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Gastroenterology (Expert Forum)
Prevacid/Protonix or H2b for GERD/Nausea/Dyspepsia
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Prevacid/Protonix or H2b for GERD/Nausea/Dyspepsia
by mflu, Sep 15, 2004 12:00AM
I wrote a couple of weeks ago regarding Prevacid and nausea/dizziness. After stopping the Prevacid under my GI Dr.’s supervision the nausea remained/got a bit worse and some of the stomach pains came back. (Burning sensation with some off and on nausea relieved by eating large meals).
In the meantime my new psychiatrist has helped to me to start getting my anxiety under control without all of the SSRIs that initially started my stomach problems in the first place. This has helped the dizziness I was experiencing go away so now I don’t believe the Prevacid caused those symptoms).
A few days ago I had a follow-up with my GI doctor to discuss the ongoing sporadic nausea and the return of the burning feeling after stopping Prevacid. (Was only on it 23 days). After reading my detailed symptom journal and taking into account my 100% normal Upper GI Series he still feels I have nothing serious (as in Gall Bladder/Liver/Gastroparesis) however he said dyspepsia (maybe gastritis or GERD not showing up on GI series) could be at work here and has scheduled an Endoscopy next month to take a look.
He also prescribed (samples) for me of Protonix 40mg once a day to see if it helped the dyspepsia/nausea without side effects we once thought were Prevacid. (Or if I felt up to it could go back on the Prevacid for which I have a 3 month supply). My questions for you today are:
1. When nausea is caused by GERD/Dyspepsia/tiny ulcer, how long does it take for a PPI to work?
2. Is Protonix, Prevacid, or Zantac better for my situation? (He talked about all three)
3. If the NSAIDs and SSRIs caused abraisions/inflammation too small to see on the upper GI series, how long would they take to heal on a PPI?
4. In your professional experience with people suffering anxiety problems, which PPI/H2 medication have you achieved the best results with? (Something that may help me decide which way to go.
My Dr. thinks it’s great that I am so proactive in my treatment and doing my research. Your expert advice has been a tremendous help in conjunction with seeing a local GI Dr., thank you so much for providing this service.
In the meantime my new psychiatrist has helped to me to start getting my anxiety under control without all of the SSRIs that initially started my stomach problems in the first place. This has helped the dizziness I was experiencing go away so now I don’t believe the Prevacid caused those symptoms).
A few days ago I had a follow-up with my GI doctor to discuss the ongoing sporadic nausea and the return of the burning feeling after stopping Prevacid. (Was only on it 23 days). After reading my detailed symptom journal and taking into account my 100% normal Upper GI Series he still feels I have nothing serious (as in Gall Bladder/Liver/Gastroparesis) however he said dyspepsia (maybe gastritis or GERD not showing up on GI series) could be at work here and has scheduled an Endoscopy next month to take a look.
He also prescribed (samples) for me of Protonix 40mg once a day to see if it helped the dyspepsia/nausea without side effects we once thought were Prevacid. (Or if I felt up to it could go back on the Prevacid for which I have a 3 month supply). My questions for you today are:
1. When nausea is caused by GERD/Dyspepsia/tiny ulcer, how long does it take for a PPI to work?
2. Is Protonix, Prevacid, or Zantac better for my situation? (He talked about all three)
3. If the NSAIDs and SSRIs caused abraisions/inflammation too small to see on the upper GI series, how long would they take to heal on a PPI?
4. In your professional experience with people suffering anxiety problems, which PPI/H2 medication have you achieved the best results with? (Something that may help me decide which way to go.
My Dr. thinks it’s great that I am so proactive in my treatment and doing my research. Your expert advice has been a tremendous help in conjunction with seeing a local GI Dr., thank you so much for providing this service.
Doctor's Answer
by Kevin Pho, MD, Sep 16, 2004 12:00AM
, Sep 16, 2004 12:00AM
To answer your questions:
1) Normally it takes a few days for a PPI to work to full effectiveness.
2) Protonix and Prevacid are in the same class of medications (PPI). Zantac is an H2 blocker. Typically, PPIs work better than H2 blockers for GERD.
3) Time to heal depends on the severity of the lesion and on the patient. The time it takes to heal can range from weeks to months.
4) I'm not sure that anxiety would play that much of a role as to which anti-GERD medication I would choose. The studies suggest that PPIs have better results than the H2 blocker.
Thanks for your kind words - I would certainly discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
1) Normally it takes a few days for a PPI to work to full effectiveness.
2) Protonix and Prevacid are in the same class of medications (PPI). Zantac is an H2 blocker. Typically, PPIs work better than H2 blockers for GERD.
3) Time to heal depends on the severity of the lesion and on the patient. The time it takes to heal can range from weeks to months.
4) I'm not sure that anxiety would play that much of a role as to which anti-GERD medication I would choose. The studies suggest that PPIs have better results than the H2 blocker.
Thanks for your kind words - I would certainly discuss these options with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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