburn or IBS? In the IBS book there are some troubleshooting suggestions. For me personally, the candida diet guidelines (the portions and types of grains and fruits) that i was following, kept me symptomatic with SIBO for 2 years! I had to take out rice cakes and fruit for a while, because my SIBO was very overgrown and so those seemingly safe carbs were still being digested by microbes more than absorbed! So, for at least a week or two, if you are going to go off the meds, you might consider several things: Try only eating 1/2 cup fresh cooked jasmine rice, and maybe only a few days per week (not the rice cakes until later). Eliminate the fruit for a few weeks as you are transitioning and then add back small amounts. If still not getting results you may have to take out the rice for a little while, and also consider reducing protien and increaseing fat (I bought a kitchen scale and I stick with fattier cuts of beef and ground beef, fatty fish, raw milk cheese and eggs). Microbes dont eat fat, but some do eat protein. This would be more of a ketogenic or “low carb” diet, and would just be temporary. This really helped my digestive system, but I hope to add back safe carbs soon. It is a lot of trial and error and tracking your symptoms. Keep us posted!JIParticipantFebruary 19, 2015 at 7:10 pmPost count: 180
Hi Jules, my gastroenterologist recommended Gaviscon liquid. But, I do not like the formula sold in the United States as it contains aluminum. I order Gaviscon Advance liquid and tablets online from British Pharmacare. The UK formulation has no aluminum, and contains much more of the active ingredient, sodium alginate. The shipping is free, but it will take some time to arrive. The Gaviscon Advance forms a barrier over your stomach contents, and prevents reflux from getting into your esophagus. It also soothes the stomach. You cannot eat or drink anything after taking it with the exception of about 1/2 cup of water to wash it down, or the barrier will be broken. This product may help you a lot with the rebound from getting off Nexium. Good luck!JulesParticipantFebruary 20, 2015 at 5:26 amPost count: 14
Dear bearsmom and JI, thank you for your replies.
JI, we have what appears to be a Gaviscon similar to Gaviscon Advance which has more alginate in it and I use that as necessary to combat a large pour of acid into the stomach. Thanks for your advice and yes, it does work quite well.
bearsmom, I haven’t been allowing myself rice because I gave up all grains last December apart from the puffed ricecakes. However, I will try your suggestion about a small amount of jasmine rice as a possible replacement or rotation with puffed ricecakes (which appear to have a low FP according to Norm’s tables). I know the puffed ricecakes are a processed food but I have used them for many a year as a platform for breakfast when wheat toast has given me problems. If I were to dop the ricecakes I’d have to turn to something like omelettes (adding even more eggs to my diet) and would find these rather rich for breakfast. I allow myself two serves of yoghurt a day for later in the day when I get hungry (or to give the acid surges something to think about) and so I probably shouldn’t have it for breakfast as well. I find it hard to be creative about breakfast. I eat only about 4-5 tablespoons a day of watermelon – my only fruit – but as you say, I may have to reconsider this in the future.
I’m anticipating the majority of my digestive woes are being caused by the reduction of Nexium. There are so many, many people across the internet struggling to get off PPIs and it’s obvious the medical model for treating GERD/LPR is broken and must be reassessed. Of course funds for further research about better ways to alleviate GERD will not be coming from the pharmaceutical companies anytime soon. Nuff said about that!
Doubling the Nexium last December got me into trouble as per my first post and so I put myself on pretty much the same diet I used to completely overcome long-term candida because I knew how good that way of eating made me feel overall and how it balanced my system. It was an act of desperation switching to this diet from one day to the next because it takes some adjusting but I was helped by the fact I’d done it all before and the rewards back then were outstanding. In fact, I stayed with that stringent diet for almost 10 years. I lost too much weight but felt great. It took me 12 months to completely overcome the candida using diet but that is another story. I ate no grains on that diet until ricecakes became available.
