Hi just a general question regarding the long term use of Omeprazole .
I'VE had PAF since 2017 , an unsuccessful cryoablation in 2019 and am currently on the waiting list for a follow up RF ablation .
My episodes are infrequent , reasonably mild and always self resolve within 12 hours.
I've been on various PPI's for about 20 years as I suffered a lot with acid reflux originally but after 3 endoscopies, a colonoscopy and numerous visits to the hospital all they could find was stomach inflammation and H Pylori most recently which was cleared up with a course of antibiotics .
Talking to my EP we both tend to agree that the fact my episodes of AF usually follow either a meal or an upset stomach of some sort its possibly vagal irtitation that triggers the AF
I have heard so much about the possible effects of long term PPI use but my GP says the dangers of stomach cancer due to excess acid damage is more concerning than any long term effects of taking Omeprazole so I should continue taking my 20mg daily and that also the reduction of stomach acid means less upset stomach leading to AF .
I'm torn as I would love to stop taking them and also understand that we need some acid for the digestive system to work efficiently . I'd also like to take a magnesium supplement but I'm told PPI's stop the absorption of this necessary vitamin .
Is there a solution to this or a middle ground ? By the way I apparently don't have a Hiatus Hernia and my gall bladder was removed 6 years ago which does affect my ability to digest fat normally.
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Hi - that’s a difficult one for sure as you can get what is called rebound if you stop PPIs and that would not be good and you really don’t want ulcers so your stomach needs some protection.
I guess addressing what is causing the stomach inflammation (gastritis) in the first place would be the answer. As you have been treated for H Pylori, it may just be time? or it could be something in your diet? In your position I would look to consult a medical doctor with a dual qualification in Nutrition and get tested for any irritants and you probably won’t get that on the NHS.
Do you ever suffer from dry mouth? If you don’t produce and swallow enough saliva that can lead to gastritis. This often happen if you are a mouth breather.
I refused to take PPIs in the first place and manage my inflammation - I had Ulcerative Colitis which developed in my teens - purely with diet and the one thing that helped more than anything was kefir drunk first thing in the morning which was recommended by our Nutritional GP about 10 years ago. It seems to put a lining on the stomach which really helps. You need to start with a very small amount teaspoon and build up to a small glass and you won’t notice any improvement for 6-12 weeks. And you need time to adjust to the sour taste.
At it’s worst, I had periods were the only foods I ate were well cooked vegetables but you can’t exist on that for more than 6 weeks as you need protein and fats.
I cut all dairy and gluten from my diet for over 12 months, that helped and I find I can now tolerate small amounts but stick to fermented dairy - kefir, yogurt cheese etc and only Rye bread (had minimum amount of gluten) which my GP back in the 1970’s told me to do.
I also followed a very strict anti-inflammatory diet and I also started taking an antinflammatory food supplement and settled on Revserveratrol in liquid form. I kept a strict symptom/food intake diary to correlate flares with various foods and eating much small meals so 4-5 instead of 1-2 large ones. I also took a mug of warm/hot plain water after eating. Took a long time to start to help as it’s no instant fix but that protocol is now my ‘go to’ for any flare ups.
The latest advice from the researchers is to fast for at least 12 out of any 24 hour period and longer if you can. Resting the digestive system really helps as we weren’t really designed to eat this well every day as we do in modern society. I struggle with that because I need to eat to take my meds but I can do 14 hours and so don’t take anything between 7pm and 9am apart from water.
Below very general article is quite helpful at explaining Gastritis and you probably know all of this stuff already if you have been suffering for a while so apologies but sometimes it is worth starting from scratch and revisiting to see if anything clicks. I take garlic, ginger and Tumeric as foods daily but NEVER as supplement capsules if you are taking anti-coagulants.
If you manage to see an improvement - only then start to very, very slowly reduce the PPIs was our GP’s advice.
All I can say is the above worked for me and everyone reacts differently. I know that in recent years the causes have been the medications I can’t avoid taking and for which PPIs are automatically prescribed but I have been working with gastric inflammation for all of my life
You got my best shot and good luck because it’s a hard, long slog and you need to totally commit to this protocol to have an improvement but if it gets bad enough, for long enough you try all and everything.
Thanks so much for your very informative reply .My GP said he can no longer help with my stomach issues and suggested I saw a specialist which I plan to do . In all honesty he seems to put all my symptoms down to acid which doesn't feel right somehow.
My usual symptoms are nausea after bowel movements , frequent bloating and excess wind with chest pains after eating .
