Esomeprazole dosage increase advised

[gillsky8]

A long story still ongoing, after diagnosis with Hiatus hernia earlier this year, my GP has made varying changes to my dosage of esomeprazole, bearing in mind that I also suffer from PMR and am on prednisone, which as I understand it can irritate the stomach and cause acid reflux .

However she has now decided after review to start me on a much higher dose of PPI. I do have major issues with full stomach feeling, bloating and feeling the need to belch, very uncomfortable and always towards the end of the day, but it is an issue I am concerned about.

My symptoms are certainly the above, constant throat clearing, the feeling of phlegm in the throat and need to clear this but so far as indigestion is concerned not greatly and no problems when sleeping or laying down at night time.

She is suggesting a months course of esomeprazole 40mg in the morning and 40mg pm, I am worried about the long term effects and also have been reading that using too much ppi can cause bone issues and also rebound ? which I can well do without.

Has anyone had any experience of this higher dosage and it's success or otherwise.

thanks as always for any help received.

🙂

[Badger2024]

I understand your concern. PPIs are not for long term use. They work so well that doctors are prescribing them for too long and sometimes at high doses. Disgraceful. I too have a hiatus hernia and GORD and have been on esomeprazole for a few years. This drug is commonly called nexium. Google the class action for it. I developed chronic kidney disease nearly a year ago. My nephrologist thinks from the nexium. I’ve joined the class action. Many people are getting stomach or oesophageal cancer from it. My advice is to stay clear. I have no doubt it will be eventually removed from the market like Zantac was. There are safe H2 blockers like Famotidine that don’t work as well but aren’t as risky as Nexium or any of the PPIs. I wouldn’t be surprised if I have to have an operation to fix my hernia. I have another gastroscopy on Thursday. Have you had a gastroscopy recently? Advisable to keep having them to check for polyps before they become cancerous. I had a few removed six weeks ago. Luckily I am in Australia where it is easy to see doctors and have investigations done. I hear that the NHS is struggling with waiting lists at the moment. Speak up for yourself. You are worried for a reason. Insist on a gastroscopy. Have a colonoscopy while you’re at it. I had a few polyps removed from my duodenum too which is an unusual place to get polyps or cancer. My new GP thinks that these could have been from long term PPI use. We are supposed to have some acid in our guts. PPIs block all acid. H2 blockers block some of it. That’s my understanding anyway. Good luck with whatever you decide. Ironically I’ve been back on Nexium for the last six weeks since my gastroscopy to heal the ulcers in my oesophagus. They’re repeating it on Thursday to make sure they’re healing and I may need a few more weeks of it then will switch to Famotidine. I’m dreading the return of the discomfort which is why I may consider an operation. It sucks!

[RestlessOwl]

I have been prescribed 40mg twice a day for 2 weeks (was in A&E with asthma exacerbated by acid reflux). Just a couple of days to go then I drop to 20mg twice a day. I don't think it's made much difference to the acid effects but I'm also weaning off steroids so maybe it's protecting me more than I realise. Been prescribed 60days of Vit D and calcium chewable tablets twice a day too.

[gillsky8 in reply to RestlessOwl]

What dosage of steroids are you on . I have been trying to taper down but everytime I drop below 10mg I feel awful 😞

[RestlessOwl in reply to gillsky8]

It's so tricky, and every day is different for me atm. I've got down to 15mg Prednisolone (3 tablets) dropping in half tablets every 3 days, even quarters as I get lower to speed things up. I'm in a vicious cycle - I'm on steroids for asthma but my acid reflux is exacerbated by the steroids, so until I wean off it won't really improve. I was supposed to reduce Esomeprazole from 40mg twice daily to 20mg this week but as my symptoms aren't under control, was told to stay on 40mg until steroids are finished.

[gillsky8 in reply to RestlessOwl]

Yes this is exactly the same for me it's like 2 steps forward, 3 back !! Very frustrating to have got to 10mg and then every single time I drop down problem is back again. I have not yet tried in 1/2 mg taper but I think this is the next step. To be honest I wonder if 10mg might be the optimum dose for me with all other issues going on. Symptoms of acid reflux exacerbated by steroids is interesting you say that, and again the same each time I reduce to 20mg per day, problems !! is it a steroid inhaler you use for your asthma, mine is a preventer, but chronic throat clearing is another issue I feel not helped, but uncertain if this is a symptom of asthma or acid reflux. I would just love to get on to medication which I can reliably use on a day to day basis. !!

[RestlessOwl]

Absolutely! Nothing I'm using seems to be helping me. Today I'm staying on 40mg esomeprazole twice daily (3rd week) and reducing from 10mg to 8.75mg (1 & a quarter tabs). Still have wheezing despite using Fostair (steroid)preventer 2puffs twice a day for 3 weeks and also my blue salamol at up to 6 puffs to try and get relief. Also lots of Gaviscon Advance.All this has led me to start researching the effects of acid and particularly pepsin, which can spread up the oesophagusinto throat, nose and ears (yes I had earache too!). I started an Acid-free diet almost 2 weeks ago. I don't see much change yet but it's not going to make a huge difference until I'm off the steroids (and I guess PPIs). My specialist wants me on 5mg by 29th Oct when I see him! So I'm practising using a book called The Acid Watchers Diet by Jonathan Aviv.

[gillsky8 in reply to RestlessOwl]

Hi I just wondered how you are doing with your medication. I have just been recommended to try Esomeprazole 40mg twice daily for the next 4 weeks as I am making no progress at all with symptoms of silent reflux,

With regard to steroids I am now tapered down to 8mg per day. Touch wood I feel quite well atm

[RestlessOwl]

Hi A lot's happened in 5 months! I did improve on the Acid Free diet. However, I had to come off Esomeprazole to have a Bravo capsule fitted in my oesophagus to test for acid reflux. Guess what - no acid recorded! Very strange. Asthma has been very bad 3x visits to A&E. More high dose oral and inhaled steroids, Montelukast, Dymista nasal spray. Then a GP sounded my chest, said it sounded dreadful and prescribed 3days of Azithromycin antibiotics (I had already had 3 lots of 5 days Amoxycillin and Doxycycline which didn't help). It was a game changer. Now on it 3x a week as a prophylactic. Has side effects - stomach upsets, and worse, tinnitus, possible hearing loss. However, I have turned a corner. Not using PPIs just Gav Adv occasionally. Weaning off steroids (now 8mg) and the scary Montelukast. I can breathe again and carry on my life. Glad you're also feeling better