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Re: Prevacid
Posted By HFHSM.D.-rf on May 26, 1998 at 23:43:41:

In Reply to: Prevacid posted by rd on May 19, 1998 at 21:52:06:

I have been taking 90mg of Prevacid for 6 months now for what was thought to be reflux.  Before that, I took 60 mg of Prevacid for 4 months.  I was initially put on it for asthma like symptoms, and malaise after eating.   An acid ph study done while I was taking 60 mg was abnormal.  My gastroenterologist (my third one) referred me for surgery because he felt I would never be able to come off of the 90 mg dose, so the ph study was repeated.  This time I went off of the Prevacid for 5 days and the study came back normal so the surgeon was skeptical that I have reflux.  Although my EGD does show recent evidence of reflux, I do not have classic symptoms.  My other symptoms initially were burning in my back, URQ pain (intermittent), belching, and malaise after eating.  When I started taking Prevacid, the malaise slowly went away and I felt normal.  After several months, the RUQ pain also stopped.  On the suggestion of the surgeon, I tried going off of the Prevacid slowly, but after I was completely off for 8 days, the malaise after eating and the RUQ pain (which had been gone for 4 months!) came back.  I started taking the Prevacid again and am slowly returning to normal.  This happened to me a couple other times early on when I went off of the Prevacid for some tests; that was how I knew the Prevacid was helping intially.  I have had numerous ultrasounds, ct scans, enteroclysis, blood work-ups, secretin stimulation test, etc.  I guess I can stay on the Prevacid for the rest of my life but I really would like to know why I have severe malaise after eating and RUQ pain if I don't take it.  If my stomach makes too much acid, could that cause these symptoms?

Dear rd,
The dose of Prevacid that you are taking is substantially greater than that used by most gastroenterologists.  The inconsistency between the two pH studies is disconcerting and further confuses the clinical picture.  I assume from your tests that the physicians looked for Zollinger ellison syndrome and were unable to confirm that diagnosis.
You do not provide information regarding your age and concurrent medical problems.  I would wonder about other diagnoses including delayed gastric emptying and mesenteric ischemia.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
*keywords: abdominal pain, esophageal reflux

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