It's mainly uncomfortable and irritating but was worrying after being diagnosed with AF and mild stenosis of the atrial valve however after a CT scan and Echo I was reassured my heart wasn't causing the chest pains .
I do believe some form of diet plan may help but generally I don't eat much thats going to cause reflux .
I only eat brown seeded bread , no processed or red meat just chicken , a high fibre cereal daily with skimmed milk .I have reduced sugar intake with no gassy drinks just squash and take a probiotic like actimel daily .
As I said to my GP if I go any further I'll just be eating paper 😒 .
If you have IBS (symptoms are familiar) the brown seeded bread and high fibre cereal are no nos. And squash (why?) has nasty additives which can cause all sorts of problems - I am allergic to one of them, diluted pure fruit juice would be much better and would actually be nutritious. I really think you need to see a nutritionist as one person’s healthy diet is another person’s poison 😀
I was advised to eat a cereal and change to brown bread by a consultant after a bout of constipation that caused a fissure He also recommended a banana daily It was a short term problem but I've stayed on that for a year now .Seems I can't do right for doing wrong 🙂
Unfortunately GPs have no training in Nutrition and what is and isn’t good for IBS unless they have had specialist training.
Inflammation will be the most likely cause therefor you need to treat and eat for the cause.
Buffafly has given great advice, brown seeded bread irritates the lining of the colon and will cause inflammation, that will cause bloating which will reverse into the stomach and cause further problems - hence the nausea.
During times of high irritation you need to really be very careful what you eat and stick with cooked vegetables, organic only and mainly of the greens variety. Avoid carbohydrates in general.
Buy a smoothie maker and use water melon as a base - it has the most neutral Ph. Pineapple is good anti-inflammatory - in moderation - add in Avacados and wheatgrass for a green smoothie. Very nutritious and neutral to the gastric tract and easily absorbed. Do 24 hours on just home made smoothies/soups.
There so much more to write , but just one quick thought , if you able to find a good ( preferably organic ) sourdough bread that would be a good substitute perhaps for the rye bread . Good quality fibre is so important , bananas are brilliant & good source of magnesium . I’ve had similar AF & PPI issues , which took time to diagnose . Had an ablation in 2020, hoping to avoid another ! By being careful to eat small meals & eating carefully , it helps calm the vagal nerve a lot . It was thanks to all the lovely people here that I found info on Vagal nerve & AF issues . Porridge with bio yoghurt & blueberries soothes the gut too, always my go to
, if gut not happy ! Good luck in finding what works for you 🙏❤️🩹🙏
i would like to ask same questions and i think as result of been on them for years , i have bile acid malabsorption now and don’t absorb phosphates ether and my digestive system is knackered !! i’m wondering it it’s the omeprozole? i don’t absorb any fats or nutrition or anything
Can I ask how that was diagnosed ? The reason I ask is that after my gallbladder was removed my stomach issues seemed to get worse and after an endoscopy I was told I had some bile in my stomach which could be causing irritation .I do feel there is a link and although a further endoscopy last year showed no Hiatus Hernia, just an Infection , my stomach seems permanently irritated after eating and waking every day with stomach ache , often urgent , loose bowel movements and constant wind makes me think there's a problem other than just acid in my stomach .
I’m no medically trained doctor but the wind, pain, bowel movements sound like colitis or IBS. As Buffy said, no seeded bread, careful what fruit you eat and eat lots of veg. Carbs in general can cause an issue if this is the problem.
Omgeeeee you have just described me!!! I was worse after my gallbladder removal have suffered for years...tried all the low fodmap stuff etc ....get bouts of arterial flutter after an episode of stomach ...now off ppi but have severe burping after all food ...was put temp back on omesoprosol but acid returned after coming off it (!!) ...weeks later back to acid free but still burping lots!!! It's exhausting. Daily stomach ache 😫 🤷♀️
Definitely sounds a common theme. One consultant told me some people who have their gallbladder removed live with permanent stomach issues due to bile leaks
those are my symphony’s also but they said i have it as tested me on the treatment for the condition and it went away however the treatment can then cause other issues so stopped and it all came back , i just go to loo up to 10 times a day and feel dreadful , i think more going on but die to covid not had much testing. Get tested for magnesium and phosphates etc is these are low it could be cause your not absorbing them and that’s how mine was spotted but mine were really low as in dangerous low i had several stays in hospital after collapsing and haven’t drips to put them back in to me. it was ongoing then they decided well she clearly can’t absorb it so hence i take magnesium and phosphates as supplement and blood tests every 2 weeks now to check levels .
