Problems trying to come off Lansoprazole capsules

[Steve-C]

Firstly apologies for the length of this.

I was put on Lansoprazole 30mg capsules over 2 years ago by a GP for chest pain after food. After no improvement I asked to be referred to a gastroenterologist who, after many tests, diagnosed Achalasia as the problem. But I was never told to stop taking the Lansoprazole.

The Achalasia was very mild to begin with but is now rapidly deteriorating and I do need surgery. The problem with Lansoprazole is this: if I miss even one capsule I get agonising stomach pains, like I have swallowed nitric acid. The stomach feels on fire; although generalised in the stomach area, it feels like individual stomach cells are burning. I have to quickly take capsules again and it can take many days for things to settle down. When I first mentioned this to the gastroenterologist he said it was nothing to do with the Lansoprazole. I do know people who can just stop taking the capsules and get no effects or just mild discomfort which goes away. I deliberately missed a capsule a few weeks later and exactly the same thing happened and I went straight back to the capsules. Gastroscopy eight weeks later showed ‘just’ mild erythematous gastritis.

When I have surgery (Heller myotomy) I will not be able to take capsules or tablets for 2 to 4 weeks. In anticipation I tried orodispersible on the tongue, but I have a large osteophyte at c3/c4 which the rather sticky dissolving particles stick to and cause serious throat inflammation. The GP said just put the tablet in water and swallow. I tried this but the severe stomach pain occurred in the night and continued. So back to the capsules.

I spoke to the surgical registrar as I couldn’t go ahead with the operation until this issue was sorted, he said he didn’t know, he wasn’t a pharmacologist, but I had to somehow find my way out of this.

I asked the local pharmacist who said capsules are slow release, they don’t start acting until into the intestines and presumably more gradual than throwing liquid Lansoprazole into the stomach. She said ask my GP. He said ask the pharmacist!

No-one seems to know what to do. Doctors in particular just don’t seem to understand what these PPIs are actually doing.

Thank you for reading this far. I have a couple of urgent questions:

1). Any suggestions as to what I can do?

2). Can this agonising pain actually indicate permanent damage to the stomach lining ? The docs say no. But if I let it continue (which is not a happy prospect)?

3). Acid rebound seems to be the case here, but why do many not get this? I wonder if my extremely tight lower oesophageal sphincter is ‘trapping’ the acid - I don’t get reflux.

Any help appreciated, and sorry for going on at length.

[Mauser1905]

1.gaviscon advance liquid is your friend in pain.

1.your local pharmacist is your best friend, speak to him/her for the issue of medicine.

2. its subjective, hyper anxiety can add to the stress and chemicals released, not helpful for the stomach balance. also lining healing takes ages due to obvious location and constant digestion process.

3. everybody is different with different underlying conditions or not. comparing is fine for a generic view but individual symptoms have to be taken on its own individual merit. PPI's are one form then there are H2 blockers.

[Steve-C in reply to Mauser1905]

Thank you Mauser1905.

{2} So you're saying acid rebound does damage the stomach lining? If I stay off Lansoprazole will damage likely be permanent?

[Mauser1905 in reply to Steve-C]

No, sorry if you got confused. I meant if the damage is already to the lining such as ulcer or other reasons then it takes time to heal. Stomach is meant to hold the acid and lining is what protects the stomach tissue. The tissue in Oesophagus is not protected with lining hence "heartburn" due to reflux.

for the duration post surgery, gaviscon advance liquid will be of great help to mitigate your concerns. Have a word with Pharmacist please. your GP should prescribe it.

[Steve-C in reply to Mauser1905]

Thanks Mauser for your help.

[liz_crisp]

Try Zoltan fastab. They are oral dispersible and have no sticky residue.

[Steve-C in reply to liz_crisp]

Thanks Liz_crisp. I think Fastabs are the same as Lansoprazole orodispersible. These do stick to the back of my throat. But thanks for the suggestion.

[liz_crisp in reply to Steve-C]

I can only use the zoltan ones as the othe generic are awful. These taste of orange and do not have that chalky residue

[Harmonious]

I can't take my lansoprazole at the moment because of forthcoming endoscopy. The acid came back immediately but I find Gaviscon very helpful.

Good luck!

[meggiemog]

Hi Steve,

Would the operation not change what is coming up from the stomach anyway? Just a thought. I kind of realise I am in the wrong group here - as I have issues with a failed fundoplication and after my initial surgery I didn't need any medication any more.

[Steve-C in reply to meggiemog]

Hi meggiemogg

No the myotomy/ fundoplication is just to allow food and drink to pass more freely into the stomach.

Was your fundoplication for Achalasia?

Steve

[meggiemog in reply to Steve-C]

No I had a hiatus hernia and really bad reflux. So had a 270 degree fundoplication and hernia repair 4 years ago. About 3 months ago I started coughing and retching after eating - had endoscopy and the repair is still ok - but the lower esophageal sphincter is constantly open. Still waiting for gastroenterology to get back to me - lost over a stone in weight as I can't eat a normal portion of food. Unfortunately gaviscon advance no longer helps as it refluxes back into my throat. GP gave me domperidone- which also makes things worse (I start coughing before I eat) and they won't give me anything else until gastroenterology reports back. I reckon if I wait another 15 weeks like my first appointment I will probably lose another stone! If I eat small amounts and sleep upright I can manage . I appreciate most of you on here have much more worrying problems and this is just a minor issue. I hope someone can suggest something to help you with the acid issues. I used to find cimetidine was the best for me - old remedy - could not tolerate PPI s

[052517]

My pain resolved after the Heller's. I found Ibuprofen to help because the pain was related to esophageal spasm and not actually acid reflux. Sleeping on a wedge may help. Gaviscon is your friend.

[Raverbabe23]

This is what Lansoprazole did to me and I am 3 years after taking it and still not right at all. Out of the blue, I stopped taking my Lansoprazole one day and for some reason it didn’t do this like all the other times before and I haven’t looked back!