LPR: PPI's making my digestion reflux worse?

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Holly G
New Member


Date Joined Mar 2013
Total Posts : 16
   Posted 3/14/2013 10:28 AM (GMT -6)   
Hi there...
So, I was diagnosed with LPR a little over two weeks ago.
-irritated throat
-Post nasal drip
-bitter taste in mouth
-cough from chest congestion that is now dry and isn't improving
-had lump feeling in throat previously, but it went away.

---> I do not have a history of upset stomach and can usually eat spicy or just about anything.

MY GI said he believes I probably have normal stomach acid and that I can watch my diet and take a PPI for a few months and then probably get off of them. My PCP thinks this too. MY GI gave me samples of Aciphex to take for 6 days as the prolosec made my stomach feel weird most of the time.

The first day and a half on Achiphex was great and then I went out for some sushi. Ordered something mild and only ate two pieces along with some miso soup and edamame. Did not overeat. When I got home I had some ph 8.8 water which just felt like it was sitting in my stomach with the small meal I ate.

Went to bed 3 hours later and had an awful acid reflux at about 3-4 in the morning. It reached the back of my throat and I can taste it now as I type. Yay.

Before my diagnoses I recall having a sour tummy after eating some beef stew with a beer. Before that, I've never really had any stomach issues except for IBS type symptoms. Even with that I could pretty much each what I wanted and my stomach would be fine.

Do you think my digestion has changed or could it be the PPI's messing me up when I eat certain foods?
What does one do if they can't tolerate PPI's?

Thanks for reading...hope someone has some advice.

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/14/2013 10:40 AM (GMT -6)   
Holly,
Your digestion has changed because of the ppi, your stomach now has less acid in it so digestion will be slow as food just "sits" in your stomach. You can try taking digestive enzymes to help your stomach digest food.

Holly G
New Member


Date Joined Mar 2013
Total Posts : 16
   Posted 3/14/2013 11:18 AM (GMT -6)   
Doggbones...
Good point! Do you think that could have caused the reflux too OR maybe I'm not getting quite the full potential of the meds/diet/Lifestyle changes?

I'm guessing my digestion will return to normal once I got off the PPI.

I was thinking about looking in digestive enzymes, but now you have sold me.
Any idea on the to get?
Like a papaya enzyme?

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/14/2013 12:02 PM (GMT -6)   
Holly,
It seems like you were refluxing before the ppi, however the ppi can help but in the same token it can make things worst. You will have to be your own judge as to whether you feel better on or off the ppi. Taking ppis short term can offer some relief (it will not cure reflux) but taking them long term usually cause more issues.
 
I suffer from gerd/lpr, I only had gerd symptoms until I was on a ppi daily and then the lpr issues started. IMO, ppis may help with reducing stomach acid but for me they make pepsin/bile reflux worst (pepsin/bile reflux = lpr).
 
My advice would be to consider getting more testing done, and focus on diet changes to see if it helps. I would eat more green veggies, lean meat and stay away from spicy food, beer, coffee, junk food etc...
 
You can buy digestive enzymes at any health store (ie; GNC, etc.), as well from amazon. Papaya is a good enzyme but it's no way near what you need in an enzyme. My bottle is at home so I can't list what's in the one I take until later so I will post what to look for when I get home today.

Holly G
New Member


Date Joined Mar 2013
Total Posts : 16
   Posted 3/14/2013 12:54 PM (GMT -6)   
Doggbones...
That would be great! I have no clue what to get.

Yes, I've been changing my diet over the last few weeks. The only real change I have seen is that my voice is no longer hoarse. I could tell I had some bad reflux last night and some bitter taste in my mouth today.

I figure I will try to stay on the PPI for about 3 months to see how I fair, but overall I think they make me feel worse at this point. I was hoping they would be me control my LPR : (

Thanks again for your help and I look forward to your input later.
~Holly
~Diagnosed with LPR 2-25-13

Gastricman
Regular Member


Date Joined Jan 2013
Total Posts : 294
   Posted 3/14/2013 1:46 PM (GMT -6)   
Hi Holly G,
 
Welcome to Healing Well!
 
Please see my link on eating uncooked foods while on PPI/H2 therapy.
 
 
Hope this helps.
 
Gastricman

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/14/2013 6:34 PM (GMT -6)   
Holly,
I take digestive enzyme called multi-enzyme formula from GNC, there a lot of brands out there some better than others. I make sure the enzyme has amylase, protease, lipase, lactase, cellulase at a minimum and make sure no pepsin if your having lpr issues. Goggle some and take a look.
 
Sour/bitter taste for some is caused by ppis, others not (ppis cause for me). All I can tell you is I chew a lot of gum to put up with it. PPIs usually have little effect on lpr symptoms but everyone is different.
 
Theres a thread on here by justpassingthrough called 10 ways to beat airway reflux you may find helpful. I'll bump it up for you.

Holly G
New Member


Date Joined Mar 2013
Total Posts : 16
   Posted 3/14/2013 8:46 PM (GMT -6)   
Thank you soooo much!
I really appreciate the help!
~Holly
~Diagnosed with LPR 2-25-13

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/15/2013 4:57 AM (GMT -6)   
Holly,
Your welcome. We're all here for the same reasons, to try and get better and to pass along to others what may or may not have helped. Good luck to you. :)

Willovercome
Regular Member


Date Joined Mar 2013
Total Posts : 105
   Posted 3/15/2013 12:02 PM (GMT -6)   
Have you get endoscopy done? There are meany reasons you get bitter taste in your mouth.(and chronic cough) I do have gerd(saw the eroded esophagus in the endoscopic picture) and when it was more severe i did cough at night and had sour taste when i bend over or something but didn't have bitter taste. Could it be metallic taste?
http://www.livestrong.com/article/86757-causes-metal-taste-mouth/