I take 15mg lansoprazole every day for an hiatus hernia and also have AF. I’m beginning to wonder if I have vegal AF as things are more uncomfortable after eating. It’s a real problem as to whether you can stop your PPI because your doctor advises you not to. I wish you well. Xxx
Where to start. This subject has been a minefield for me since my gastric issues, very similar to yours (I had my gall bladder removed four years ago too) started to really kick in back in 2009. Before then it was all manageable.
Acid reflux necessitated an endoscopy and colonoscopy and all was largely ok, I have a small hiatus hernia, I have had the tests repeated several times since then and copious amounts of other cardiac and gastric tests, too many to mention. My afib kicked in two weeks after my tests in 2009. I and my medics were in no doubt one thing had kicked in the other even back then it was suspected but not given the same credence until about three years ago in my case.
I was put on PPIs in 2009 along with a beta blocker when my afib was diagnosed. I stayed on them until around and I am guessing here, around 2013. I had become increasingly of the opinion that the PPIs were controlling my reflux but my afib had morphed into SVT also and something, just something, made me wonder if PPIs were in fact being counter productive on my cardiac burden.
As they became somewhat less effective over time I changed to Ranitidine which worked differently and seemed to do the job just as well at the time, but my afib and horrendous SVT burden became less onerous both in intensity, which was the worst thing as it hospitalised me every time for days on end, and frequency.
It took time for my excellent, rated as one of the top ten in the UK, electrophysiologist and my gastric consultant to get on board with what I felt to be the case regarding PPIs in my particular experience but they both agreed my personal experience had merit and recognised PPIs are not for me.
Now what to do about the gastric issues, well the jury is still out with us and together we are constantly trying to find a suitable solution as ranitidine was withdrawn and some of the other similar meds are known to have an opportunity to trigger heart rhythm disturbance. My two medics and myself are acutely aware of the need to control the reflux due to obvious long term bad effects which can ensue, but still not got a protocol which satisfies those needs. Believe me I am greatly aware of that danger. Currently gaviscon advance helps a great deal.
I suspect I am not alone in my experience of PPIs and hope others can give you some thoughts and personal experiences. We are all different. I have no medical training whatsoever just my own cardiac gastro experience to draw upon which has been long and tedious. I wish you well in your PPI decision making in conjunction with your trusted medics. Be well.
Many thanks , I think this issue is going to be raised much more in the future as AF is on the increase along with gastric problems .Maybe it's the modern diet that's to blame but there's undoubtedly a link between the two diseases in my opinion.
A very emotive subject PPIs. Personally I would not take them for more than a couple of weeks maximum as I found years ago they the tend to perpetuate any problem. If ever there was a drug designed to make one dependent on it PPIs are that drug.
The lower sphincter in the stomach needs an acid environment in order to open and pass food down into the gut. Take that acid away and the stomach remains full making reflux more likely.
I may be wrong but in one past post I seem to recall a link to a Mayo Clinic paper on this and how to come off PPIs. You might be better off just googling Mayo Clinic PPIs. Good luck whatever you find. It is probably thirty years ago that I went through the process and memory is hazy.
Thanks Bob , definitely worth some research on my part .Sadly the GP's hand them out like sweets and don't seem to look long term or concern themselves with associated diseases .
My advice to you would be cut out all fat, vinegar (hidden in a lot of food products and yogurt. Raise the head of your bed slightly, I used to use old books piled up. Doing this has cured my sore stomach.
Someone on this forum, think it was Carneuny, asked me if I was eating yogurt and then recommended I stop. I was buying the plain ones, I did and haven't been bothered with acidity since.
Like BobD I would never take PPI's other than for a few weeks, after an ablation - and then only if I felt I had to.
Thats good advice , I'll certainly stop with the yogurts as its a daily addition to my lunch and would be easy to see if it's part of the problem. I always thought natural yogurts were a healthy option 🤔
What's good one day. isn't the next! No you cant win. I was only wondering about this type of thing earlier today. Eggs were bad for us, red wine was said to be good - then was bad. The next one you probably wont remember - it was said that eating potato skins caused problems for expectant mothers. I can't remember if it was for them or their unborn babies. Salt is bad, then salt is needed to be healthy. Soft cheeses could contain some type of bacteria that was damaging. There must be more that I haven't remembered Honestly, how have we all survived? Lol.
