Effectiveness of PPI's

[Toeboy]

Further to an earlier posting on 06/12, I found that a dose of 2000mg (400mg with meals and at bedtime) a day of cimetidine was inadequate to reduce the pain in my stomach (duodenal ulcer, erosions of the stomach lining, HP-ve, not using NSAIDS) and control the heartburn (which has started since I finished helicobater treatment that I didnt need) and diarrhoea.

I am now taking 30mg lansoprazole twice a day and I am taking it properly before meals to get the best results.

The problem is that if I take a tablet at 7am before breakfast, by 2pm I am already starting to get burning in my chest and abdominal pain. When I take my second tablet at 6pm the pain has gone within an hour and seems to last until morning.

I should only have to take 1 dose of 30mg a day to eliminate all the symtoms so how come it only seems to last a matter of hours??? I read that it should last 24-72 hours!! Has anyone else experienced such a short benefit from a PPI?

[nanci]

Yes, Me!  I am taking 80mg of Nexium a day plus over the counter acid blockers.  40mg of Nexium is suppose to last 17 hours (it's time released).  I take one in the AM and one around 5:50PM.  I wake up with burning and pain which will last most of the morning,  Have some relief in the afternoon for a few hours.  The burning is tolerable but the discomfort in my stomach, like a gnawing pain, will last most of the day.  I've had a particularly bad day today in the office and been suffering all afternoon.  

I have a doctor's app't in a few days so hopefully, he can shed some light.  I don't want to take PPI's forever, especially at the dosage I'm on now.

[hounddog]

I also take 80mg of Nexium per day, plus 250mg of Zantac. I started at 20mg Nexium and worked my way up to a dose that actually made me feel better. My doctor told me people metabolize these meds at very different rates, and that it is not uncommon for younger women (20-35) especially to need more than the one-pill-per-24-hours regimen. I, too, wonder how we are ever supposed to cut back on these..."Concerned lady" may appear and post some of her tips about acid reflux and indigestion...

[feelbetter]

Hi. I was on prilosec for 3 years with little relief and nasty side effects. I found this forum and I saw a Concerned Lady post and I learned about DGL. I stopped taking prilosec in Feb. and I have almost complete relief from my reflux. I no longer suffer with pain that could ruin my whole day. I can make plans without worrying that I may have an "attack". (my reflux was more pain than actual acid backing up) I know some remedies that you hear about seem too good to be true (and of course, many of them are) but I would swear by the DGL. It has really helped me and I cannot wait to see my Gastro doc and let him run his tests so I can show him how well I am doing. (he was skeptical when I asked him about DGL and told me it would raise my blood pressure which it does not and my blood pressure is still perfect)All I am saying is it is worth trying other routes if the meds give you trouble. Best wishes to you all.

[dabadew]

What is DGL? What exactly does does it do? I have the really tight feeling in my throat & a rubber band feeling around my upper stomach. Nothing can touch my stomach (clothing)  & if there is a breeze it makes my throat really tight & uncomfortable,my stomach too. Does any of this sound famaier?

[Toeboy]

DGL is Deglycyrrhizinated Liquorice. It tastes bad and did nothing for me.

[needabreak]

I have to tell you, I was taking Prevacid and had terrible side effects, one being stomach pain which I didn't have before the medication!  I am now taking DGL, thanks to the advice of Concerned Lady, and just yesterday had my endoscopy done.  There was NO sign of irritation, inflammation, gastritis,or ulcers in my esophagus or stomach.  I'm not sure that I can make the claim that the DGL and aloe juice I've been using (along with Probiotics) "healed" me or not, but I know from my own research that DGL stimulates the production of prostaglandins, that promote healing to the whole gastrointestinal tract and especially the stomach.  If you're curious, do a little research of your own on the web.  I haven't had any reflux in a long time, except for maybe once, when I used Gaviscon and was fine.  But, that was my fault for eating something I shouldn't have.

