Sudden return of symptoms after 7 years successful treatment with protonix

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bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/11/2010 6:48 PM (GMT -6)   
Hi, I know this kind of thing has been discussed some elsewhere but I'm brand new here and looking for help so I thought I'd raise this topic new.  I have been taking protonix for about 7 years after an onset of gerd in 2003 and a diagnosis of Barrett's in 2004.  In 2007 I had a follow up endoscopy (at a different hospital since I moved) that claimed they found no evidence of Barrett's so I don't know if I have that or not.  But anyway, things have gone along fine taking 40mg protonix each night.  A couple of times I did try to get off it, but the rebound was intolerable.
 
So here's my problem.  This week I've had a sudden onset of new symptoms - the most disturbing of which is difficulty swallowing - like the food is getting caught in my esophagus and almost feels like choking or wanting to throw up (not nauseus but food stuck feeling).  I also have a scratchy sore throat - not bad but annoying.  And lots of nasty belching.
 
mad  I haven't eaten in two days because I'm frightened of having that swallowing experience again.  (I'm normal weight and generally have a pretty good diet and exercise regularly although I do drink coffee - seemed OK and the protonix worked so well that I was just cruising along).
 
My question is - can the PPI just stop working suddenly after 7 years?  I did just get switched to a different generic by the pharmacy which makes me wonder, although they say it's exactly the same.  Has anyone had issues with generic protonix?  Has anyone had this experience protonix stopping working?  Is there a good chance that switching to a different med would help?  I'm seeing a doc tomorrow but I don't have much hope that he will do much.
 
Any help would be most appreciated.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 3/11/2010 8:34 PM (GMT -6)   
I recommend talking with your GI doc and see what they say. Could be a stricture that might need dilating.

Take care,
Bill

bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/11/2010 8:47 PM (GMT -6)   
Thanks for your help Bill I'm actually seeing my PCP tomorrow but I'll make sure he gives me a referral to a GI dr.
 
 

bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/11/2010 8:55 PM (GMT -6)   
Is stricture common? Is the prognosis OK? It sounds scary.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 3/11/2010 9:36 PM (GMT -6)   
Some people have strictures. It's just a stiffing or constriction in the esophagus. Dilulation breaks up the stiffness.
Please eat or at least drink a protein supplement. You need the nutrition.


Joy

bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/20/2010 2:04 PM (GMT -6)   
Still looking for help.  Saw the GP doc and had a barium swallow - negative other than a hiatal hernia I didn't know I had, but I understand this is common and doesn't correlate well with symptoms.  I have a referral to a GI doc but can't get an appointment until May 10 - which really stinks.  (Gee - good thing I don't live in Canada where they have waiting lists!).
 
In the meantime I still have really unpleasant symptoms.  No heartburn (I've never had that) but regurgitation and food-stuck-in-throat feeling, and really really nasty uncontrollable belching (which means I'm way too embarrassed to leave the house).  I don't know what to do to keep going until May 10.  The GP had absolutely nothing to offer.  On my own, I've started taking 40 mg prilosec in the AM as well as the 40 mg protonix in the PM (because I can buy prilosec over the counter, since GP wouldn't prescribe anything more for me).  I've also tried ginger capsules, DGL and digestive enzymes.  Nothing seems to make a difference.  I bought some ACV but haven't had the courage to try it - wouldn't it interfere with the PPI drugs?  Or do people do both simultaneously?
 
Please help! 
 
Am I just being too impatient - will the extra dose of prilosec eventually work?  Is there anything else I can do?!  I feel desperate.  I'm an otherwise basically healthy person - I work outdoors (environmental scientist - I monitor water supplies), get lots of excercise, normal weight, good diet.  I don't understand why this is happening to me.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 3/20/2010 3:47 PM (GMT -6)   
Hi Bovt,
So sorry to hear you're having problems. Join the club! I don't know whether or not the generic Protonix is different than name brand, but my PCP was specific about wanting me to take the name brand as he was not confident that it acts exactly the same as the name brand. I ended up with 40mg Protonix twice a day, so your idea of adding Prilosec is probably a good stopgap to try. It would take some time for it to make a difference.