Best to ignore all this crap. What is bad for us is what our ancestors did not eat- rubbish produced in factories masquerading as food . Large amounts of sugar - as we evolved the ony way of having sweetness was honey which considering the perils of obtaining it from it's rightful owners would have been a very rare treat. I never believed the saturated fat and eggs rubbish. Nor do I believe in the new fad on the block - plant based diets which is just a less off putting way of saying vegan. Luckily here in France real food is still valued and grandmother's recipes still appreciated. Most food "studies" are a complete waste of time as the only reliable work must be done on " captive " populations who have no choice in what they eat.
I started making my own Kefir about two months ago and have noticed several improvements, especially in my skin. I don't have any issues with it like I did with yogurt.
It's best to buy some Kefir grains and make your own (very easy). I pour mine over a banana and eat it first thing every morning. If you live in SW England I could give you some, but I have a feeling you're further north.
I had the same issue and did not know what was best, the Dr reduce my dose to 10mg daily. This dose worked just as well as my 20mg dose did, I then tried reducing further, 10mg every 1.5 days, then every 2 days. After a year I found the effectiveness of omeprazole varied slightly, with spicy foods 1 every 1.5 days worked otherwise 1 every 2 day worked. Effectively I have near quartered my dose and it still works fine.
No, within 3 days I will get really bad acid reflux. Just shows how effective it is. However it is clear to me that the original 20mg was far too much. More significantly reducing the does reduces the potential side effects.
That's interesting , I intend to see a private gastroenterologist in a few weeks time to discuss my ongoing stomach issues and PPI's will definitely be part of the conversation .
I have a sliding hiatus hernia and reflux oesophagitis and, like you, had the exact same quandary four years ago when I chose to stop taking lansoprazole, against my GP's advice. I had been taking it, or similar, for perhaps a decade. I tried to replace it with strict dietary measures and a mixture of ranitidine and Gaviscon, which seemed safer choices.
My experiment failed miserably. I was ill for very many months with reflux, pain and nausea. The ranitidine and Gaviscon were simply unable to stop the acid. In dismay, I persisted for some months but eventually returned to taking esomeprazole. Even then, it took several more months to recover. I was convinced that I had permanently damaged my oesophagus or had developed Barrett's. Today, still taking esomeprazole, I am stable and comfortable from that perspective.
During that awful time, I studied PPI trials and drew the eventual conclusion that my GP was right all along. The drugs are, he and I have decided, essentially, very safe and the long term effects are unproven and irrelevant to most people. The health consequences to the oesophagus of chronic acid erosion far outweigh any risks, A leading GI professor I saw recently told me that he has never seen Barrett's in anyone taking long term PPIs and that magnesium deficiency is very rare. He favoured PPI use entirely and claimed they had transformed long term treatment of severe reflux disease.
My daughter in law is a nurse and her ward treats patients with CA of the oesophagus and Barrett's daily. She can tell horror stories that make Stephen King novels seem like children's nighttime reading in comparison.
Thanks for that Steve , it's a bit of a minefield that's for sure .I'm seeing a private gastroenterologist so will discuss it with him and hope to get some clarityMy GP just seems to think doubling the dose when I'm suffering is the answer but 40 mg seems a lot and tests where my concern arose .
He basically said he can no longer help so see a specialist.
I think the worry of having PAF and the fact my episodes seem to start after a stomach upset has led me to try and settle my stomach .
I'm not convinced there's a perfect solution though .
Having uncomfortable chest pains after eating and an over active bowel certainly doesn't help .
I am very similar to you and I have diverticular disease with a redundant colon that causes slow transit; add to that the other gastric and cardiac issues (and now weeing troubles - oh Age! what hast thou done to me!!). I wonder whether being very tall hasn't caused some of this - a crazy conclusion but not without some evidence. My anxious nature likely hasn't helped either.
Best of luck with your GI doctor. I doubt there're any tricks up his sleeve, but let's hope!
You have all my sympathy. I suffered with awful indigestion & bowel problems for years, GP tested for coeliac. Nope. I went through phases of thinking is it a yeast intolerance, not eating bread helped, dropped cereals and went onto yoghurt & fruit. All this measures seemed to have a temporary effect. Finally after loosing a stone in weight because I was struggling to eat without a horrible reaction like tummy pains, acid reflux & diarrohea. I went strictly gluten free, checking that nothing I ate had gluten in. I was amazed I started to slowly improve. A year on all of my symptoms have resolved...... I now eat gluten free bread, cereals, pasta etc with no problems.....And if by mistake I eat any food containing gluten am very ill the next day. Ive since been formerly diagnosed with gluten intolerance on the nhs resulting in gluten ataxia. There are only two nhs centres in the whole of the UK that can tests for this so am sure many people are missed because of this. My advice to you is to source the cause of all of this. Doctors know diddly squat about nutrition. Like others have said a nutrional doctor may help. Whether they can screen for gluten intolerance I dont know. I have been left with mild neurological damage because of it not being picked up for over a decade. So I would always suggest to anyone with digestive problems to check for gluten intolerance which is a different condition to coeliac. GPs can test for coeliac but not gluten intolerance. I dodnt know if a nutrional doctor can do this. Another way is to do a trial period of 6 months excluding gluten from your diet. This means checking everything in your cupboard including herbs spices sauces etc are gluten free. By law manufacturers have to list in bold allergy ingredients.
