Digestive Disorders / Gastroenterology Expert Forum
Long term use of Prevacid
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Long term use of Prevacid


  I have been taking 30mg of Prevacid daily for two years for GERD. I also had been suffering with severe burning pain under my left shoulder blade. Since beginning the Prevacid, my life has changed completely. No reflux, and more importantly, no shoulder pain.  
  But now, my GP does not want to allow me to continue the Prevacid stating that Prevacid COMPLETELY stops the production of stomach acid and without some acid, my body will not absorb the essential minerals it needs. He took me off Prevacid and I have been taking 300mg of Rantinidine daily. Although it helps somewhat with the reflux, the buring pain is back and my quality of life has deteriorated.
  I have not lost any weight, I am very fit, alll bodily functions work as they should... I would think if I was mineral deficient, there would be physical manifestations...
  Does Prevacid completely stop acid production?
  Can I be tested for mineral deficiencies?
  Please help, I do not want to continue with this pain..
  My doctor suggested Propulsid.After doing some research on it, there is no way I would take that drug...
  Thanks
______________
Dear Rich:
Prevacid is a Proton Pump Inhibitors (PPI), a drug that directly inhibits stomach cells to prevent acid secretion. The FDA recommends  Prevacid for short term (6-8 weeks) treatment of erosive esophagitis, gastric ulcer, duodenal ulcer.  Long term use is recommended only for Z-E syndrome (abnormally over production of gastric acid).
Prevacid 30 mg daily dosing can suppress 99% of the gastric acid production.  Due to the decreased level of gastric acid while on Prevacid, the absorption of some of the essential nutrients may be interfered. For example, iron absorption is reduced because its absorption is facilitated by gastric acid. Whether you have iron deficiency or not can be tested easily by measuring of the blood iron and its storage levels Currently there is no evidence for adverse effects with long term use of Prevacid, although atrophic gastritis (thinning of the stomach lining) may occur in some cases.
Ranitidine is a compound that also inhibits acid secretion. It works by a different mechanism than the PPI and is not as effective.  Ranitidine is often given with a prokinetic agent e.g. propulsid (see below).
Propulsid is used to promote gastric emptying and to strengthen the lower esophageal sphincter, the barrier between the stomach and the esophagus.  This drug is safe although changes in cardiac rhythm can occur if patients take propulsid with several other medicatiojns.
While medical treatment is important in managing GERD, life style modifications are equally important if not more.  These modifications include sleeping with the head elevated, avoiding alcohol, cigarettes, tomato products, chocolate, caffeine rich beverages and large meals late at night. You may also discuss your concerns with a gastroenterologist about other treatment options for your reflux such as surgical intervention.
This information is for educational purpose only. Always consult your doctor for specific medical problems.
HFHSM.D.-rf
*keywords: esophageal reflux
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