High 80mg daily PPI dose

[Bengalbeanie]

A few years ago I had acid reflux and was put on 1 20mg PPI tablet a day, It was an ongoing prescription but eventually I weaned myself off it and was ok for a couple of years.

About 4 years ago I had an endoscopy related to something else. It came back ok, just with some gastritis. About two years ago my acid reflux reappeared and I was put back on PPIs. This time it just worsened (and the thing is, I only have refllux issues, nothing else} and my dose was doubled, however it didn't help and I tried various PPIs and Gaviscon. It just kept getting worse, waking me up during the night, up to 4 times with severe reflux in my throat and choking me. I had another endoscopy about 5 weeks ago and this time it came back that I had a hernia (not mentioned in the previous endoscopy report} and my gastritis had worsened. The guy who did it said to double my dosage of PPIs, for a month, which shocked me a little as I was already taking 40mg, he also said to take Gaviscon. I queried the dosage as everything I have heard and read suggests that PPI are not the greatest medication. He said there was no problem. I had to discuss the results with my own practice doctor and he also said no problem. I voiced my concerns and he said, 'who told you that'.

For the last month, I have now been taking 80mg Omeprazole daily and Gaviscon after each meal and before bedtime. Initially it seemed to work well although I would still feel fluid in my throat sometimes after eating and drinking (a precurser to more symtoms if not heeded) but this last week I have been waking up again with 'mild' reflux, but obviously enough to be waking me up.

I have now come to the end of the month and am worried I may be told to continue on 80mg a day with Gaviscon. Should I be concerned and why is it so bad? As I say, I do not have indigestion or anything else, other than an occasional very bad pain in my back between my shoulder blades and I don't know if this is related?

Any comments appreciated. Thank you.

[Sarah106]

I have been suffering from Acid reflux since 2006 after a stomach infection. I have been taking Omeprazole ever since, sometimes 40 mg and regular dose is 20mg. Unfortunately I got diagnosed with Barrett's esophagus last year. Since last year, I have started getting pain in my shoulder blades, very uncomfortable 🥵. During lockdown my reflux has got worse, due to stress, lack of exercise and overeating. It's a vicious circle I can't break free from. Please speak to your GP regarding medicine dose. You can request a gallstones ultrasound. All the best

[Bengalbeanie in reply to Sarah106]

Thank you Sarah.

[Scandi123]

Hi Bengalbeanie - just a thought - have you tried a different PPI? There are quite a few on the market and some people find that one suits them better than others. Sometimes the side effects of PPI’s mimic the actual condition, so maybe you are not getting worse as such, it’s just the side effects of the one you are on. It might be that a change of PPI is all that is needed. Just a thought….

[Bengalbeanie in reply to Scandi123]

Many thanks Scandi. I think I have tried most of them over a period of time including the now banned Ranitidine. Its funny you should mention that perhaps it was not getting worse, but may be a side effect. When it was increased from 1 to two tablets a day and was still getting worse, I asked the doctor if it could be that I was taking too many PPIs, but the answer was no. I am rethinking that at the moment because after I posted my original post, I decided I was not happy taking so many PPIs, or even any PPIs, not least because each time I went onto them, my weight increased (quickly) and in the month I have been taking 4 a day, my weight increased by 12lbs over three weeks. I decided to stop taking the PPIs two days ago, expecting a horrendous rebound effect and although I have had a slight one I am at the moment managing it with several doses of Gaviscon. Confused??

[Mauser1905]

Sorry to know your concern.

A hiatus hernia HH has different grades being lesser to higher grade. Please visit charity website opa.org to get more information in the reflux.

As to Dr's question kf who told you, please refer him/her to the leaflet inside the medicine pack.

Not all HH and lax Lower oesophageal sphincter LES are easily identifiable during the gastrostomy. Simply because the triggers for the reflux may not occur at the time of the scope as well the laxity or HH maybe on the borderline of diagnosis. FLASE negative type.

The gas pressure test during the scope confirms the LES efficiency. Aka laxity.

A short term dosage even with very high dosage may be required for the underlying causes and treatment plan for the same. Perhaps if you jot continuing to take very high dosages for many months and years then concern should be less.

As we grow old, age the muscle efficiency also diminishes and this is subjective to every single human body. The age grows and the muscles (LES) issues creep accordingly. Such anatomical issues are futile to be treated with daily symptom management PPI or blockers such as tidine group meds.

[Bengalbeanie]

Hi Mauser1905.

Thank you so much for taking the time to send me a reply. I looked on the opa website and put hiatus hernia and hernia in the search bar but unfortunately, the eight responses didn't really address hiatus hernias at all.

It was odd really, but the first endoscopy that I had took a small amount of time and I chose not to be sedated. I felt nothing really, other than it going past my throat and when they were cutting bits off for biopsy. The second one I had (again non sedated), they kept telling me, 'it only takes five minutes'. I was dubious as the first one had taken quite a bit longer, however, this time (different place), they rammed it down my 'gullet' and indeed it did only take five minutes, or less). I could feel a strong resistance this time and was aware that he 'caught' the camera one or two times and pulled it up to push it back down again with resistance. Very unpleasant experience.

After the procedure, they explained that I had a sliding Hiatus Hernia and suggested that 'it' was responsible for at least some of my reflux. I repeated this to my own doctor when I spoke with him, but he said that many people had hernias and suggested that it had no bearing on my reflux.

Last week I made a telephone appointment for Monday coming, with the lady doctor (she is sympathetic as she too suffers from reflux). At the time I made the appointment, it was to ask how I should proceed with the PPIs. It was after I made the appointment that I made the decision unilaterally to stop all of the PPIs. I am not sure now, how she is going to feel about me stopping all the PPIs, or even whether there is any other treatment for reflux now available to me, (apart from Gaviscon).

Are there any questions you feel I should be asking at this point Mauser please? And do you have any suggestions of what I chould be doing please? Many thanks.

I also read your diagnosis on your page Mauser and I am so sorry to hear of your diagnosis. I am hoping you are well at this time and you continue fighting.

I also donate through Smile.Amazon and will be sure to redirect my donations. Keep well.x