Yes it helps a lot thanks. I'll certainly look into gluten 👍
Unfortunately, there is also a suspected link between long term use of Omeprazole and dementia too. If you are going to stop PPIs this would probably best be done under the supervision of a gastroenterologist. If you couldn't stop Omeprazole completely but were able to reduce the dosage (taking the reduced dose in conjunction with, say, Gaviscon) that would be a good outcome. I would imagine that this sort of thing would involve a lot of trial and error, but it sounds as if, with persistence, you have a fairly good prospect of success.
Yes its a hard one. But your doc will be right I think. Me, I heard of the side effects and only take Gaviscon forte liquid sachets but Im lucky in that I dont need more ,or often. Hope you find a solution x
Hi there. I've been taking Omeprazole 20mg/day for the last 30 years or so funnily enough started by my then cardiologist because of symptoms he thought weren't cardiac related. I have at times wondered whether I could come off and indeed did try last year when diagnosed with PAF but quelle horreur. I tried every which way to do this but in despair went back on them and my stomach is now happy again.
Yes I've read about the risks of dementia and heart attack and you do get to the point where you think shall I just dig a hole and jump in! Sure there are risks but not 100% of people get them so ..... My GP at one point said he had his parents on them and not to worry too much. So many of the drugs we are given can have appalling side effects on some people but you just have to adapt to what you are taking and hope for the best as the alternatives are also pretty horrid as well!
Been on and off PPI's for over ten years. I found Dexilant to be the most effective which I've now been on for several months. Love to get off of it, but reflux triggers my afib. Now that I'm on Flecainide, I may try and wean off a bit.
Easy to say, PPI's are bad for you -- and they may be -- but if you've ever had really bad reflux, and tried all the diet and lifestyle changes, as well as the other meds -- it's kind of what is left. And then there's Barrret's for some of us to contend with.
Hello HammerboyI am gladly on Omeprazole. I went to my GP a few years ago with what I thought was a breathing problem. A rattling of mucus in my chest esp when leaning forward eg to load or unload the washing machine. I was surprised when she said it was gastric reflux. She explained that stomach acid is very dangerous to the lungs and in order to protect them an excess of mucus is created in the bronchial tubes. This can lead to asthma and long term lung problems. The reason it is so dangerous for anyone who is unconscious or drunk to vomit is that it only takes a small amount of gastric contents reaching the lungs to create a life threatening condition or even death. I have PAF and no problems with that since taking Omeprazole for about 4 years. And of course the rattling mucus stopped. No medication is without some side effects but the good can outweigh that.
I had bad painful gastritis after daily aspirin taken for years after which a course of antibiotics finally triggered it . 6 months on PPIs.
Can I suggest you read Dropping Acid The Reflux Cookbook and Cure by Dr Jamie Koufman? It's been a great help to me in understanding the mechanics of reflux and gastritis and lists the acid content/pH of every food. Some will surprise you!
The plan is to eat low acid diet for a few weeks and gradually introduce more acid foods as the inflammation heals. Every time I have a flare up I do it. There are some nice recipes too.
The absolute best foods for bad reflux are oats and bananas, and fruit squash or fruit juice and tomatoes are the worst. Stay off till you heal.
The other thing (from reading Ulcer Free by Georges M Halpern) is that Zinc Carnosine is routinely prescribed in Japan for those with stomach inflammation caused by taking NSAIDs (they disturb the natural protective lining of the stomach - as aspirin does - by interfering with prostaglandin production). Might be worth a try.
My doctor put me on Nexium after an endoscopy. I also have a hiatal hernia. They diagnosed gastritis. I was concerned as you are. They told me the benefits outweigh the risks. I do all I can not to stress the upper valve in the stomach. I eat a bland diet and limit the amount at one time. I lost a ton of weight and my BMI is normal range for my height. I guess you soldier on.
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