[nanci]

How long did it take before you noticed the effects of DGL.  Can you take this while on PPI medication.  I would love to
wean off Nexium.  I have gastritis and little reflux.  

Can you share how you took DGL and aloe juice.  And how long does it take?

[needabreak]

Hi nanci,
First of all, yes, you can take DGL with your PPI. I take two DGL (chewed slowly to mix with your saliva) before each meal and when I first started taking it, also took 1-2 before bed, depending on how my stomach was feeling.  The aloe vera juice, I mix with a little diluted juice (or TANG), usually an ounce or so in the evening before bed.  Aloe is VERY healing also for your digestive tract.   How long it takes before you notice an improvement probably is different for everyone.  For me, because my system was so screwed up from the PPI and I was having some pretty nasty stomach pain, it took me longer, (3 weeks?) because I was also weaning myself off the Prevacid at the time...and it took awhile to get it all out of my system.  I think "feelbetter" got results much quicker.  The DGL tastes very "different" and a bit "yucky" at first (like strong licorice) but I really am used to it now and don't mind the taste at all.  I really hope you find relief with this.  I believe it is the way to go.

[Toeboy]

Does DGL have a laxative action?

[Abbey]

Where would someone buy DGL...thanks.

[Concerned lady]

Thanks, Needabreak, for sharing your experiences with the DGL, etc.

I'm going to do a "cut & paste" of some GASTRIC REFLUX TIPS (without acid blockers!).

The DGL does not have a laxative effect. DGL can be bought at health food stores and good pharmacies. (See the "tips" below!)

It takes a different amount of time to see good results, for each person. The tips below have more ideas, in addition to the DGL.

**********************************************************

Some GASTRIC REFLUX TIPS (without acid blockers):

GER=Gastro-Esophageal Reflux. (Gastro=stomach. Esophagus=food tube.)

LPR= Laryngeal-Pharyngeal Reflux. (Larynx=voice box, containing the 2 vocal cords. Pharynx=throat, above the larynx. The larynx is above the trachea/windpipe.)

Reflux=acidic or alkaline stomach material that backs up into the esophagus (food tube), causing any of these problems: VCD/Vocal Cord Dysfunction/Laryngospasm attacks, cough, voice problems, asthma, globus (feeling of lump in throat), constant need to clear throat, worsening of sinus condition, sore throat, pre-cancerous conditions of throat &/or esophagus, etc.

SOME GER/LPR CONTROL THINGS WE DO, that we learned from the excellent book: STOMACH AILMENTS AND DIGESTIVE DISTURBANCES, by Michael T. Murray, N.D. See page 9, References, in my website: http://cantbreathesuspectvcd.com   and, also see GER/LPR info on page 5, and on LINKS page.

PLEASE READ THIS GREAT BOOK. It may possibly be bought on-line, from Michael T. Murray’s website.

Some of the following we learned from people &/or other books, &/or other good websites about voice, GER, etc.

(1) DGL (De-Glycyrrhizinated Licorice) is one of our main methods of controlling the GER/LPR. We use Enzymatic Therapy brand DGL, shortly before ALL meals (breakfast, lunch, supper). The DGL does NOT cause high blood pressure, and does NOT cause fluid retention/edema, because the bad (steroidal) part of whole/crude licorice has been removed, leaving the DGL. DGL is available at most health food stores, and at good pharmacies.
  
The DGL tablet(s) must be chewed, to mix with saliva, to be effective. If it is too dry, one could mash/crush it and mix with a little water, and then chew it up. Chew tablet(s) for about 10 seconds (at least), to thoroughly mix with saliva, shortly before EVERY meal, and if necessary, between meals (Read label directions).
  
The DGL seems to not only promote healing of throat, esophagus and stomach, but also seems to help prevent OUR reflux.(resulting in no more globus/lump in throat sensation, no more constant throat clearing, excess mucous, excess phlegm, no more NIGHT-TIME VCD/Vocal Cord Dysfunction/Laryngospams attacks, no more laryngitis, etc. for us)

We like the taste of the plain, fructose-free, DGL CHEWABLE tablets, but for those who hate the taste, try mixing the crushed tablet with a tiny bit of mashed organic banana, and then chew thoroughly, to mix with saliva. Avoid any DGL that contains mint. (Mint—in all forms, can cause gastric reflux episodes. AVOID MINT!!).

