Stomach Liner

[cmjoyce]

As most of you are on anti-coagulants do you take a stomach Liner? After being on Apixaban for several years the doctor now wants to put me on a PPI although I have no acid reflux. Lansoprozole gave me chronic diarhea which has resolved after stopping for only 5 days and wants to switch to Omeprazole. I don't want that either. Can you tell me what you take, I am looking for an alternative I can suggest to the doctor. Do you think a stomach liner is a necessity? Any thoughts would be really appreciated. I am beginning to learn that it is not wise to blindly follow a doctor's suggestion without research it. Many thanks.

[BobD Volunteer]

Personally I would rather rub raw chilly in my eyes that ever take PPIs for longer than a fortnight. They are dreadful drugs which rather than solve anything actually perpetuate the problem. There is ample information regarding this and from memory Mayo Clinic issued a fact sheet on how to get off them a while back. If you use the search facility you will find lots on the subject.

[JOY2THEWORLD49 in reply to BobD]

UmI had a stroke as I had AF undiagnosed.

Thyroid Papillary cancer was to blame.

So you dont take them?

cheri JOY

[BobD Volunteer in reply to JOY2THEWORLD49]

Once many years ago and they seriously made things much worse. Went to hell and back getting off them and zero issues since. The body needs acid in the stomach or the lower sphincter will not open and pass food into the gut. This means food stays in the stomach far to long and eventually starts backing up causing the very thing the drug is supposed to be stopping. There have been a number of papers on this but still doctors hand them out like Smarties.

[mjames1]

Hi cmjoyce,

I tried the chili pepper eye thing BobD alluded to, but it didn't help my GERD. Just made me cry like a baby LOL

But seriously, I think step 1 would be to ask your doctor why he wants to put you on PPI's. Then take it from there. There may be alternatives.

In defense of PPI's -- for some of us, it's the only thing that keeps GERD and/or LPR at bay. And in my case, GERD triggers my afib. And I do not want to be in afib.

Have tried everything from H2 pumps, to antacids to stomach liners (carafate) to dietary changes to smaller meals to not eating three hours before bed, etc, etc, etc. But when things get bad, only PPI's work for me. Have been on them now daily for about 4 months. Hopefully, the healing is done and I will start to wean, as soon as I feel stable enough with my afib meds. Until then, no chili peppers except in my salsa. Oh wait, Salsa gives me GERD, even when on PPI's!

Jim

[secondtry]

Gut problems I am convinced need not just a GP visit but urgent action from an experienced Alternative practitioner(s) e.g. Naturopath, Nutrionist, Holistic medically trained doctor practising integrative medicine. The '10 minute GP appointment' route is quick but you cannot really expect a solution longterm it and could make matters worse.

Gut issues are very likely the 'canary in the mine', stressing the Mind and will in due course travel via the Vagus Nerve to the heart and AF. I can recall way before my AF was diagnosed having reflux and visiting an ENT consultant & taking some standard Gaviscon or a prescribed drug.

[LaceyLady in reply to secondtry]

👏🏼 Marilynn Glenville, is such, well respected naturopath/nutritionist, well qualified and I met her some years ago.

marilynglenville.com/?utm_t...

[JOY2THEWORLD49 in reply to secondtry]

HiMy reflux was due to a Desintegrating Gall Bladder. I have just2 stainless steel clips!

When I was on antibiotics I felt much better.

Removed through tummy button, I have 4 extra portals as surgeon had to remove al the bits which had stuck on other organs!

Since I monitor myself on LOW-FAT DIET.

A meal like well drained fish and chips no salt (I use sparenly, I finish with a milky drink or low fat icecream.

I have never had any more episodes and balls showing in vicinity of gall bladder were blood balls.

Take care, JOY

[secondtry in reply to JOY2THEWORLD49]

I had to have my gall bladder removed whilst on holiday in Portugal - Braga hospital was first class! Maybe this all points to confirming poor diet choices is an important AF trigger consideration.

[Ppiman]

It seems that your GP is reacting to NHS advice concerning the risks of internal bleeding caused by certain drugs (e.g. anticoagulants and NSAIDs). This advice recommends the use of PPI drugs where a risk of internal bleeding is high, such as where there's a risk of gastric or intestinal ulceration or bleeding, e.g., in diverticular disease.

