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Old 09-12-2015, 10:02 AM   #21
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Low stomach acid does result in nutritional deficiencies such as low vitamin B12, and it does make the stomach more susceptible to bacteria such as H. Pilori (ulcer bacteria), parasites, and other microbes.
I think long term users should also be on a good multivitaman.
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Old 09-12-2015, 10:19 AM   #22
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Great topic!

I have been taking PPIs for about 15-20 years due to very bad acid reflux at night. I have tried weaning myself off over the years but the results have not been good. I have also read the warnings about increased chance of fractures and there was a recent study potentially linking PPIs to increased chance of heart attack (although I don't think this was really a scientific conclusion but just to point out the need for more study)

Even though I take 15 MG of Lanzoprolol (Prevacid) a day, I still will have issues on some nights. I had heard of the wedge style pillows for helping with acid reflux at night but hadn't tried one until recently (about 2 months ago). I started using the InteVision Folding Wedge Bed Pillow. Let me tell you that this really worked! I have not had an issue with reflux since I started using one. I cannot believe I waited so long to try one of those pillows. I also have been avoiding sleeping on my right side when falling asleep since I read you can have more issues with reflux when sleeping on that side. Both of these has worked wonders for me!

I am working with my gastroenterologist to try weaning myself off PPIs starting this week. I have Pepcid to use if I have a bad night. Wish me luck!
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Old 09-12-2015, 10:38 AM   #23
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I have tried changing my diet. Certain foods worsen the reflux. But even adhering to the diet, plus taking tums, I would still get many incidents of the hacking cough, especially at night. Sleeping with extra pillows didn't work. So much easier and effective to just take the 15 mg Lanso every morning. Every other day is not enough. Cough comes back. I'm going to try skipping every third day.
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Old 09-12-2015, 07:36 PM   #24
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Great topic!...
I am working with my gastroenterologist to try weaning myself off PPIs starting this week. I have Pepcid to use if I have a bad night. Wish me luck!
Good luck! And can you describe your upcoming weaning process?
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Old 09-13-2015, 06:01 AM   #25
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Good luck! And can you describe your upcoming weaning process?
My gastroenterologist had me use both Lanzoprolol (morning) and Pepcid (before bed) for a couple of weeks. I am first stopping the Pepcid for a week. Then I will be switching to every other day of the Lanzoprolol and then stopping that altogether.

I also wanted to be clear about the wedge pillow: I also have attempted to sleep with several regular pillows over the years with no luck. The wedge pillow has worked wonders for me over the past months.
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Old 09-13-2015, 09:13 PM   #26
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Similar story here. On and off omeprazole for years. Things that really aggravate reflux: high fat or protein diet, too much caffeine, chocolate. and all alcohol aggravates it the worst. However, we have a sleep number bed in which the head can be elevated, and even the smallest tilt helps a lot.

One last thing, for me, swimming can aggravate it unless I swim on an empty stomach (first thing in the morning.)

Excess use of PPIs can cause bone loss, so I only take the omeprazole a few days at a time, take a senior vitamin which has a larger amount of vitamin D, and an occasional Tums. Another risk is pneumonia, from reflux without the acid. I want to avoid Barrett's esophagus which may lead to esophageal cancer.

Had no problems when I lost weight a few years ago but I regained it. So, I'm trying to lose it again, watching my diet and alternating between 3 mile jog/walks and swimming.

A few bits of advice: most Calcium antacids have sugar in them, so take at least 30 minutes prior to bed and brush your teeth well. Do not take antacids in excess of the recommended daily amount, or you could end up in the hospital with hypercalcemia and kidney insufficiency, especially if you are on a thiazide diuretic, which happened to a friend of mine. Last, a high protein diet and excessive food will tend to aggravate reflux rather than carbs, which are not digested in the stomach. Someone suggested too much carbs was causing a reflux problem, but carbs contribute little or nothing to reflux, unless the but the problem may be too much food.


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Old 09-14-2015, 07:07 AM   #27
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Someone suggested too much carbs was causing a reflux problem, but carbs contribute little or nothing to reflux
That was probably me, with the anecdote that my problem nearly vanished when I switched to a LCHF diet.

But it's probably more accurate to say that we don't know for sure exactly what causes it, except that we become more prone to it as we get older.

Here's a very interesting explanation from a doc I respect:

GERD: Treat it with a low- or high-carb diet
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Old 09-15-2015, 04:03 PM   #28
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That was probably me, with the anecdote that my problem nearly vanished when I switched to a LCHF diet.

But it's probably more accurate to say that we don't know for sure exactly what causes it, except that we become more prone to it as we get older.

Here's a very interesting explanation from a doc I respect:

GERD: Treat it with a low- or high-carb diet
Very interesting article.
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Old 09-16-2015, 05:23 PM   #29
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A wise man once said "Show me a drug without side effects and I will show you a drug without effect." All pharmaceutical use is a risk-benefit calculation. To a GREAT extent you are required to trust your doctor to help you make the calculation. If you don't trust you doc, get a new doc. My doc recently put me on a new drug (not for GERD) but said do NOT read the side effect profile! He told me instead to report any side effects to him. I trust him, so that is how I am proceeding.

I have been using PPIs since they became available (forget how long - almost 20 years?) They work most of the time and I accept that there will be side effects which may not all be known at this time. I agree that using the smallest dose that works is a good idea. I agree that life-style changes (which may or may not work) are a better way to approach many diseases/conditions. Realistically, however, life-style changes are difficult for most of us. A pill which alleviates some of the "penalties" of less-than-perfect life-style is a bargain I'm willing to make in some cases (not all.) By the way, guys, you shouldn't read the side effects on the ED treatments either (or so I'm told.) Naturally YMMV.
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Old 09-17-2015, 11:18 PM   #30
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My dad had reflux for many years before PPIs were available despite being thin, having a dislike of "greasy" food, being a minimal drinker, etc. He eventually developed an esophageal stricture which causes recurrent problems with food becoming stuck and which requires periodic, somewhat dangerous stretching procedures under anesthesia. He has taken PPIs since they became available, but the damage was already done. It's a pretty miserably uncomfortable problem and I would want to prevent it, if it were my esophagus.

People who take PPIs have lower B12 levels, but not to a degree that causes a problem. My dad's level is fine. My dad does have mild osteoporosis -- as did his father and his sister who didn't take PPIs.
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