(2) We use Thayers brand of SLIPPERY ELM Throat Lozenges when we feel the need. (Soothing, coating, healing, nourishing). Slippery Elm (inner bark from a tree) also comes in teabag form, or in bulk, etc. as an herbal supplement.

(3) We drink the occasional small glass of CARROT JUICE (organic, fresh) which soothes, coats, heals the digestive tract, is nourishing, and stimulates the immune system, with beta-carotene, soothing and coating PECTIN (a type of fiber), and other good nutrients. (Carrot soup, cooked carrots are also good. Beta-carotene is heat resistant.) (Beta-carotene later is turned into Vitamin A inside us). Do not overdo. If your skin turns orange, cut back on the carrot juice. Avoid beta-carotene pills -- too potent.

(4) We tried elevating the head of the bed a few inches, by putting 6 inch to 8 inch BLOCKS, ON THE FLOOR, under the head end of the bed. This creates a slant (tilt), where the head is 6 to 8 inches higher than the feet. This helps some people, but not all people. (Check with a pediatric Gastro-enterologist, about raising the head end of a bed of a child, or a crib of an infant). Also, see (16) about a special GERD PILLOW, for adults.

(5) We try NOT TO BEND OVER too often, and we try to AVOID STRAINING (Valsalva maneuver). We AVOID LIFTING HEAVY objects. (No weight lifting!) (at least until after no more reflux symptoms for 3 months).

(a) If CONSTIPATION is causing any straining, see Ref.15,18,23,24,25 on page 9 for ideas about gently treating constipation, including eating whole grains, not white (de-natured ones), etc.  For us, exercise, increased water intake, acidophilus/bifidus, digestive enzymes, avoiding junk food, improved diet, chewing slowly (takes will power!), eating when not under stress or angry, etc., all are helpful.

(6) NO MORE TIGHT pants, belt, corset,--AVOID TIGHT CLOTHING etc.

(7) We try to not eat too much junk food. Some people avoid acidic  food, while others need to eat acidic food, if their stomach is not producing any (or enough) acid. (It is good to avoid acid, if one has an ulcer.) These gastric reflux tips methods often can help to heal ulcers. Some people need betaine hydrochloride supplements, which becomes HCl/hydrochloric acid, or, some use vinegar (acetic acid) in salads, or mixed with water, while others need to avoid eating excess acid. Each person is unique. We avoid all artificial sweeteners. Anyone with diabetes might want to look at the excellent book Reversing Diabetes, by Dr. Julian Whittaker, M.D..

Diet soda pop contains the harmful artificial sweetener Aspartame (Equal/Nutrasweet), which can cause WEIGHT GAIN, HEADACHES, UPSET STOMACH, BLURRED VISION, BLINDNESS, TWITCHING, SEIZURES, BRAIN TUMORS, HYPERACTIVITY, MOOD SWINGS, ETC., and soda pop often has strong acids, plus other harmful artificial ingredients. Plain water, gentle herb teas, certain fruit juices, brown rice-milk, etc. are healthier substitutes for soda pops.

We try to avoid all artificial ingredients, including fake fats (like Olean, Olestra, etc.), because these can destroy the digestive system, and prevent absorption of vital nutrients, such as fat-soluble vitamins (A, D, E, K) from foods. These fake fats also prevent digestion and absorption of needed fats & oils, used to repair myelin nerve cell sheaths (made of fatty material, mostly cholesterol). Hormones are also made of mostly cholesterol.