I’m a little nervous about being liberal with saturated fats as I have two first-degree relatives who have needed cardiac bypass surgery in their 60s plus two extended family members. I know fats have recently been thought not to contribute to heart disease but I think it will take a while, and as such some proof, before this becomes accepted by a public who were led to believe otherwise some time ago. Having said that, I’m eating butter, coconut oil and my yoghurt is full cream. I’m about to have a cholesterol check so that will be interesting.
My diet fits closely with Norm’s FP tables and I’ve dropped things like banana so that I am eating only those foods with a low FP. After eating this way for just over two months my large intestine feels so good because I can’t feel it. LOL. Previously I had chronic constipation, uncomfortable wind at times, which I guess could mean the intestines were a bit inflammed, bloating and sometimes cramps which my doctor told me was IBS. I’m 98 per cent regular now and this coincided with starting to juice vegetables. I have no more than a quarter of a cup of juiced veges before each meal as I don’t want to overdo it. Now that there is some stomach acid in play I’m dropping the apple cider vinegar I was drinking in water before each meal. The ACV was a godsend for the heartburn that the double dose of Nexium created but I don’t think it’s a natural thing to drink this past the necessary time although some would disagree with this. It wasn’t doing my throat any favours and I suppose that was my main motivation for dropping it – will see how that goes.
I will be interested to see how the landscape looks when I can finally dispense with the Nexium and the lingering rebound. Then I will obviously have a much better idea of how much my eating plan is helping from the small intestine upwards. My energy has improved other than for the times I get bogged down in anxiety and worry about what damage may be occuring to my oesophagus, throat and larynx on the bad days. Anxiety steals so much energy. I’m a meditator and practice mindfulness as well as I am able to and that all helps. I do marvel at the ability of the body to recover or partially recover from the reflux episodes. For one thing, these months of what feels like chronic ill health is forcing me to learn how to find peace amongst the turmoil if only for short periods but those periods are regenerating.
I’m probably starting to ramble so will sign off now. Thanks bearsmom and JI for your interest.Norm RobillardKeymasterFebruary 25, 2015 at 2:11 amPost count: 445
Thanks for posting your story and great to see you are getting some good input from JI and Bearsmom. Sounds like you may have read at least one of these papers on saturated fats, but just in case, they are both linked in this post. https://digestivehealthinstitute.org/2014/12/31/saturated-fat-good-digestion/
Getting off PPIs is important, but there is one caveat. If symptoms persist for some time – say two or three months, that indicates that you are still having reflux and it’s source/cause needs to be chased down and addressed. Chronic reflux can lead to Barrett’s given enough time and stopping it is important for long term health. If you need our help, feel free to drop us a line via the consultation page.JulesParticipantFebruary 28, 2015 at 12:08 amPost count: 14
Hello Norm and thank you for your response.
I thought I was eating a very low carb diet (which I am by “normal” standards) but after buying digital scales a couple of days ago and weighing my food I realise I have more often than not been eating in the high moderate range for the last three months. I am going to try to keep under 30 points a day for a week and see how that goes. Juicing vegetables adds to the points but I need this to keep me regular in the bathroom.
I was encouraged that I’ve had no heartburn for the last seven days but I’m having some heartburn after breakfast this morning which is disappointing. Also my throat felt a bit more irritable last night and I’m having some ear pain at the moment coinciding with the heartburn. This could possibly point towards a small serving of casserole I had the night before last which I discovered had onion, some tomato sauce and wheat flour in it.
I’m on the verge of giving up Nexium (now only taking around 3mg daily). If I fail to improve with lowering the FP points I will take up your kind offer of a consultation.JulesParticipantFebruary 28, 2015 at 12:33 amPost count: 14
bearsmom, how have you been going?
I thought about what you said and I have dropped the watermelon from my diet (only fruit I was having) and am going to swap the thick rice cakes for thin ones. As you did, I may have to be prepared to let go of these as well. I tried some Jasmine rice but the next morning I had a windy lower intestine so perhaps I’m not ready for that yet. You will see from my previous post to Norm that I’m going to try to keep to under 30 points a day.
