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Severe pain when discontinuing Ranitidine

Without going into a lot of detail, I am 45 years old and have always been healthy until I started having mild nausea and lower GI "discomfort" about 20 months ago.  That was followed a couple months later by a burning sensation in my throat and then the onset of acute heartburn a few weeks after that.  I was put on Ranitidine and need to take 300mg 2X/day to keep the heartburn under control. Whenever I stop the Ranitidne or reduce the dosage, not only does the heartburn recur, but I also have severe abdominal pain.  While travelling last weekend, I intermittently missed a few doses and suffered with severe pain that felt like labor contractions for several days this week until I was taking the Ranitidine regularly again.  Another time I tried to reduce the dosage to 150mg 2X/day and I had more of a constant pain higher up in the abdomen.  

I have had numerous GI tests, including an upper GI, CAT scan, gallbladder ultrasound, and a colonoscopy, as well as an OB workup.  The only problems found were reflux and some small uterine fibroids, so they say that my other GI symptoms are due to IBS (a new diagnosis for me).  

What concerns me is that I cannot discontinue the Ranitidine. I would prefer not to take medication if I don't have to, and the doctor is suggesting that I try Prilosec instead of Ranitidine because of the pain.  I can't do that if I can't discontinue the Ranitidine.

In addition to controlling my heartburn, Ranitidine helps my sinuses.  What else is it doing?  

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Both the Ranitidine and Prilosec are acid reducers.  So if acid reflux is causing your problems, the Prilosec should work as well if not better.  

You may want to consider an upper endoscopy to more comprehensively evaluate the upper GI system since an upper GI cannot evaluate if there is any inflammation.  I would also suggest testing for H Pylori - a bacteria associated with inflammation and ulcers.  Typically GERD by itself does not cause abdominal pain, so you may want to consider these other diseases.

The definitive test for GERD would be a 24-hr pH study.  This can also quantify how severe the GERD is.  

At this time, the trial of Prilosec is reasonable to see if it improves the control of the reflux symptoms.  

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.

Kevin, M.D.
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