How to sufficiently line the stomach vs. Omeprazole

[Sefu]

Hi (aside from the 'we are all different'), what insights do we have on what should be sufficient in minimum terms to line the stomach (and how far in advance timing wise b4 taking Pred.) to successfully replace Omeprazole ? AND, how much/what are the warning signs, if an individual has got it wrong, so that the situation can be rectified no harm done ? [Not aiming for min., but good to know the bottom baseline.) Thanks.

[GOOD_GRIEF]

I won't speak for others, but I always take my pred with a real meal. I found eliminating coffee and coke, and reducing the spices helped a lot. When I was on higher doses, I split my doses in half, morning and evening. Now, at lower doses, I take my pred in the evening with dessert, about an hour before bed.

And I make sure I drink plenty of water with any and all medications.

[Sefu in reply to GOOD_GRIEF]

Thanks. What was low enough a dose to switch ?

[GOOD_GRIEF in reply to Sefu]

I tapered my morning dose by 0.5 or 1mg at intervals of 3-4 weeks depending on how I felt. Then I started lowering my evening dose by 0.5 intervals. I'd go back up 0.5mg if I wasn't feeling it after a week or so, and sit there another 3-4 weeks before trying again. I never hesitated to take and extra 0.5 or 1 mg if facing a period of physical challenges (snowdrifts, a cold) or a particularly stressful period at work (quarterly and year-end financial reports) . I didn't wait for the pain to begin, but these increases would only be for 2-4 days. Then I'd drop back.

My current dose is 6mg, and all systems are go. Have never had a flare after I seized control of tapering from my doctor, who early on had a very ambitious tapering plan that left me nearly crippled for 3 months. We had a very loud and protracted conversation. I won.

[GOOD_GRIEF in reply to GOOD_GRIEF]

PS: I have no other conditions and take no other medications except calcium, D3 and folate (which I take with lunch.) If there's another reason for OMP, then do what your doctor tells you to do, If OMP doesn't agree with you (it gave me epic concrete constipation after just a few days) , there are a lot of alternatives.

[PMRpro Ambassador]

I honestly don't think there IS an answer besides we are all different.

Pharmacists have recommended the optimum is to take your dose in the middle of a real meal - a proper breakfast with protein and fat, not just cereal for example. They are of the opinion that a biscuit with the tablets isn't enough, you need half the meal, take the tablets and eat the rest of the meal.

Some people find that a spoonful of (preferably) full fat yoghurt is enough and they take it and the pred together. But as GG says - eliminating other potential irritants is probably helpful as well.

Mine are a different formulation - they have a specially designed coating that breaks down after 4 hours in the right gastric condtions which they define as taken within 3 hours of a meal or with a substantial snack including ham and cheese for example. When they break down the pred is all released into the stomach at the same time, exactly the same as if I swigged normal plain pred all at once. I have absolutely no gastric problems I am aware of and currently I'm taking 15mg. I have never taken a PPI.

[Sefu in reply to PMRpro]

Switching to taking Pred at 2am has shown advantage, but don't think I could persuade Mum to eat much at that time. As Mum is now taking Methylpred. I am told that there is not an enteric coated Methylpred.

[PMRpro Ambassador in reply to Sefu]

That's what I'm saying really - mine is the same effectively, although it is coated it isn't a stomach protective coating, it just delays ordinary pred being absorbed, and I am fine taking it within a few hours of a full meal. Never mind the 2am timing and food - if she will take it after her evening meal, go for that.

[SnazzyD]

I found it very much to be trial and error. I started on 60mg Pred and nothing helped, plus I’d had years of night time reflux if I didn’t take gaviscon. Omeprazole made me feel weird, gave me upset gut and didn’t help, Ranitidine gave me bloating and after two weeks, rebound acidity. I begged the GP for coated Pred and stopped taking stomach pills and the reaction was like boiling lava. Omperazole shouldn’t be stopped suddenly for this reason. I had a hunch it would improve and it did after 2 weeks, but I still needed Gaviscon at night. It got better with dose but it wasn't until I was probably under 5mg that my stomach coped on its own.

[Manchesterlady]

Really thick yoghurt works for me

[Sefu in reply to Manchesterlady]

How much ? cupful - say 3-4 tablespoons ?

[Polymialgia in reply to Sefu]

I buy the large tubs, full fat live yogurt and have about 3 heaped tbs for my breakfast then take prednisone, never had any problems

[Manchesterlady]

I take about three teaspoons before , and a large teaspoon with each tablet , and a bit more afterwards.

Not very scientific I know, but I feel it’s lining my stomach.

[Sefu in reply to Manchesterlady]

Thanks very much for the steer. Very helpful to be able to bear in mind.

[shazstep]

My stomach is inflamed. I have started having a diet drink made with milk, blueberries and yogurt as the research I have done says a drink first thing in the morning is easier for the body to digest. My gastro doctor also advised me to use low fod diet until I see a dietician on Monday week. Currently taking 15mg preds.

[Sefu in reply to shazstep]

Sorry to hear about all the trouble you're having right now. Thanks for response.

[Hidden]

I have 2 desert spoons of homemade yogurt then wash the tabs down with milk at 2 am. After 2 years so far so good.

[Daffodilia]

I had large bowl of porridge before taking pred when on higher dose - stopped nausea

[Sefu in reply to Daffodilia]

Thanks.