(8)  We try to drink more water, to prevent chronic dehydration. We like hard (nicely mineralized) well or spring water.
We do not drink distilled water (soft water, no minerals), because it can leach minerals out of our bones, possibly contributing  to osteoporosis. (See Ref.18,23, on page 9.) We avoid water softeners (chemicals) because they can be toxic, and because good minerals help keep us healthy. People with KIDNEY PROBLEMS &/or GLAUCOMA, etc. should ask their docs how much water is safe to drink, since too much water can be dangerous for them! (But, dehydration can cause problems also.)

(9) We use ACIDOPHILUS/BIFIDUS ( edible beneficial bacteria which keep bad YEASTS away, such as Candida Albicans, formerly called Monilia). ACIDOPHILUS/BIFIDUS also can eat or control some bad bacteria, and some viruses. The acidophilus/bifidus are also called PRO-BIOTICS and are beneficial intestinal flora (mainly for the large intestine). We keep the jars refrigerated, but not too cold. These are available at health food stores & pharmacies. (See Ref.14,15,23,24,25, on page 9).

Acidophilus/bifidus can re-populate the large intestine, with good bacteria, after antibiotics &/or steroids, etc. have killed off these good bacteria! Some of us have to continue eating the acidophilus/bifidus (daily, or from time to time), but the results seem worth the effort to us.

Yogurt and buttermilk contain similar beneficial bacteria, but are milk products, so see (11) below about milk products.

(10) We use DIGESTIVE ENZYMES. My husband likes Acid-Ease by Prevail, which contains Slippery Elm (inner bark), Marshmallow Root, Gamma-Oryzanol (from Rice Bran Oil), and the plant enzymes Amylase (digests starch), Lipase II (digests fat), and Cellulase I (digests cellulose from plant cell walls). The Acid-Ease does not contain Protease, which can be very irritating to ulcer/GER folks.

The Acid-Ease is NOT an acid blocker. It is not an antacid. It soothes, coats, nourishes, and promotes healing. Its enzymes help with leaky gut syndrome.

   I use Total Enzymes (which does have Protease, a protein digesting enzyme) by Nutri-West, a company that sells only to health practitioners (Chiropracters, Physicians, and others). One could ask their physician to order, at cost, for them, by having physician call 1-307-358-5066.

   Digestive enzymes are NOT FOR EVERYBODY.

(11)  My husband has found that AVOIDING MILK PRODUCTS helps him feel less congested, with less mucous in throat. Milk and milk products can cause gastric reflux episodes. Brown-Rice Milk (look for gluten-free) can substitute for milk (but not for babies!).

Gluten is in wheat (includes spelt & kamut), rye, oats, barley, & buckwheat. Read labels to avoid hidden gluten, in some soy sauces, gravies, grain alcohols, beer (barley malt), etc. People with Celiac Disease need to avoid all foods containing gluten. BROWN RICE (organic) is gluten-free. Corn is gluten free, but is very allergenic (allergy causing), so avoid corn. Avoid millet, at first, because there is disagreement about whether millet is safe or not, for Celiac patients.

MILK MAY CAUSE MORE ACID to be produced, IN THE STOMACH.

I occasionally eat milk products, like yogurt, cheese, whipped cream, or my ACIDOPHILUS/BIFIDUS, which is mixed with goat milk powder. So, at these times, I take LACTASE ENZYMES, to digest (break down into easily absorbed small molecules) the milk-sugar called LACTOSE. Many people (due to heredity &/or disease) have Lactose intolerance, where the small intestine does not secrete the lactase enzyme. Result is that the milk-sugar (lactose) travels further down the small intestine than it should. Then, bad bacteria eat the lactose, giving off lots of gas (a by-product of the digestion of bad bacteria), and this causes folks to get bloated, gassy, have diarrhea, and cramping. I use Lactaid brand lactase enzymes, and it works for me. Ordering direct from them can save money.

(12) Using the above methods has almost completely freed my husband of needing to use Tums, and seems to be nicely controlling his and my GER/LPR. We have never used acid blockers.

