Can I ask you guys what your thoughts are on PPI’s? I’ve been on Omeprazole for nearly 8 years now. I was diagnosed with having a TIA, so was told by the neurologist to take a 75mg Aspirin and 20mg Ompeprazole daily, which until 3 months ago I was doing.
But I’m now on Rivoroxaban so I’m off the Aspirin, but I have GERD and hiatus hernia, but after my ablation etc I’m really changing diet and lifestyle. I’m now on 40mg a day as it appears the anticoagulant caused a stomach bleed. I’m having an endescopy in a couple of weeks to see what’s going on.
Just wondered if anyone came off them and noticed a change for the better?
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Dangerousdriver
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Interesting question to which I will give my understanding.
I was told that in order for the lower sphincter in the stomach to open and allow food down into the gut, an acid environment is required. If you stop that acid with PPIs then food can sit longer than it should in the stomach which actually increases the chances of reflux and other digestive problems etc.
Whenever I have been put on PPIs such as lanzoprazole I have always stopped after a couple of weeks as historically I found symptoms returning with a vengeance after that .
I took ppi lansprazole for about six years after being diagnosed with a small hiatus hernia. One month later was diagnosed with af and put on the ppi then. Eventually it stopped helping and I was switched to histamine H2 Receptor, ranitidine and been on it for threeish years and latterly it's not worked as well as previously. Tried all the ppis again and they caused me dreadful stomach pains so back to ranitidine.
I honestly don't think ppis and the like are anything like the answer to stomach acid issues, who says it's too much acid no one has ever tested my ph to check. I had an endoscopy last July after horrendous stomach pain but they didn't find anything, however they still didn't check acid levels.
I am seeing a gastrologist in a couple of months and am certainly asking for further investigations. I remain convinced hiatus hernia is a culprit if not the only culprit but surgeons and gps seem reluctant to intervene surgically and push ppis instead.
Have the medics told you to stop the ppi in advance of your endoscopy, mine said not to only two days before but I looked at NHS recommendations and other reliable sites where they say stop for two weeks before endoscopy. Honestly we have to check things for ourselves and challenge or we can be encouraged to Long term meds without question.
Good luck with your endoscopy, stomach issues can be dreadful, I can attest to that myself.
Totally understand unscientific as it only applies to me, but after taking Ranitidine for years because of Gord I was put on Lansoprazole after my ablation. After a few days I developed persistent diarrhoea and was eventually diagnosed with a bowel abscess as a result of diverticulitis. This may have been a coincidence but I have found out that PPIs allow bad gut bugs to flourish.
Also I note you are taking Rivaroxaban which requires an acid stomach to be effective.
I am still taking Ranitidine and have changed from Rivaroxaban to Apixaban so that I don't have to eat a meal when I don't feel like it.
You need to take it with a meal and the acid your stomach produces to help digest the food dissolves the Rivaroxaban which is absorbed in your stomach. So if you take Rivaroxaban with water on an empty stomach or you stop acid being the produced the Rivaroxaban doesn't work as well.
Definately better wihout! All comments I have read strongly recommend that any PPI is only for very short term use. I really don’t understand why doctors prescribe? I was prescribed several PPIs - with several of my meds - which I didn’t want, didn’t ever use and when I questioned both neurologist and cardiologist they I got a very strange look.
NB - please note Bob’s comments- your stomach is supposed to be acid otherwise you can’t digest food & meds especially proteins. Carbs are broken down by a more alkaline environment- the intestines. If you eat cereals & bread, especially for breakfast, the stomach doesn’t empty & acid is pushed up the esophagus causing pain - acid reflux. I got to the stage I just cannot eat any bread or ceareals period.
Because PPIs reduce acid production, which happens anyway as we age, reducing stomach acid production is a really bad idea long term, especially if you are on Rivaroxaban.