This is an example of an NHS guideline on this, one that explains also the very low risk of possible long-term effects of PPI drugs:

westessexccg.nhs.uk/your-he...

Steve

[Tomred]

picture this, your on ppi s for years ,so your also without adequate stomach acid for years,so you havent been able to digest and utilise all sorts of nutrients which your system requires, with the quality of food available today its hard enough to get what we need to survive in life , then the battle against afib doesnt help, i think everything is cumilative, and would try to do without ppi s and maybe try some baking soda ,quarter of teaspoon in water , i swear by it. you start on meds today ,next thing you know you have been on them for years.

[LaceyLady in reply to Tomred]

There should be blood tests to check the levels of drugs in your system. The body can get rid of the drugs through the urinary and digestive system. Everything gos through these systems, disposal units.

[rothwell]

I am a bit fed up with Bob continually flipping his lid every time PPI 's are mentioned. I have a hiatus hernia and suffer terribly from acid reflux and its resulting pain and inflammation of the oesophagus. This ALWAYS results in episodes of AF. I have tried naturopathy, kinesiology, bicarbonate of soda, slippery elm, kefir, Gutrest etc. etc.,and of course gradually weaning off them. All to no avail. I try to keep to the minimum dosage. I don't like taking them, I am aware the side effects but as people keep saying on this site QOL is important. So ..I really don't want to feel that I am committing a crime and almost putting my life in danger every time someone asks about them and Bob responds in his usual exaggerated way. We know our own bodies.

[MoyB in reply to rothwell]

I'm with you on this one! Like you I have a hiatus hernia. I also have chronic lung issues that have most likely come about as the result of GERD. So I have been taking Lansoprazole twice a day for years and cannot manage without them. In fact, some twerp told me to stop taking them two days before a gastroscopy and the result was a badly ulcerated oesophagus. I was in agony for the two days. I then had to have the procedure repeated to find out if the ulceration was a result of stopping the meds or if I had Barretts Oesophagus. It was proven to be a result of stopping the meds, so I WON'T be doing that again!

I had a GI bleed years ago, despite being on PPI and have this very much in the forefront of my mind now that I take Apixaban, but it won't make me stop taking it! I used to drink Gaviscon straight from the bottle and got through gallons of the stuff before I was finally diagnosed with a HH and prescribed PPI.

I didn't tolerate Omeprazole but am fine with Lansoprazole.

Like you, rothwell, I think QOL is as important as anything else.

I'm afraid I take the short term view - live for today! Tomorrow may not come - that pesky bus my mother always warned me about may run me over when I'm wearing my old underwear and shabby clothes! But at least I won't have an ulcer!

xx Moy

[CDreamer in reply to rothwell]

And that’s fine if all else fails - but should they be prescribed as a default is what we are getting at.

[Auriculaire in reply to CDreamer]

Exactly. Cmjoyce said they did not have reflux. Nor did they mention any symptoms that might suggest silent reflux . Is the doc thinking that everybody on Apixaban should be on a PPI?

[LaceyLady in reply to Auriculaire]

PPI is? I googled and answers didn’t fit 😜

AND I’m in that dratted drug too!

[Auriculaire in reply to LaceyLady]

Proton pump inhibitor.

[Sue1955]

Hi I was on omeprazole for a long time then decided I didn’t need them so slowly stopped, but an episode which required paramedics, resulted in the question why are you not on them with the meds you take so I’m back on omeprazole personally I’ve had no problem with them ever.

[Tapanac]

I’ve been taking Lansoprazole whenever I get sore for years snd my husband has been on omniprazole and others for about 50 years as he has hiatus hernia as the operation only worked for a couple of years. We are both fine with them touch woodAll the best

[CDreamer]

I’m with Bob - not required for anticoagulants if you take it correctly. It’s not like asprin which can irritate the lining but there are caveats as PPIMan explained so ask for the reasoning.

Just research how and when to take some need to be taken with food and many with full glass of water.

Which one have you been prescribed?

IMHO - Vastly over prescribed but what do I know….

