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Rebound question-Acid hypersecretion

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GERD & Acid Reflux
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crf
New Member
Joined : Missing Key Value : en-US, 577 2021
Posts : 7
Posted 2/7/2021 3:31 PM (GMT -7)
Greetings...new member here - I fortunately came across this site/forum and have been reading the posts, and getting alot of great info. I have a question and I'm wondering if anyone has experienced what I'm going through. I'll try to be as brief as I can with some back ground info. I'll fail at being brief. I'm sure I'm not as well versed in this as many of you, so please bear with me. I'm no expert. For info purposes, I'm a 62 year old male.

I've been through two fairly recent bouts (last 2.5 - 3 years) of this, and right now I have what my GI is describing as gastritis. Again. Basically inflammation and irritation. Discovered when they did an endoscopy about a month ago. Normal tissue under the irritation, no ulcer, no cancer, no H pylori, no celiac sprue. All biopsies negative. My doc thinks that after taking the Famotidine and Sucralfate, that there was definitely healing going on. I'm very thankful for all that. I do have a small hiatal hernia that they discovered the first time I went through this a couple years ago. I suppose the first time I had gastritis was worse as it affected my intestines and I had alot of diarrhea. Not the case this time...all normal bowel movements.

The first time, I was hospitalized a couple times before they figured out what was going on. I was on Omeprazole and then Ranitidine. Gradually, I got better and I weaned off them and was more or less ok for around 18 months. No symptoms that I noticed. I should mention that I do have other health issues. I'm a heart attack survivor and on meds for that. They stopped the Plavix I was taking for my heart because they thought it was contributing to the stomach/intestinal problems. Years ago, I also had my thyroid destroyed with radioactive iodine, so I'm on meds for that too.

This latest bout of "gastritis" started at the end of last summer 2020. I started having some stomach discomfort. Just didn't feel right. Not really pain, just alot of discomfort and indigestion/dyspepsia. Bad stomach ache every once in a while. During the pandemic, it's very difficult to get into a docs office, so I started taking Tums, then Famotidine on my own. I kind of knew the drill. I would have taken Ranitidine, but it's off the market. I get very bad side effects from ALL these acid reducing drugs. I'm very sensitive to them. The side effects are almost as bad as the condition. I'll never do another ppi...those made me feel so sick, it wasn't even funny. I'll do the H2 blocker, but no ppi's. I already had changed my diet after the first go round, so I didn't have to change it very much again, but I did even more bland foods. I've had to watch what I eat ever since my heart attack back in 2004. I eat fairly healthy.

Anyway, by the time I could talk to my GI doc this time, I was taking Famotidine and trying to handle the side effects. I had the endoscopy and results as I mentioned. He also put me on Sucralfate. That gave me a whole other set of side effects on top of the Famotidine. I took the Sucralfate for about 2.5 months, and the Famotidine for about 3.5 months. I just couldn't take the various side effects any more, so I decided to try and wean off both of them and see what I felt like. Get a baseline and see how I was doing. I did what was probably not quite enough time to wean off the two drugs, but I finally stopped the Sucralfate almost a month ago, and finally the Famotidine a little over two weeks ago. I started taking Tums to help with whatever discomfort I felt. I stopped taking the Tums about 5 days ago and I'm trying to go without taking anything as of now. I know I'm going through alot of rebound effect symptoms from the drugs. I expect that to last quite a while, even though I wasn't really on the drugs for as long as many of you. As I said, I'm real sensitive to these acid reducing drugs. I've seen anywhere from a few weeks to several months to deal with the acid rebound hyper secretion. That's a very tough go, and it HAS been very tough. My body feels better being off the drugs, but my gut knows that I'm not taking them...that's for sure. I'm trying to tough through it.

I guess after boring you with all that, here's my basic question...and I appreciate any and all info.

Does anyone ever get what I've seen referred to as rebound "acid surges"? I get several every day and they're extremely uncomfortable. They can come at any time...I could be sitting at my desk, or having some food, or watching tv, or doing anything else. Feeling more or less ok...certainly not 100%, but ok. All of a sudden, I'll get this kind of flushed feeling. Similar to what a hot flash must feel like for women. I can feel it building in my gut, then it goes up to my chest, then sometimes to my upper back, then sometimes into my arms. I can't describe it any better than that. It's really uncomfortable. I'm hoping that someone has experienced these before and can give me some insight. I don't know how long the acid rebound effect is going to last, but I sure hope it ends soon.

As long as this post already is, I'm sure I left many details out. I thank you for reading and hope to get much more info than I know right now. Bless us all and stay safe!
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SharonZ
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Joined : Mar 2014
Posts : 2385
Posted 2/8/2021 4:52 AM (GMT -7)
CRF:

Your symptoms are certainly something that I have not experienced, but that doesn't mean that other people have the same issues. Have you tried following a strict GERD/Gastritis diet, bland foods aren't always the answer? Are you keeping a food diary to try and pinpoint any trigger foods? Hopefully someone will come around and comment with their experiences, but I must warn you that the Boards are very slow.

Sharon
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crf
New Member
Joined : Missing Key Value : en-US, 577 2021
Posts : 7
Posted 2/11/2021 5:00 PM (GMT -7)
I wouldn't say I'm doing a 100% "strict" gastritis diet, but I'm definitely not very far from that. Very bland with very few exceptions. At this point, it doesn't appear to have a whole lot to do with my diet. I've been eating relatively healthy since my heart attack in 2004. As far as trigger foods, I haven't really discovered any, but as I said, I'm not being adventurous at all. I'm kind of following the info in L.G. Capellan's book "The Gastritis Healing Book". Of course it's sure possible that it could be diet related somehow, but nothing really obvious stands out.

