Why 6 months of PPIs?

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lostsub
Regular Member


Date Joined Feb 2013
Total Posts : 49
   Posted 6/19/2013 10:00 PM (GMT -6)   
Hello all. I've had GERD or LPR or whatever it is for some time. Let me clarify: I've had a sore throat for 9 months but no heartburn. The GI did an endoscopy and said my esophagus was inflamed and he diagnosed me with NERD. After 3 months of a single dose of 40 mg of a PPI, there was little if any improvement. After reading a lot on these forums that a single dosage was not aggressive enough, I switched to Nexium twice a day (total of 80 mg) with a strict, low-acid diet. Just when I thought I was seeing some improvement (after four months of that), I awoke today with a terrible sore throat that has lasted all day.

The GI here at home (I live overseas during the year) doubts that it's reflux but has schedule a ph test next month. My regular doctor said he thinks it's reflux and I haven't seen an ENT yet. The dentist today noted that there doesn't appear to be any tooth erosion. So my question is this:

For those who claim it does take 6 months of an aggressive PPI use, my question is: why? Why does it take 6 months of 80 mg a day? Has anyone actually had any success with this. I'm worried about the surgery route, as I'm only 26.

Any help would be appreciated.

Bureaucrat
New Member


Date Joined Apr 2012
Total Posts : 6
   Posted 6/20/2013 9:54 PM (GMT -6)   
lostsub-

To your question, I don't recall that it took me 6 months for the PPIs to have a beneficial effect. I think it was probably more like 2 months where I started to heal and I did have success. 6 months seems like a long time and 80 mg per day seems like a pretty high dose to me (this is what I was taking after 12 years of PPI therapy) but then, I'm not your doctor.

Just some more thoughts and I'm not trying to preach, just some things to consider...

For 12 years before I had my hill repair surgery (please see the thread, "Hill Repair..success so far"), I took up to 40 mg of Omeprazole (prilosec) twice a day for my LPR. Each year, I had to increase the dose in order for it to work. While I think that PPIs can be very effective in the short tern, if you take them for too long, you run the risk of developing osteopenia due to an inability to replace calcium in your bones - it essentially weakens your bones and can also lead to osteoarthritis. I have osteopenia now at age 54.

Check this out: http://www.ehealthme.com/ds/prilosec/osteopenia

You probably know this but if you do have GERD or LPR at such a young age of 26 and you let it go unchecked, you run the risk of developing strictures (scar tissue that closes your esophagus which you have to have stretched or dialated in order that you can eat again) and Barretts esophagus which could lead to cancer. If you can manage it through lifestyle changes like changes in your diet, great. But if you can't and you have to use PPIs for awhile, it could become problematic for weakening your bones. So, at some point, you have to weigh whether it is worth it to stay on the PPIs or have surgery. At least, that is my story. I opted for the surgery and have not regretted it. Had I known that I could have avoided getting osteopenia and having strictures all the time (I had six and they sucked!), I would have forgone the PPIs and had the surgery a long time ago.

Good luck. I really hope you don't have LPR or GERD. But if you do, there are different options that do work. Take care.

Post Edited (Bureaucrat) : 6/20/2013 8:57:38 PM (GMT-6)


lostsub
Regular Member


Date Joined Feb 2013
Total Posts : 49
   Posted 6/22/2013 4:26 PM (GMT -6)   
Thanks for your advice. I had an appointment with an ENT yesterday at the Cleveland Clinic and he shares the GI's skepticism that it's acid reflux. They did a video scope and said it technically could be reflux but they weren't seeing the usual warning signs. Anyway, the PH Bravo test will be in about a month, so we'll see. Thanks again.
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