This feels like a never-ending journey at the moment. I know I’ve improved overall but am disappointed to step backwards into heartburn and ear pain again this morning. I thought the lack of heartburn over the past week might be the start of real healing for me and was mindful that it takes much longer for LPR to get better. Hopefully it’s only a temporary setback.
There are times when it is definitely challenging to keep the right attitude as we traverse the road to healing for this condition. I find my little “what if…” voice hangs around a bit. 🙂ftderParticipantFebruary 28, 2015 at 2:34 pmPost count: 210
You are really on the right track. I have only started adding in a 1/2 serving of fruit recently. You are right that the LPR symptoms take longer. I don’t understand why, but know that the bacteria shift as they compete for less food (a good thing). For some reason there are a lot of reports of LPR symptoms and I have experienced that as well. I think you will get to the point where you can have things like rice a fruit and few times per week and then more often. Strangely my LPR has gotten better, even tho I added back fruit, because I watch my veggie portions more carefully now. I used to be of the mind that “veggies are good” and would just eat a ton of them. But my digestion can’t really handle that, so, there you go! Don’t be discouraged. I am thouroughly convinced that diet is the best way to improve your health. It just takes more time! If you are not getting the results you want in another month, you can look at underlying issues. Keep going!!JulesParticipantFebruary 28, 2015 at 11:57 pmPost count: 14
bearsmom, you must be so pleased that your LRP symptoms have diminished – a very nice reward for all your efforts.
I too share your belief that veges are good which, of course, they are but with our condition you come to realise that even they need to be limited.
I feel the heartburn of yesterday is tied to weaning off Nexium. Just the day before I’d made another drop in the dosage level and the rebound is exacerbated at such times. I had overlooked that when I got worried about having the heartburn again. I tried Gaviscon for it and that didn’t do very much so then took some apple cider vinegar in water and that was far more effective. Last night after a small dinner my stomach was a bit painful for a while until I took some yoghurt which settled it. The acid surges have no doubt irritated the stomach and I’m going to mix some pure cream with the yoghurt and have a tablespoon of this mixture after every meal. Many people across the internet encountering the acid surges while weaning off/eliminating PPIs say this effect can last for weeks and I plan to stay on the current level of Nexium for a little longer – rushing to completely eliminate these drugs might do more harm than good. I do believe that eating the way I am is being a huge help in enabling me to keep reducing the Nexium. Considering the events of yesterday and last night, this morning I’m surprised at how calm my throat, oesophagus and stomach feel.
Have you ever tried juicing? While the digestive process is not optimal I figure this is a reasonable way to get more goodness from veges without the fibre. Each juice of mixed veges I have totals around 3-4 FP points.
I agree with you wholeheartedly that diet is the best way to improve health and that it takes more time, which reminds me that patience really is a virtue.
Best wishes for your continued improvement and nice talking with you.mgarrity2361ParticipantMarch 5, 2015 at 5:48 pmPost count: 2
I to have been on ppi’s for 4.5 years and now after reading Dr Robillard’s book and adopting his diet I am just about ppi free. I was on 20 mg dose for almost the entire time and then my symptoms got worse and the doctor upped me to 40 and I had no improvement. I have been cutting back since I started the diet from 40 to 20 for two weeks to 10 for two weeks and right now I am attempting to go omep free. Been 4.5 days now and last night and this morning I had an episode but have been ok for the last 3 hrs. I think I am going to see how long I can go with the rebound effect. Otherwise I might have to cut back to 5 for a while. I’ll update my results in a couple of weeks. Good luck to you all in your endeavor to be omep free. I certainly had enough. See this link for a look at a study on omeprazole rebound. http://www.fda.gov/ohrms/dockets/ac/00/backgrd/3650b1a_11.pdf
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