Prontonix vs Nexium et al

I was diagnosed with GERD/reflux in November 2002. From November until March I was on Protonix 40mg daily. This seems to do an OK job with symptoms. But after about 12 weeks it seemed that there might be hair loss related. About two weeks ago I was switched to Nexium. For about five days I felt normal - no symptoms on Nexium. Then I developed diarrhea, then this came and went, but the Nexium seems to be doing less well with symptoms. For most of the day my lower throat/esophegus feels very tight, although it does not inhibit swallowing at all. It just feels like there is always pressure on my lower throat/esopohogal area - juts below the adams apple. (I'm a 54 year old male).

Have not yet had my Endoscopy as my travel schedule has constantly intervened.

Worried that the throat tightness inhibits sleep etc. I only had this occasionally on Protonix, but have had it last three days on Nexium?

Should I switch back to Protonix? Try Aciphex? Frustrated a bit that symptoms seem to stick around forever.

Martin

[Kevin Pho, MD]

Hello - thanks for asking your question.

The endoscopy is a wise next step.  This will make sure that the throat tightness you are experiencing is not caused by an anatomical abnormality or cancer.  If that is negative, then focus can be turned to appropriate treatment of your GERD.

There is no consensus study that suggests much difference between the proton pump inhibitors - there are only smaller studies suggesting differences.  However, some patients react differently (i.e. in terms of side effects and efficacy) to different medications.  

You may want to try other medications (like Prevacid or Aciphex).  However if medications cannot control your GERD symptoms, then surgical therapy may be a consideration in the future.  

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.

Thanks,
Kevin, M.D.

[DANCINDEANO]

7/23/03 i have gerd and a non-noticeable small hiatal hernia.i
was taking zantac 150 for many years and now i am taking nexium.
i seem to have gastric distress in abdomen,stomach and gi tract,almost daily, lately. was more or less under control a few
weeks ago. i am 66 yrs. old. i felt my abd.distress may have been
from taking zocor for cholesterol. tried other statins in the past and had similar response with abd.distress. much gas.mostly
at distal end of esophagitis. now have been without zocor for
a week and dr. is putting me on pravachol 40mgs. with zebetia 10mgs. taken once upon retiring in the evening. have nausea from
time to time and pressure of gas under diaphragm. been taking gas
ex to relieve symptoms of gas. i feel that maybe my symptoms are
being generated from meds. i take, such as lopressor 150 (1)daily,xanax(1)daily, nexium 40mgs.(1)daily, vitamin e.400iu with
folic acid(once daily)norvasc 5mg.(1) daily, imbur 60mgs.(1 daily), and starting this week...pravachol 40mgs.(1)daily and
zebetia 10mgs.(1daily).some meds such as pravachol,zebetia,imdur,
norvasc are taken at bedtime; rest are taken in am and around 6pm. i am tired of gaseousness, possibly caused from ibs and/or
hypertension. can you give me some sound medical advice.am under
care of cardiologist and family physician. have had my gb removed about one yr. ago. thankyou. clarence g.

[km64]

A related discussion, Reflux was started.

[grams981]

A related discussion, treatment was started.