I'm having some very tough days currently, and somehow each and every day is different. I have no idea why. I had some of these exact same flashes/surges back in 2019 when I first had the gastritis problem. Nobody could really figure it out then...not my GI doc, not my endocrinologist, and not my GP doc. However, I know a lot more about it now. I'm sure at least some of it is from dealing with the acid rebound effects, but I'm also wondering if being on the anti-acid meds has possibly messed up some of my blood levels. I won't be able to get a CBC and CMP for another couple weeks when I see my GP. Hard to get in to a doc during the pandemic, and they won't do blood work prior to an office visit. I won't go to the ER unless it's a life threatening emergency. Been there, done that. I'm trying to hang on and hoping to see some kind of light at the end of the tunnel. Thank you for your input.
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WJF
Regular Member
Joined : Sep 2011
Posts : 279
Posted 2/12/2021 2:33 AM (GMT -7)
Rebound is real, my one lasted for 3 months when I weaned off from a PPI.

After you have taken an acid-reducing medication for a long time, the stomach adjusted its acid production output. So when you go off the meds, the acid output is above normal level. Eventually it will normalize.

To help it, wean off the meds slowly and in tiers:
PPI -> H2 blocker -> antacid -> some home remedies that has acid-neutralizing effect

It's good you are no longer on PPI, because that's the toughest to wean off from.

I suggest you use a liquid based antacid, such as Graviscon, instead of Tums. It's easier to control the dosage. You want to take less and less of your meds, and liquid is best: 2tbsp -> 1tbsp -> 0.5tbsp.

The last one in the sequence is some food that you know can calm your stomach which can replace antacid entirely.

Also you are taking quite a number of meds concurrently, you might want to check with your doctor on any drug interaction. I know for sure Sucralfate can hinder the absorption of other drugs.

For gastritis, it's manageable with an anti-inflammation diet: for example cabbages are good for gastritis.

Good luck.
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nick6a4
New Member
Joined : Missing Key Value : en-US, 577 2021
Posts : 1
Posted 2/15/2021 7:58 PM (GMT -7)
Hi new here been on pantoprazole 40 mg for 10 1/2 weeks should i tapper off slowly or just stop. I did not know just how bad this med is to get off of . I am 65 and have heart stens also afib and pacemaker this is how all this started doctor put me on 3 blood thiner -Coumadin-Plavix-81mg aspirin for 1year after heart stens. this gave me a ulcer. so I quit taking all but the plavix for 6 months and uler healed up.then went back on plavic and they put me on Eliquis and back came the ulcer.so went to the gastrologist for help and they put me on this da%$# pantoprazole.so 5 day before i am to get a watchman put in my heart get off the blood thinners i find out how bad pantoprazole is. seems you can't trust any doctors anymore I asked if I could take this long-term and they toll me yes. any info would be great--thanks
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crf
New Member
Joined : Missing Key Value : en-US, 577 2021
Posts : 7
Posted 2/16/2021 6:20 AM (GMT -7)
Hi Nick6a4...I certainly can relate to some of what you're going through, and understand your situation. Please realize I'm no doctor and wouldn't presume to give someone definitive instructions as to what to do in their life. Everyone is different and has different reactions to meds etc. I can tell you my experience. I'm 62 and I had a heart attack back in 2004. A "widow-maker" LAD blockage. I had several stents put in and I was put on Plavix at that time. Generally, people are on Plavix for a year or so, sometimes a little more. I was on it for 15 years at my cardiologists recommendation. Probably WAY too long. When I had my first episode of gastritis, they finally took me off the Plavix because it was determined that it was a major contributor to my stomach/intestinal issues. I also take an 81 mg aspirin, and according to my GI doc, that alone can cause stomach upset and problems. I've always been told to make sure to take the aspirin with food, not on an empty stomach.

As for the PPI (pantoprazole), my understanding is this...and as others will I'm sure tell you...do NOT quit cold turkey. The rebound withdrawal effect from stopping any PPI or acid reducing drug is very real. You need to wean off them very carefully and do it over a drawn out period of time, gradually reducing the dosage. Then maybe going down to an H2 blocker for a period of time, then maybe finally down to plain antacids like Tums or one of the liquids. There are plenty of posts about how to do it. Your doc may not even feel it's necessary, but it is. If you quit cold turkey, you'll get hit with the rebound and your body will make more acid than before you started taking the PPI. The rebound effect can be very bad and I'm sure it's part of what I'm dealing with now. I did a PPI the first time I had gastritis 2-3 years ago and weaned off it slowly. I got another bout of gastritis at the end of last summer, and I only took Famotidine, which is an H2 blocker. I'll never do another PPI again. I get bad side effects from all these acid reducing drugs...PPI's and H2 blockers. Your stomach needs acid and the drugs shut all of it down. Your body needs to adjust to the lessening of the drugs to hopefully return to "normal" acid levels. Whatever that may be for you.

One more thing...you also should make the necessary dietary changes to help your body heal. If you don't do that, you'll just keep feeding the problem. Again, this is only my experience and opinion. You should discuss all of your issues with your doctor before doing anything. I hope some of that answers your question and helps a bit. Best of luck with your situation.
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SharonZ
Forum Moderator
Joined : Mar 2014
Posts : 2385
Posted 2/16/2021 6:26 AM (GMT -7)
nick6a4:

Since you are also on other medication and have a pacemaker - you should really contact your doctor about a tapering off plan - just to be safe. FYI - I was on Protonix for most of my adult life (I'm in my 50's), and it helped me greatly without any side effects. Any medication that you take is listed as having side effects on the internet.

Sharon
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