Thank you - Now I understand why so many people push the bread/cereal-free type diet- because they don't have enough stomach acid to digest it properly. In fact one can increase one's stomach acid by taking 'Beta Hydrochloride' (from a health food shop) with any meal that is likely to cause problems. Alternatively drinking a glass of water with up to a tablespoon of organic cider viinegar first thing in the morning, or during the day, or cooking with this kind of vinegar, should also help to increase the amount of stomach acid you make overall.
That definately helps but doesn’t cure the carb problem because carbs need alkaline not acid environment to be digested - which is found in the colon.
You need acid to breakdown proteins and fat AND often the the problem is the bulk of carbs, especially white bread, fills the stomach and doesn’t pass through the sphincter into the colon and pushes the acid upwards into the esophagus to make room and to change the Ph level so the carbs can start to breakdown.
What they don’t always tell you is that RivorXaban and Pradaxa both need acid environments to be properly absorbed and if you take with something like a biscuit - you are asking for acid reflux problems.
My mother, 97 in September, stopped taking her lanzoprazole and said she felt so much better without it. Interestingly my new-born grandson was also prescribed lanzoprazole as he, like his brother, suffered severe reflux coupled with total dairy intolerance. Both are fine now and off meds.
BTW what are PPIs? I googled and found 'payment protection insurance'!
PPI 's are Proton Pump Inhibitors. I have been taking Omeprazole for years as I have a Hiatus Hernia and acid reflux. I hate taking this drug as all the literature tells us that it should only be taken short term. I have tried many times to come of it by using alternative natural solutions....apple cider vinegar. Bicarbonate of soda etc. All to no avail. So I have recently been trying to take it on alternate days . However what I have found is on the day where I don't take it I invariably get at least one af attack whereas when I do take it I only sometimes get an af attack. So I looked this up and there is clearly a link between the inflammation caused by the acid reflux and af and some people are actually recommended to take a PPI . We are between the devil and the deep blue sea I think and I hate taking medications but sometimes there is no alternative so I take the lowest dose of Omeprazole..10mg every day to minimise the af. I also take Apixaban...no problems with that.
I switched from Ppi to ranitidine after 8 years. Don't just stop ppi in similar circumstances, rebound of acid level can cause problems, I came off it for 2 weeks prior to endoscopy and had a lot of discomfort and found mild oesophagitis and gastritis had become severe with ulcers! Better is to switch to ranitidine or use antacids such as peptac (cheap alginate) especially at bed time. Both can help you get off the ppi. Also be aware diet has serious effect on acid so very fatty food, irritants (which may be very personal) like chilli, black pepper, for some tomato and chocolate even need controlling. My change in diet has helped a lot, but as I now have hiatus hernia also sleeping on left side or with raised upper back. My AF came some 5-6 years after GORD and PPIs. Also now have reduced bone density in spine (osteopenia) which may be linked to ppi?
I wouldn't take PPI particularly with the meds I take for AF . My sister takes them to see if they would help with an undiagnosed tummy problem she had years ago ( oddly I had the same thing ) and I keep trying to get her discuss with her GP coming off them.
We are learning so much more about our digestive system and how it influences our health and in particular about the need to maintain a healthy gut bacteria which PPIs do nothing to promote see this study in the BMJ....
''Conclusions The differences between PPI users and non-users observed in this study are consistently associated with changes towards a less healthy gut microbiome. These differences are in line with known changes that predispose to C. difficile infections and can potentially explain the increased risk of enteric infections in PPI users. On a population level, the effects of PPI are more prominent than the effects of antibiotics or other commonly used drugs.''
We can do so much to help ourselves by taking a good look at our diets. Since adopting a very healthy diet to help my body cope with AF and the medication I have to take I feel so much better.
There are many safe and effective alternatives to PPIs. I was on a PPI for about 1.5 years and stopped. My acid reflux was cured by change in diet, including eliminating gluten and the use of a herbal bitter gentian which actually helps to start the production of stomach acid when you need it (before a meal and during digestion of food). The use of PPIs is counter to the body's natural functioning and is another of the problem drugs the Pharma industry has visited upon consumers. It has let to the disruption of normal gut bacteria and creates other medical problems. I would suggest you see a good Naturopathic Doctor and work out a regime that works for you and supports your body system naturally.
