Question about quititng PPIs

[Theresa526]

I have been taking Nexium 20 then 40 mg 1/day for the last ten years or so.  I am currently trying to get off the medication, but am experiencing very strong symptoms of acid reflux (burning in throat mostly) with EVERYTHING I eat no matter what or the amount.  Is it true that stopping these meds cold turkey can cause excess heartburn in the beginning?  Or is this more likely because my condition is that severe and I need these meds indefinitely?  If the acid rebound is real, how long does it typically last for someone taking these meds for so long?  Also, will supplementing with Zantac 175 and or tums interefere with getting the body better adjusted to not taking the nexium anymore?  Ill take any advice I can get.  My GI is not very helpful.  Thanks!

[HealthQuest]

Hi Therasa526,

Was just wondering if you'd tried stopping the Nexium and how your body responded?  My BF also takes Nexium...has been for two years, 40mg, twice daily...and would really to stop taking it...

[Ratnakar Kini]

Hi Therasa526,
It is not advisable to take PPI for 10+ years. You need to stop the medications. But since you are getting the symptoms of GERD when you are off the drug, my suggestions are -
1. Take another PPI ( not Nexium) along with bedtime Zantac for 4-8 weeks. Take the PPI twice a day just before meals.
2. Life style modifications

Stop the drugs at the end of 8 weeks. If symptoms persist consider surgery.
==================================================
The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.

[Theresa526]

Doc - what are your feelings towards continuing to take these meds for ten+ years?  Should one try to wean off or continue taking indefinitely???  I know all the basics for avoiding gerd and practice them daily.  My concern is with the long term use of ppis.  I am worried about that, so therefore trying to quit...Thanks for your opinion!

[Ratnakar Kini]

Hi Therasa526,
PPI (Nexium) is usually taken for 4-8 weeks. If no relief is found, pH monitoring should be done for confirmation of diagnosis.
If symptoms persists after confirmation and taking PPI, the last resort is surgery.
But one of the most important factors is life style modification -

1. Head elevation while sleeping
2. Small frequent meals
3. Going to bed 2- 3 hours after food
4. Avoiding bed time snacks
5. Avoiding smoking and alcohol
6. Avoiding tight fitting clothes
7. Avoiding cola, citrus drinks, carbonated drinks, tea, coffee, spicy food
8. Weight reduction

Stopping Nexium cold turkey do not cause excess heart burn in the beginning. Supplementing with Zantac also do not interfere.
Bedtime Zantac  in addition to Nexium in fact provides better relief.
------------------------------------------------------------------------------------------------
The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.