Becaus ppi makes you have many kind of mineral and vit deficiency, taking ppi when you are not sure about diagnose, can hurt you.
I myself is trying to get off of my ppi because of the adverse side effect. I have my own thread about that here under'stopping nexium due to the possible side effect. I don't think that side effect is so common but what i felt was real. Maybe because the people who is twice as big gets same dose as me? I am a small person 5'2 and 106lb and had 40mg over a month(20mg for a month before few month)

You don't need enzyme only because you are taking ppi because your stomach can be 'spoiled' so to speak. it will ask you for it all the time later just as ppi may make poduce more acid when it's not in the system anymore. Basically acid just helps a bit, but stomach muscle does all the chewing and crashing and getting it down so that intestine can absorb the nutrient but you do need acid for many good reason.
If your stomach is not moving like me and not sure about actual 'too much acid' i am not sure ppi helps. Please talk to your docotr.

I read some academic articles and in europe they prescribe ppi only a few days at a time but in US they bombard it weeks at a time. For who's good, i wonder?
Also in 2011, FDA warned about the magnesium deficient related symptom which i experienced but i see more and more prescription of ppi these day.

Anyway there is a nexium coupon in their site and it got $50 off from my copay on my third refill. It's not generic so it was getting more expensive. If you decide to continue, hope that helps at least costwise. Good luck!

Post Edited (Willovercome) : 3/15/2013 12:05:01 PM (GMT-6)


Holly G
New Member


Date Joined Mar 2013
Total Posts : 16
   Posted 3/15/2013 3:16 PM (GMT -6)   
Willovercome...

No, I haven't had an endoscopy yet. I was diagnosed my an ENT.

Do you think it will be hard to get off PPI's after 3-6 months?

Thanks!

~Holly
~Diagnosed with LPR 2-25-13

Willovercome
Regular Member


Date Joined Mar 2013
Total Posts : 105
   Posted 3/15/2013 5:46 PM (GMT -6)   
Holly, I cannot say because everyone is different.
But since i had adverse side effects, i couldn't wait to get off, seeing so many people take ppi for years only to be forced to get off after they frature their bones or something.
Even if you won't have my kind of side effect(heart racing, anxiety) or anything else hopefully, since many minerals and vit are absorbed through stomach acid, long therm use of ppi is NOT recommended for sure. Just talk to your doctor and ask if you can go with at least h2 blockers. Some people need stronger than that(ppi), i understand and you may HAVE TO go with ppi to cure your symptom for now.
I was to go another month of ppi but have talked to my doctor who made sure i did not have heart problem itself(she asked if i had faint spell when my heart was racing. The answer was no), she agreed to get me off the nexium.

It's now 6th day with 75/150 ranitidine(she wanted me to go with 300 at night for two weeks but i wanted to go a bit lower) and doing pretty good. I had not had any episode(the reason i went to the hospital in the first place was that i felt nauseated and felt full stomach even though i ate not much. Losing weight because i had no appetite and couldn't eat very well for weeks ) except right after i eat, naturally i am a little nervous.

Next week i am going to lower the doesage again to 150 at night only and see what happens. They said you can stop cold turky and suffer through it or you can gradually lower the lesser strength drug and stop eventually. I asked the doc if she wanted me to go with my nexium every other day, she said no, just stop.

So, if you really Need ppi, again, you must take it i guess but i saw many, afer taking ppi for a long time, test their stomach acid later and often find out their acid level is not high, even lower than normal. 'Cause you know, as we get older stomach produce acid less not more, they say.
http://www.nutritionreview.org/library/gastric.acid.php
So again, talk to our doctor and always asked option for the possibilities of lesser strength drug.
Wish you the best!

DOGGBONES
Veteran Member


Date Joined Apr 2012
Total Posts : 707
   Posted 3/16/2013 7:30 AM (GMT -6)   
willovercome,
Acid rebound is well documented, we all agree that when you stop ppis cold turkey it happens. I can not find anything about any sort of "enzyme rebound" when stopping them. I would be very interested in reading any studies on this. Please provide a link as to were you form such information.

Snowinsummer
Regular Member


Date Joined Jan 2013
Total Posts : 40
   Posted 3/16/2013 7:36 AM (GMT -6)   
Hi Holly,

I was going to mention the same point about H2 blockers as Willovercome. If PPIs aren't working for you, try Zantac or Pepcid etc. instead. They are not as efficacious as the PPIs, but they still work to reduce stomach. I switched to Zantac after 2 months on a PPI, and other than a feeling of heat in my belly for several days, which was annoying but not painful, the transition was relatively easy.

Willovercome
Regular Member


Date Joined Mar 2013
Total Posts : 105
   Posted 3/16/2013 3:24 PM (GMT -6)   
Doggbones,
the links are all not in English but the zest is, as now i carefully read them, I guess,
first, if you take enzyme and not go to the hospital without knowing the real reason then it's not good. (Duh, right?)
Second, we can assume that it's usually your pancreas or others that produce enzymes to help digest don't work very well that's when you need anzyme intake.
But i got pancreas, gall bladder, liver chekced out and other than one of the 4 number of the liver,(due to the drugs i was taking, my doc seemed to assume. Said don't worry about it) all were normal. So do i still need enzymenor not, i can't tell.
I did have enzyme yesterday because i had dinner a bit too much(for my condition), my stomach was so full i felt like it couldn't move to work properly.(i have a lazy stomach) And it helped actually and i got no heartburn.
If it's safe, great! I am just sick and tired of side effects and naturally weary about the drugs in general.
I will keep look out but as you said, i couldn't find any adverse effect about it in reknown academic journals so far.
Good news, eh?
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