If you're on PPI's and still having reflux, you could be experiencing bile reflux, rather than acid. It is still very damaging to the esophagus, so isn't something to ignore. Glad to hear you've got a GI appointment. You could try calling daily to see if there has been a cancellation. I have found that a great way to get in earlier.

You definitely should stop with the coffee. I know that's hard, but coffee is very acidic, and if it's caffeinated, it will further relax you LES valve, creating even more reflux.

Your hernia could have gotten worse, thus allowing more reflux. It typically does lead to more symptoms in GERD patients. Bill has already discussed the swallowing problem. That's pretty common for people who've had reflux irritating their esophagus. It doesn't effect everyone, but does bother some. Your GI doc could handle that.

Are you sleeping with an elevated head of your bed? That would alleviate some of the reflux damage at night--allowing gravity to hold more of the acid/bile in your stomach. Check online for specifics on that.

Also, be sure to check out GERD triggers and avoid those foods. With all your throat problems, you may be doing a lot of air swallowing--dry swallowing to relieve the symptoms. GERD sufferers tend to get more air in their stomachs.

Here's a URL of a site that discusses belching in more detail.
http://www.medicinenet.com/intestinal_gas_belching_bloating_flatulence/article.htm

Good luck in finding answers!
I'm sure others will be by to post information and provide support.
Take care,
Denise

my7pinecones
Regular Member


Date Joined Feb 2010
Total Posts : 74
   Posted 3/21/2010 12:58 AM (GMT -6)   
Sorry to hear of your struggle. I agree, bug nicely the doctor's office each day...squeaky voices do get appointments :=} When you see your GI doc, you may want to discuss having a stomach emptying study. If you aren't emptying in a normal length of time, reflux and regurgitation can be worsened. Carafate (1 gr) and erythromycin can help with this and if the meds you are currently taking don't seem to be helping, discuss Kapidex 60 mg as a possibility. These help some people. The other suggestions already made (diet, bed elevation, stress management, eat small amounts more often and chew really well also can help.

Good luck finding your answers and let us know what you learn!

bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/21/2010 10:56 AM (GMT -6)   
Denise and my7pinecones - thank you so much for your support and your great suggestions. I'm supposedly on a waiting list at the GI doc's but I think I'll call Monday and just reinforce it as yuo suggest - I'm not usually good at being the squeaky wheel, but if ever there were a time...

I'm feeling slightly less icky this morning, so slightly less desperate. I actually ate some egg for breakfast and haven't thrown it up. It's so nice to know that there're others out there that have been threw this and I so appreciate your input.

I was surprised to see the erythromycin on your list, 7cones. Isn't that an antibiotic? Interesting. I've never heard of the other two meds so I'll look them up, so I can ask the doc when I see him. Good to know there are other things out there that might help - that gives me much needed hope.

i'll look into bed elevation too. I don't seem to have much symptoms at night - mostly during the day, especially after I eat, but maybe the bed thing would still help (?). I'm not sure how you go about this but I gather you can get something to put under the mattress so I'll look for it.

Thanks so much again. I hope I can return the favor some day.

Best, bosvt1

REDSAM
Regular Member


Date Joined Feb 2007
Total Posts : 98
   Posted 3/21/2010 11:41 AM (GMT -6)   
Bovst1, I was on protonix for several years and yes, one day I realized it had stop working. I went to my primary doc, who sent me to GI. He changed my meds from Protonix to Nexium. That was my saviour. I did well on that....until my insurance changed and they new plan did NOT cover Nexium. I could not afford to pay for that out of pocket. So the doctor rx'd Aciphex, and the pharmasist said take OTC Ompereazole because it was the same as Nexium.... WRONG. It did not work and I tried the Aciphex, which was barely doing the trick... Flash to now, I am experiencing misery.