[TheMoaningViolet]

Hi Sefu, I take Omeprazole and now that I stopped AA I am planning to start tapering it after a couple of weeks. I also take aloe vera in a full glass of water first thing in the morning (as suggested in Kate Gilbert's book). I have a substantial breakfast featuring coconut yoghurt, coconut kefir, linseed oil, nuts, seeds, berries and an apple. I was not always on Omeprazole and the symptoms that encouraged me to start taking it were a recurring pain in my stomach when I went to bed at night and an acid reflux which would usually start after my second cup of tea, around mid morning. It took me a few days to realise what was happening, but as soon as I started Omeprazole all my problems disappeared. I was very fortunate not to have a negative reaction to Omeprazole and my only reason to want to stop taking it is the issue of the alleged reduced nutrient absorption which comes with long-term use. As it happens, I have only been using it for the last 4 months. I also found that eliminating snacking and endless cups of (oat)milky tea is a good idea. I have developed a new habit of having just one cup of tea at 11am (with 100% dark chocolate, turmeric, cinnamon, pepper and oat milk), which seems like an indulgent ritual and keeps my cravings at bay.

[Mollbhan]

Omeprazole gave me chronic constipation, I cut it out and now always take my pred twice daily with two big teaspoons of psyllium husks in fruit juice. No problems now but try to have food in your stomach as well.

[Sefu in reply to Mollbhan]

I had to google what psyllium husks are. Thanks ! What do they taste like roughly ?

[TheMoaningViolet in reply to Sefu]

They don't taste of very much. They are often added to keto breads for texture. If you leave them in liquid too long they increase in size, so I would drink them up fast if you have them in a juice. Or you can add them to porridge, this is where you would not notice them.

[Chengdu18]

Morning just a warning which I posted a few weeks ago re Omeprazole. I was given this after an endoscopy which showed mild gastritis. I was not monitored and unfortunately I am now a patient in the kidney clinic as the tablet has affected the tube going into the kidney. Kidney function is now very low, might need dialysis in the future. Make sure you ask for a blood test after starting on omeprazole please do not get into the same state of health as me! The kidney specialist said the reaction I have is rare but the KF should have been monitored.

[Sefu in reply to Chengdu18]

Thank you very much. That is a concern I have at the same time as constipation issues from Omeprazole which was prescribed without waiting to see if needed, If wasn't for this great website and forum I would be taking much longer to work out alternatives and who knows how many more weeks/months. How do we ensure that the medics monitor the situation while Ompeprazole is being taken ? I hope you recover and avoid further trouble.

[Chengdu18 in reply to Sefu]

Thank you and the same to you, keep questioning and hopefully you will get the correct medication for you.

[S4ndy]

I cannot take ppi's. I take my dose of 7mg of Pred with 3 tablespoons of probiotic yoghurt which I make myself from a mix. I have never liked shop bought yoghurt much but have found that I prefer the mix from Hansalls a New Zealand product which I buy direct from them online or on Amazon. You can see what's in them and can use the plain ones as a starter culture too. They do a good variety from plain low fat no suger up to very creamy "dessert" style offerings.

I have found that on higher Pred doses I was unable to drink coffee as this irritated my stomach. My gastro guy advised Gaviscon after every meal to help when my stomach was inflamed. Don't need this now as the yoghurt seems to do the trick.

[Sefu in reply to S4ndy]

Thanks so much !

[maria40]

My morning routine is: half cup of decaff coffee, take beta blocker, bowl of jumbo oats with Agave syrup and ginger, take e/c pred, more coffee, one round rye cripsbread with marmite or marmalade , take multivits and omega 3 capsules, small orange and more coffee. It's a sort of multi layered sandwich of medication and food and seems to work. Nothing else until lunch (unless tempted by a digestive biscuit).

[Keeping_healthy]

I follow a ketogenic diet and I’m not that hungry first thing in the morning, when I take my prednisone, so I usually have a ketogenic lemon cheesecake mousse, which is basically Philadelphia cheese, sour cream, Lemon extract and sweetener.

[Millipede01]

I usually eat half a banana take my pred then eat the other half washed down with coffee...so far so good. I've never been a breakfast eater and found that this is all I can manage.

[Carriemetz in reply to Millipede01]

That’s my morning routine, exactly. Works (so far) for me...

[Boss302Fan]

I’m on Omeprazole not because of being on Pred, but because being treated for GERD the past 30 years and take it on an empty stomach 20 mins before my meal. Started at 40mg, 2x/d, and until recently had been able to get by with before breakfast only. But because my globus pharyngeus sensation started intensifying I’m back to 2x/d.

I’m on 5.5mg Pred now and take it with dinner.

[Tago]

Hi. I take mine with breakfast which varies between toast and oatmeal porridge with a high quality multiflora. Never had any gut issues, touch wood😉, in 2 1/2 years. I've been on high doses a lot of that time.

[Hildalew]

A GP who happened to be on prescription duty one day after I'd been taking Pred for, I think, about 6 months, rang me to say she'd added Omeprazole to my prescription to protect my stomach.

I said, 'but I've not had any stomach problems since I started taking Pred'. She replied that it was probably a good time to start Omeprazole before problems started. I didn't say I'd been taking Pred with yoghurt because I wasn't game to try to have any kind of discussion with her and I appreciated her initiative in trying to prevent me from an additional problem.

I got the tablets, read the possible side effects, hunted through posts on here and carried on taking yoghurt.

The tablets are somewhere, untouched, in my collection of other things I haven't taken!

I am now nearly two years down the road, still taking my tablets with yoghurt (goat's milk in my case because my system doesn't like UK cow's milk) and following up with a bowl of porridge oats and red berries cooked in coconut water a surprisingly sustaining breakfast.

I've had no gastric problems so far. (I have no other conditions/medications.)

[Sefu in reply to Hildalew]

Well done ! That is what I am doing. Go along without confrontation and try to achieve best outcome. Thanks.