PPI's, are they safe or not?

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worrywort87
Regular Member


Date Joined Jun 2013
Total Posts : 195
   Posted 4/21/2014 5:58 AM (GMT -6)   
Hi,

I started taking my prevacid again after I thought that my acid reflux was giving me breathing problems and I was deathly afraid that it would cause an adult-onset of asthma. I have been on prevacid for about a month now but the internet is drowning in horror stories and negative information on PPI safety, specifically for the long term. I had taken prevacid a couple months before, also for about 1 month duration, and when I stopped taking it I got the worst rebound heartburn imaginable, many MANY times worse than before I ever started the medication in the first place. After about a week of enduring the pain, it eventually went away and I got my "normal" GERD symptoms back.

Are PPI's safe or not for long term use? Are there really no alternatives besides losing weight and eating like a prisoner? I cannot leave my GERD untreated but I also cannot continue a long-term use of PPI's. What options do I have left... What on Earth do I do?

1039smooth
Veteran Member


Date Joined Sep 2013
Total Posts : 2114
   Posted 4/21/2014 7:06 AM (GMT -6)   
No, they're not good for the long-term.

My option was surgery, a Nissen Fundoplication, because damage to me esophagus due to GERD was evident.

There may be a PPI out there best-suited for you that you have yet to discover. Don't know.

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 4/21/2014 8:22 AM (GMT -6)   
Define "safe"

Andy1986
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Date Joined Dec 2012
Total Posts : 1178
   Posted 4/21/2014 8:49 AM (GMT -6)   
I've been on PPIs for 2 years, during that time I was also on what my doctor described as "industrial doses of PPI so strong it would cure an ulcer in a rhino". They may have had side effects but I have not noticed anything. My latest blood tests were normal apart from a slightly elevated liver enzyme but they'd been messing with my medication just before.

I take calcium supplements daily in an easy to digest form (not the cheapest pills) because over the long term PPIs can harm calcium uptake and therefore bone health. Thats the main long term side effect of PPIs that I've come across. Other websites have so much scare stories about PPIs, just remember that a lot of these websites are anti drugs altogether, and are not really aimed at people that have full blown gerd, more those with occasional heartburn that dont need PPIs to live a normal life but take them anyway.

Focus on what gets you feeling better now, if you haven't had an adverse reaction from PPIs in a month then you will likely be fine long term. Its good to have blood tests after you've been them on a while to make sure everything is running smoothly.

Rebound heartburn is normal when stopping PPIs, and should be treated with oral ant-acids to instantly neutralise excess acid. Or you can do a gradual reduction of PPIs rather than going cold turkey which is a far better way to do it.

Surgery may be a good solution for you long term, but dont rush into anything because you are scared of the drugs, some people have been on them 20+ years and are fine so being on them for a few months or a year will be ok. I've spoken with other people who's gerd has just disappeared after a while too so there is always hope.

Post Edited (Andy1986) : 4/21/2014 7:54:07 AM (GMT-6)


javery
Regular Member


Date Joined Sep 2013
Total Posts : 262
   Posted 4/21/2014 8:57 AM (GMT -6)   
The biggest thing with PPI's are that they suppress acid production which leaves your body with no way of breaking down foods in order to digest them. What this causes is that your body is no longer getting all of the nutrients it needs from the foods. When on PPI's, I would think that you should take an acid supplement so your body has a way of breaking down the foods along with other nutrient rich supplements to make sure you give your body what it needs. Main problems of being on PPI's long term tend to be due to vitamin deficiencies. But when on PPI's, all you are basically doing is masking the symptoms. What should be done is finding the underlying problem that is causing the symptoms and fix that. Most traditional doctors are all about knowing about drugs to help with symptoms and rarely try to find the underlying cause and fixing that. I wouldn't say that they are completely at fault for this as it is the education system that teaches them to be this way. Because of this it is up to us to become more educated so when we see a doctor for a problem we can use it more as advice rather than "this is what I need to do because my doctor said so".

With this said PPI's aren't necessarily not safe, it's just that they are not safe long term if you don't counteract against the drawbacks of using them. I would say they are safer than some of the other drugs that alter the chemical balances in your body. In some cases the benefits of the PPI's may far outweigh the cons of using them. I also think most of us are put on them for no good reason other than the doctor doesn't really know what to do so they just have a pool of symptoms that PPI's are used for and if the patient no longer has the symptoms after being put on them, they leave it at that.

Jendodd
New Member


Date Joined Apr 2014
Total Posts : 15
   Posted 4/21/2014 10:19 AM (GMT -6)   
Sorry to sound dumb but what are PPI 's ?

javery
Regular Member


Date Joined Sep 2013
Total Posts : 262
   Posted 4/21/2014 10:21 AM (GMT -6)   
Proton Pump Inhibitors.

