Reducing Lansoprazole and oesophical spasms

[Halfwayuphill]

I have been on a ppi for probably 20 years now but have oesteoporosis and SIBO now too which can be caused by long term ppi treatment. I wanted to ask if any of you have had any luck reducing your dose of ppi. I have UCTD with Scleroderma gut involvement which includes SIBO, Aperistaltic oesophagus, reflux of course, and a hiatus hernia. I was managing on a reduced dose of 15mg of lansoprazole but unfortunately my oesophical spasms have returned. I believe this is exasperated by taking rotational antibiotics for the SIBO. My gastroenterologist has suggested this could be better if I took Rifaximin but I would have to get it privately as the NHS will only prescribe under exceptional conditions. Rifaximin is better because it’s not systemically absorbed. I wouldn’t mind paying for a course but I’m worried it would be a regular thing and it would be upsetting to get better and then later not be able to afford it. In the meantime, have any of you with similar problems had any luck with reducing your ppi or am I being unrealistic. My rheumatologist has told me to up my ppi to 15mg twice a day but can’t prescribe Rifaximin and has told me to rotate between Cefalexin and one I’ve not taken before Co-amoxiclav. One of the problems is the 3 a day dosage as that means taking close to bedtime! Any advice appreciated.

Sue

[Halfwayuphill]

Hi Lou, yes I’m just starting the Co Amoxiclav so we shall see. I’ve not tried it before. I did ask my Rheumatologist and she said Rifaximin not available but I know others are getting it in the clinic. I think it may be because I did say the other antibiotics did seem to be working at my last appointment and other cases may be worse than me. But that was over a year ago so we shall see when I have my regular appointment in April. She did say something about Rifaximin ‘was coming’ so whether they might change this which will be good for us all. I have heard it doesn’t suit everyone though. It’s just some I’ve tried made we worse in other ways. Thanks for your reply

Sx