The only other med left for me to try, is Zegerid. Same as Omeperazole, with Sodium Bicarbonate. Like the Aciphex it is barely doing the trick. My GI doc blamed all my issues on my weight and told me to go to WW or Overeaters Annonymous, or possibly Gsastric Surgery. Needless to say I am going back to the primary and telling him give me a New GI.

I have read that sometimes in some people the generic equivalent does not perform the same way as the name brand.

There are alot of wonderful, wise people here. I have been able to cope with my doctor disaster and learn from people with experience, who will treat you with the utmost respect.


Big Hugs... REDSAM
Sue-Hypothyroid, hysterectomy,  Abdominal Adhesion Pain, No female parts, no gallbladder, sinus Surgery. Please put a fork in me I have to be well done!


dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 3/21/2010 2:21 PM (GMT -6)   
Hi Bosvt,
The way you elevate the head of your bed, is put blocks of wood, bricks, cement blocks, or "bed raisers" (you can buy bed raisers at stores like Bed Bath and Beyond, online, or medical supply stores at a higher price.) You put them under the legs of the head of your bed.

You may not have noticeable nighttime symptoms, but if you're getting any reflux, it's likely to be leaking into your esophagus during the night, and can contribute to the symptoms that are bothering you during the day.

You can buy a "wedge" at a medical supply store, but they can be hard on your back, and can cause more reflux if you slide down and your body gets into a position that's bent at the waist. If you're using a wedge, you want to bend at the hips.

I was on the waiting list for my GI doc, and my husband called daily. I wasn't going to be able to see him for a couple of months, but was able to move that up to about two weeks. It's definitely worth calling daily. When the opening occurs, you'll be there to take it!

Glad to hear you're feeling a bit better today.
Good luck finding an answer to your suffering!
We'll try to help support you and provide as much information as we can.
Take care,
Denise

my7pinecones
Regular Member


Date Joined Feb 2010
Total Posts : 74
   Posted 3/21/2010 3:18 PM (GMT -6)   
Hi Bosvt,

I agree, I'd not heard of taking an Erythromycin 250 mg bid (3 x), an antibiotic for GI problems such as we have. It is being prescribed in conjunction with 1 gr Carafate qid (4 x). Actually, this is being prescribed by my surgeons (not my diagnostic GI docs). I have many esophageal problems and have had 3 open surgeries and badly need a 4th, which may be scheduled in a week or two. My surgeon explained that taking the two drugs together (carafate coats the esophagus and stomach) help the stomach to empty in a more normal way. Carafate is typically used with ulcer patients (which I am not and never have been). This effort to coat and move food through in a timely way can impact regurg and reflux. This won't heal my need for surgery, but he was hoping it might bring symptoms into more manageable levels. Actually, it has helped with regurg and my loss of voice and pressure in throat is a little bit better...but, I still need to have surgery, unfortunately.

Kapadix has been the best ppi type drug I've ever used (25 + years). It is fairly new and my insurance company only pays a small amount of the high cost ($148 a month in my area...$88 after insurance). I was able to try it with samples from my GI doctor.

Wishing you a very good day and heightened abilities to productively cope!

Blessings,

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 3/21/2010 3:30 PM (GMT -6)   
I bought my bed risers from target, but I've seen them at walmart, too. Almost everybody carries them now.
I did try the wedge for a short time, I had terrible back spasms from sleeping on it. :(


Joy

bosvt1
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/21/2010 3:51 PM (GMT -6)   
Thanks so much to all! Wow - you are all an amazing wealth of information. It's shocking to me how many people on here have problems becasue of insurance companies switching meds on them. That's one thing I've been pretty lucky about - so far I've been able to get my insurance company to cover what my dr. prescribes. I'm so sorry for those that have had to fight that problem on top of everything else.

Thanks again for everything, I'm so glad I found this site and I wish you all the very best with your own struggles to stay well.

bosvt
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