I was on them for years for acid and eventually they caused me other problems as the lack of stomach acid stopped me absorbing vitamins b12 and d. I stopped them and used zantac to get me through the rebound bit just when it was really bad and now am on none but do watch what I eat. I have b12 injections every 3 months though and the lack of b12 left me with numb toes which has never got better but all the fatigue etc has They are dreadful things we need acid to digest
I have taken a PPI for the last 15 years due to GERD,a large hiatal hernia and Barrett's esophagus,,,,,I am 71 now and thought the PPI had controlled everything nicely until a routine endoscopy found 50 or more stomach polyps,some of them precancerous so they had to be removed,,,,hence,3 more endoscopies over the next few months,,,,now a year further and another endoscopy shows more polyps ,but no precancerous ones,,,,and the GI Doctor says the PPI can cause these polyps so I must go off the PPI,,,,I am doing so with alternate days on and off the PPI so far,,,,not sure how this will be if the GERD returns,,,I have some of it back already,,, the .barretts also had disappeared on its own,,,will it now return?? Not sure what the answers are ,,,it is a catch-22 situation for me.
Well, I had my bloods come back today, and all looking good. I haven't had any more bleeding that. I know of, but some pain high up near the gall bladder today. I am having an endoscopy in a couple of weeks, so hopefully that will shed light on what's going on.
Aspirin for some people are terrible for stomach lining. They interfere with prostaglandins in the stomach lining. I have read 1 in 5 people react this way. I was one. After 5 years on aspirin for AF I got very bad stomach pain which was gastritis (pre-ulcerous stomach inflammation). I took PPIs for a while and felt a lot better (though I don't think it helped the AF) and stopped the aspirin. A year later things were back to normal.
I did a low acid diet for a short while after reading "Dropping Acid" by Jamie Koufman. It seemed to work ok, but stopping the aspirin was the game changer and I'm now on Apixaban (anti-coagulants won't make you bleed they just reduce clotting if you already have a bleed)
"Ulcer Free" by Georges M Halpern was an eye opener. He writes about Zinc Carnosine which has been prescribed routinely in Japan since the 1990s for people taking aspirin. It protects stomach lining by protecting prostoglandins. If this is approved by NICE it could solve a lot of problems for people taking aspirin.
For what it's worth my husband has been on Omaprezole for 20 years and has no discernable ill effects. We are all different. Hope you get sorted soon.
Hi dangerousdriver(I'm sure you actually are a very good driver!) I'm only giving my own experience here and not suggesting that everyone ditches their PPIs and Histamine H2 receptor meds, but I have been on both and not had very good experiences with either, so I came off them. I have had digestive problems for 40 years- and suffered from :diverticulitis, IBS, gastritis( very painful), and reflux due to my hiatus hernia. I no longer take any prescription meds for my digestive problems and instead I take DGL Liquorice tablets. Liquorice has been used to treat stomach problems since way back in history. It MUST be DGL Liquorice as ordinary liquorice can cause a rise in Blood Pressure. I bought some liquorice tea and on the packet it says not to have more than one cup per day!! I also take two Fybogel sachets daily. I also take Apixaban and a small dose of Losartan for blood pressure. Do some research and then decide if you want to try a more gentle approach to helping your stomach. I'm not a herbalist and am only giving you my own experience of coming off prescription stomach meds. Ultimately, it's up to you whether or not you try the herbal meds. Good luck.
Lots of interesting reading here, but now I'm suffering a bit from information overload regarding use or non use of PPI's. Having never suffered from GERD or any other related digestion issues I am questioning the need for Lansoprazole. Prior to my TIA earlier this year I used to take a drink of fresh lemon juice squeezed into warm water before breakfast each morning in the belief this had a beneficial effect on health and digestion as I understand it has a neutralising effect on acidity. I have not resumed the lemon regime since being put on PPI and Warfarin so am unsure whether to start again or if it could cause problems down the line .... Any comments would be welcome.
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