[rothwell in reply to CDreamer]

I am not questioning the advice given by the doctor....in all likelihood this is probably incorrect. I am just saying that I am fed up with Bob's continual exaggerated reaction to the mention of PPI's...which actually is not at all reassuring but is quite the opposite and instils a kind of fear ....it would appear that they are the devil's poison as far as he is concerned. As many people have said ,PPI's are the ONLY thing that give relief and in some cases prevent the inflammation which can bring on an episode of AF.

[RajaRua in reply to CDreamer]

Thanks for that CD. I hadn’t realised that anti coag needs to be taken with food and a full glass of water. I have awful reflux and awaiting a gastroscopy. My throat and o esophagus are in a terrible state plus awful bad breath in the mornings. I’m taking my APIXABAN with food from now on!

[CDreamer in reply to RajaRua]

Apixaban not quite so important - more with a full glass of water as it’s not absorbed in the stomach but in the colon. Rivaroxaban -needs to be taken with food. I’ve had horrible reflux with Dabigatran but am fine with Apixaban. Hope all goes well with your gastroscope.

In your case - I would take the PPIs.

[RajaRua in reply to CDreamer]

Thanks for your reply CD. Why do you say in my case you’d take the PPI? Is it because i said my throat and esophagus is in a bad way. I do worry about that. Does the PPI heal the throat and esophagus? Would an over the counter antacid do the same? Why does one need to come off a PPI slowly? I just can’t bare to add yet another drug to my pile… thank you again for advice. B xx

[CDreamer in reply to RajaRua]

There are times when you need to take these drugs. Yes I say that because of your throat and esophagus - if your doctor believes the cause is acid reflux. PPI won’t heal them but it will prevent further damage. The stomach acid regurge into esophagus will burn through tissue and can damage lungs if droplets inhaled.

You can try antacid - I found Liquid Gaviston Extra taken at night - you are most at risk when asleep. Please do talk to your doctor about this.

Have you been tested for SIBO? Both SIBO and GERD can cause bad breath so mention all of these symptoms to your doctor.

[RajaRua in reply to CDreamer]

But the esophagus and throat do heal don't they? Yes I'm aware that damaging the esophagus is dangerous for many reasons....My GP unfortunately wants me to take PPI's But I think I'll try Gaviscon Liquid. I have spoken to my GP and got to see a surgeon in my local hospital and he wants to do the gastroscopy. Not at all sure when as there are very long waiting lists for procedeures and diagnostics. Thank you again CD I really appreciate the info and advice. I always had a strong stomach and this is such a pain. I've even lost my appetite recently becuase of the horrible taste in my mouth.. Those PPIs sound awful but I do understand why someone would take them. I'm at that point now. 2 days ago I got my first bout of AFib in 14 months and I think it's because of my tummy. I'm on 300mgs of Flecanide daily and I'm sure I've heard that Flecanide can be hard on the stomach too. Did you ever hear that?Love, blessings and gratitude Biddy

[CDreamer in reply to RajaRua]

Stopping PPIs causes rebound so when you just stop them your Protein Pumps in the stomach which pump acid into the stomach say - let’s make it up for lost time now the restrictions have been lifted so go into overdrive. You end up worse than when you started.

[captainKFF in reply to CDreamer]

Hi, when you say take it correctly, can you explain further? I’m on Eliquis twice daily, do you mean not on an empty stomach?

[CDreamer in reply to captainKFF]

It’s Rivaroxaban and Dabigatran that are particularly troublesome as both require acid environment to be absorbed efficiently. Acid is produced to break down protein and fats, so you need to take those with foods that contain protein & fat.

I had terrible problems with Dabigatran until I worked out that I was taking at breakfast with carbs which require alkaline environment to be absorbed. The carbs just filled my stomach so the food didn’t empty into the colon as it should so stomach acid pushes upwards into esophagus. I posted a lot about it back in 2013-2014.

I’ve had no problems with Eliquis (Apixaban) which is absorbed very differently and more slowly in the colon. Getting this info is not easy as it is hardly covered on the accompanying leaflets and not everyone reads the instructions. I only learned this stuff at various patient information lectures & groups and never from the cardiologists - always from the dual trained Lifestyle doctors.

