Omeprazole benefits ?

[kierank]

I have had Ivor Lewis surgery in July last year -2015. Just over a year on I think I am doing very good in the circumstances. I have been prescribed Omeprazole but for months now i have not taken any as I didnt feel I had any need . I notice from posts on this site that many if not most people take omeprazole on an ongoing basis . Is there some reason that I should do so ? Thanks for a very helpful and informative site .

[chrisrob]

Don't know how applicable this is to your circumstance, but PPIs (eg omeprazole) have been linked to a 71% reduction of risk of progression to cancer.

"Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett’s oesophagus: a systematic review and meta-analysis

"

ncbi.nlm.nih.gov/pmc/articl...

[kierank in reply to chrisrob]

Thanks Chris . PPIs role is to help reduce reflux from stomach into the oesophagus ? -- as my oesophagus has been removed then I wonder if there is still a benefit in cancer prevention . I know many people myself included suffer from reflux post oesophagectomy which is very nasty and frightening . I have not had reflux issues for some time now and consequently I wondered about the benefits of continuing with PPIs . Thanks again. Kieran

[chrisrob in reply to kierank]

PPIs reduce acid not reflux. I did preface my response by saying I didn't know how applicable it would be for you. Most of those I usually deal with still have their oesophagus (and Barrett's) which is why the chemo-protection of PPIs is important.

[kierank in reply to chrisrob]

Thanks again Chris . I understand your position . I had Barretts, and didnt understand the importance of PPI at the time and didnt continue taking them . Cancer developed . Anyway thanks for your interest and help

Kieran

[phil]

Hi Kieran

I am10 years post ops and for 7 years did not take PPIs.but had to take Gaviscon at night. I am quite active and enjoy cycling and swimming but over time would get a burning feeling in my throat when bending down and this did cause me soreness in the throat area.My consultant suggested a PPI which I now take and that as greatelyl improved the situation. I also think the PPI does have a protective effect of what is left of our esophagus

But it's not long after your operation and you must do what suits you.

All the best

Phil

[kierank]

Thanks Phil . Great to see you going so well after 10 years and long may you continue . How far do you typically cycle ?Age if that is not impertinent ? I will check with my consultant - however it is good to get a view from people who have been through the process . Thanks again

Kieran

[phil in reply to kierank]

Hi Kierank I usually cycle 3 or 4 times a week for about an hour.I Don,t count the miles anymore I just enjoy the cycling.

My age 66 and still going strong. You have still got a lot to look forward to.

Regards

Phil

[kierank in reply to phil]

Hello Phil . I like your approach to cycling . I also do a bit of cycling and call it "heads up cycling" where I dont measure distance or time . Recently I purchased an electric bike which is fantastic in that I can now see more of the countryside and manage hills better . Upwards and onwards (age 71) Best regards

Kieran

[haward]

I heard from a surgeon that we should expect to use PPIs for the rest of our lives. He suggested that anyone thinking of coming off them should speak to their consultant first. Haward

[Hidden]

There are quite a few people in your situation who do not take PPIs and feel better off without them. Sometimes people who have had a lot of their stomach removed, for instance, do not create the stomach acid to the same extent anyway. If you have been doing perfectly well without it I would mention this at your next routine appointment and see what the doctor says.

There is a theoretical benefit in protection against Barrett's Oesophagus / dysplasia in any remaining stump of your oesophagus, but this is a very small consideration compared to the prevention of the pain and discomfort of the reflux. There are also some side effects of PPIs, like any other medication, and being prescribed them is always a balance of benefits and (small) risks.

[chris_usa]

Do realize that in the Ivor-Lewis procedure, only a portion of the esophagus is removed. You have about half of your esophagus remaining, and it is sensitive to the acids and enzymes in reflux. And now your lower esophageal sphincter has been removed, so there is little barrier other than gravity keeping gastric contents from moving up into the esophagus. Decreasing gastric acid decreases damage to the remaining esophagus, whether you can feel it or not.

It's your choice to make, but you need to know all the facts first. \wc

[kierank]

Hello Chris . I did not know that - I was under the impression most or all of the esophagus was removed . That helps me make a more informed decision re PPIs. Thanks again for your help .Kieran