ACID BLOCKERS CAN HAVE DANGEROUS SIDE EFFECTS: Some examples are:

Acid must be present in the stomach, in order for the stomach to make a substance called Intrinsic Factor. Intrinsic factor must be present with Vitamin B 12, in the stomach, for absorption of Vitamin B 12 to happen, in the ileum (last part of the small intestine), I believe.

Acid blockers therefore prevent absorption of Vitamin B 12. Malabsorption (lack of absorption) of Vitamin B 12, causes NERVE DAMAGE (pain, numbness, pins & needles sensation, etc.) in the peripheral nerves (outside the brain & spinal cord). This is called PERIPHERAL NEUROPATHY. For details about this problem, see the Peripheral Neuropathy forum at http://www.braintalk.org

If Vitamin B 12 continues to NOT be absorbed, eventually there can be NERVE DAMAGE to the Central nervous system (brain & spinal cord).

ALSO, the minerals calcium, iron, zinc, other minerals, and important trace minerals, etc. cannot be properly absorbed, when there is no acid in the stomach (due to acid blockers, etc.).

AND, protein does not get properly digested (broken down--eventually into amino acids), in the stomach, when there is no acid in the stomach.

Doctors and pharmacists can advise about gradual(slow) tapering down (weaning) schedules (when and if safe) for the acid blockers. Some acid blockers, when stopped too quickly, can cause rebound acid secretion in the stomach, resulting in excess hydrochloric acid secretion.

ALSO, SOME FORMS OF REFLUX ARE NOT ACID REFLUX, but are ALKALINE REFLUX, (bile is alkaline). Besides refluxed stomach acid (HCl/hydrochloric acid), Pepsin (an acidic proteolytic/protein digesting, enzyme) & bile (alkaline) can irritate & damage: the esophagus, throat, vocal cords, & lungs.

(13) Do not drink ICY COLD DRINKS, and AVOID VERY HOT DRINKS. Use room temperature drinks, or slightly cool, or warm, but not ultra-hot. Extremely cold or hot liquids can irritate the stomach, which is bad for ulcers &/or gastric reflux.

(14) Ask physical therapists, chiropractors, osteopaths, etc. if they know any safe adjustments that might lessen GER/LPR, if you wish.

(15) Read (by Dr. James A. Koufman) PATIENT INFORMATION SHEET ON REFLUX by Center for Voice Disorders of Wake Forest University. Here’s a link:  http://www.bgsm.edu/voice/pt_info.html  Dr. Koufman was a pioneer in showing the connection between stomach reflux (can be acid reflux OR alkaline reflux) and breathing problems!

(16) Some have found a special (large) GERD pillow helpful for preventing GERD episodes while sleeping and while lying down. Here is a link to the Prop up pillow website:  http://www.propuppillow.com

(17) Avoid harmful chemical air pollution, which can aggravate gastric reflux. See page 5 of VCD website for more about this.

(18) Using the above methods, in addition to the SINUS SURVIVAL tips, has helped us to prevent VCD attacks, in us.

(19) Please check with your doctor, in advance, to be sure that it is OK for you to try these tips, in your particular case. Also, please get monitored by your doctor, to be sure that no more damage to the throat, esophagus, stomach, vocal cords, lungs, etc. is happening, from possible SILENT gastric reflux.

Pregnant or nursing ladies should check with their doctors, before trying any of these tips.

Avoid any herbs, foods, etc. that you may be allergic to.

Check with your doctor and pharmacist, to be sure that there would be no harmful interactions between any of your medications, diet that you may be on, and any herbs, foods, etc. mentioned in these tips.

Check with your doctor, to be sure that these tips would not interact badly with any medical condition you may have.

These tips help my husband and me (adults). Some of these tips may be OK for children, and others may not be OK for children. Check with your doctor! Babies with gastric reflux need DIFFERENT treatments, not these tips (except for raising the head end of the crib, if your doctor says it is OK to do this, etc.). Check with your doctor!

I hope these help!

Sincerely, Concerned lady
http://cantbreathesuspectvcd.com