[Lilypocket in reply to CDreamer]

I take Pradaxa and it made me uncomfortable like I had indigestion. So I take the tablet with some natural yoghurt. Seems to work for me - no problems since .

[rothwell]

Thank you for all those responses. Loved the old underwear one. Yes the risks of not addressing a burning oesophagus is an ulcer or worse ...cancer. Helpful to know that people have been taking them for decades.

[mjames1]

Near the beginning of this thread it was stated that the Mayo Clinic issued a fact sheet on how to get off PPI's.

I dont think the poster's intent was to mislead, but the statement can be misleading. To put it in context, the Mayo Clinic also prescribes PPI's for GERD and other conditions. An analogy is that there are fact sheets online how to get off of beta blockers, but that doesn't mean you shouldn't take beta blockers if needed.

Are PPI's over-prescribed in some cases? Certainly. Are they under-prescribed in some cases? No doubt. Do they have downsides? Yes.

But do the downsides outweigh the benefits? That is the question that all of us must ask ourselves and our doctors with every medicine and treatment. PPI's are no different.

For me and others, they have been a lifesaver. Wish I didn't need them but also wish I didn't need Flecainide or anti-coagulants and wish I didn't need an ablation which some day I may have.

Jim

[ILowe]

I had a bruised oesophagus. It was I think a combination of several factors. First, (and this is something they will never tell you) I had been taking a lot of vitamin C and doing my own mixtures between Vit C and Bicarb and quite liking an acidic taste. Second, due to too much mucus food and pills were often stuck for hours, so irritating the gut at specific points. Third, as part of an electrical Cardioversion I had taken advantage of the general anaesthetic so they could put a tube down me and do a special heart echo called a TOE.

But, the Omeprazole hurt, even at low strength. So I did my homework. I discovered that in older people acid coming up from the stomach was likely due to UNDER-production of acid, which meant the sphincter at the top of the stomach did not close fast enough. I did the bicarb test and confirmed I was under producing acid and did not need Omeprazole to reduce it even more. At least if you take Omeprazole make sure you genuinely do have too much acid production.

So, what to do? Then I thought of the French: bandage gastrique. Exactly what I needed. I had to find something that would coat the oesophagus and soothe it like a bandage and stick to it for a few hours. Hard to find, but fromage frais did the job. A few spoons after each meal over 8 weeks.

[mjames1 in reply to ILowe]

Glad the fromage frais did the job. Alternatively there are coating agents like Gaviscon and Sucralfate (Carafate) that also coat/protect the esophagus and stomach lining. Note that they can sometimes be a little tricky timing them with your other medications. I have tried both with varying success, but since GERD can quickly trigger my afib, my first go to is still PPI's. You mentioned you had a TOE. For those not in your part of the world, it's also called a TEE.

Jim

[ILowe in reply to mjames1]

Good points. I seem to remember that Gaviscon is sometimes sold with mint, and mint is great for too much wind, but it is also an irritant. You have to find what works for you.

[CDreamer in reply to ILowe]

Exactly, very similar to my experiences. Good call Fromage Frais! I use home made goats milk kefir yogurt first thing in the morning. It is mucus but for some reason that sort of mucus seems to work much as the Fromage Frais does = protein and fat.

[ILowe in reply to CDreamer]

The important bit is that it sticks and soothes. Yogurt does not last as long.

[CDreamer in reply to ILowe]

It’s kefir yogurt so is fermented and behaves differently but agree about plain yogurt. If I could get a good organic Fromage Frais I give that a go.

[tunybgur]

I had acid reflux and successfully treated it by having lots more fermented foods.

I reset my gut microbiome and got everything working properly again, takes a while though.

I have homemade kefir every day and lots of sauerkraut or fermented veggies every week.

No more lansoprazole, swigging Gaviscon from the bottle and popping Rennies all night!

Won't work for everyone but it works for me.

Good luck

[Dorchen]

HiI am on Omazeprole and have been for about a year. I have no side effects and my doctor put me on them to protect my stomach lining as I take about 9 tabs a day. He said it would stop me from getting ulcers. Must ask my GP or Specialist when I see them (joke ) haha is it necessary

[JOY2THEWORLD49]

HiNO but I take an acid with my PRADAXA. 120mg not so big. With food and water.

73 years.

cheri JOY