A common OTC is Prilosec and a common Rx is Nexium.

You may also see the term H2-blocker which is a weaker form similar to the PPI's. Common H2-blockers are pepcid and zantac.

Mouche
Regular Member


Date Joined Feb 2014
Total Posts : 141
   Posted 4/21/2014 11:03 AM (GMT -6)   
javery said it all in a nut shell, I'm in the process of tapering off Nexium with my doctors help. But he did stress to me how important it is to be at a health weight as this could really help with symptoms and to eat much healthier with smaller meals. I believe it helps too as I have lost 15lbs and can tell a big difference, I know it's hard, I do miss all the foods I love, but I rather do without than to keep dealing with all these symptoms or masking them with ppi's. I have to keep telling myself the drugs can't cure me, but I can try to do everything possible to make the situation better.

Worrywort87, have you been diagnosed via test EDG, etc etc?
I only ask, because so many have gone to their docs only to be given ppi based on their symptoms before it's confirmed.
TO GOD BE THE GLORY!!!

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 4/21/2014 12:23 PM (GMT -6)   
Doctors use PPI's not only to treat symptoms, but as a diagnostic test for GERD as well. That is the preferred method they use to confirm the diagnosis (without additional testing).

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 4/21/2014 12:25 PM (GMT -6)   
javery said...
The biggest thing with PPI's are that they suppress acid production which leaves your body with no way of breaking down foods in order to digest them. What this causes is that your body is no longer getting all of the nutrients it needs from the foods.


Not to be a stickler but are there any studies or evidence that you can point to for this assertion? I understand that it makes sense, but a lot of times in medicine making sense isn't enough. There have been plenty of things that I would think that have been disproven via studies. So I tend to be cautious about these things.

Mouche
Regular Member


Date Joined Feb 2014
Total Posts : 141
   Posted 4/21/2014 12:53 PM (GMT -6)   
@theacidrefluxman, so true about doctors using the ppi's as a diagnostic method, because when my doctor gave me Nexium she stated that if this helps then it is more than likely reflux. But I don't think they know for sure unless test are preformed. That's why I wanted a test to know for sure. Are you a long term user of a ppi ?
TO GOD BE THE GLORY!!!

javery
Regular Member


Date Joined Sep 2013
Total Posts : 262
   Posted 4/21/2014 1:24 PM (GMT -6)   
theacidrefluxman said...

javery said...
The biggest thing with PPI's are that they suppress acid production which leaves your body with no way of breaking down foods in order to digest them. What this causes is that your body is no longer getting all of the nutrients it needs from the foods.


Not to be a stickler but are there any studies or evidence that you can point to for this assertion? I understand that it makes sense, but a lot of times in medicine making sense isn't enough. There have been plenty of things that I would think that have been disproven via studies. So I tend to be cautious about these things.


The way I came up with this assertion is because it is said by multiple sources that PPI's are used for acid suppression. Although I have not found any studies that show how much acid is suppressed by these medications, I have seen numerous times that they can suppress acid almost 100%. I have also done research on why some of the long term effects happen while on PPI's and from what I gather is that the reason why there are deficiencies is due to there not being enough acid to break down the foods. Based on this information I did research to determine what is needed in order for our digestive tract to work correctly and found that in order for our bodies to digest food properly, it needs to be broken down by stomach acid. All of this makes me have a theory of why long term effects happen when on PPI's. I also understand that everyone will react differently and one form of PPI medication may not work the same for one person as it does another and not everyone that takes PPI's will experience the long term effects.

Why it makes sense to me is through experience I have noticed a difference in how long it takes for my stomach to empty since I stopped taking PPI's. I have also noticed energy increases and being able to be at the same energy levels on less sleep. But again it is my experience which may be different than other's experiences. I understand where you are coming from though as I question everything I see. I don't rely upon one resource or one study for anything. I tend to research a specific piece with multiple resources and then start to tie things together to come up with an answer.

Article that shows different PPI's and how much they suppress acid: http://www.medscape.com/viewarticle/754326_3

This article includes a lot of information that I see among many different sources referring to the importance of stomach acid and side effects of not having the correct levels of acid: http://primaldocs.com/opinion/the-truth-about-stomach-acid/

This article has information regarding some of the effects regarding PPIs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974811/

To me these sources, plus many more, only provide pieces to the puzzle. I have not yet seen a study or any evidence that puts all the pieces together, but based on studies, articles, knowledge that tends to be common among many sources, and my own experiences, I've pieced together an answer that makes sense to me. I also understand that this may not make sense to some as they have tried things based on this reasoning and had unsuccessful results, but that just might be due to the underlying problem itself.

So far I have not seen anything that goes against this information either. I've seen a lot of conflicting information on how to treat GERD or "cure" it, but nothing that disproves any of my research.
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