This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

PPI effectiveness fading

I've been on prilosec/omeprazole 20mg for over 12 years and it's been a true miracle drug for me.  It has completely controlled my severe chronic heartburn and, as evidenced by a recent endoscopy, has really protected my esophagus which is in rather good shape considering how long I've had GERD.

The problem is, in the last couple months, I've been getting breakthrough symptoms.  I've been getting these relatively mild but worriesome heartburn episodes and alarmingly to me I've been getting a new symptom which is waking up several times a night with an annoying and persistent dry cough. Here are my questions:

* Does this mean my GERD is progressing and getting worse or just that I'm getting some kind of tolerance to omeprazole after all these years?

* Is it possible this is just a flare-up and if I just stick with my wonder drug omeprazole that it may again sometime soon completely control my symptoms? (I would love to stay on this drug as I have zero side-effects and it's been so helpful in the past)

* Should ask my doctor for a double-dose prescription, or possibly try a new PPI or even an H2?  

Thanks for any ideas you may have.
Read more
Discussion is closed
Follow - 1
Upvote - 0
1 Answers
Page 1 of 1
1406799 tn?1281364905

I have GERD, diagnosed first by an endoskopy which also showed that I had esophagit. I was prescribed 20 mg omeprazole for about 12 weeks to heal, for some reason did the doctor not tell me that the condition would not disappear just because the esophagitis was healed. However, after the 12 weeks did it only take10 days without medication until I had severe reflux symptoms again, actually worse then before, but then I did not know about the effect the PPI have when you stop to take them, that the symptoms actually get worse for several weeks because much more gastric acid is produced than from the beginning as a response to that it has been switched of for a long period of time. Because my pain came back I started to take omeprazol again, but this time it did not work, I doubled the dose and took 40 mg a day without positive reaction. Finally I got to my doctor and got a new prescription for Nexium instead, esomeprazole, 40 mg per day. This drug worked well and within a week had all my symptoms gone away, but after almost a year on the drug did it stop to work, gradually i got some sort of break through of symptoms, especially when eating something acidic as vinegar. After almost two months with gradually increased symptoms I decided that I should not use a drug that did not help me, I started to be very  cautios about everything I ate, I had since the start of my problems been careful about certain foods, but now I got very careful and excluded everything that could cause problems.

Sorry for my long story, I just wanted to point out that I have experienced two times that a PPI drug have stopped to work, and that even though I followed a quite strict food regim and never got to bed (or layed down) until 3 hours has passed since my last meal.

I do believe that the body builds up resistance towards the drugs, it is not natural for the stomach to not produce acid.

Before I stopped taking Nexium (I have now not used any drug at all for my GERD since February 12th this year) I did get better while still using it and I think that I manage to do so by carefully chosing food. For me was it necessary to stop eat anything acidic, as vinegar, wine, but also tomatoes, Alcohol is not so well tolerated so decided to not drink at all for the first months. I personally can eat fresh tomatoes but not cooked ones, or ketchup, tomato sauces or similar. All sorts of food with chili within it did not work either. Almost most important for me was that I could not cope with cow's milk or other dairy products.

To help me I used alternative herbal drugs, one of the most effective was orange peel extract and aloe vera juice. Whenever I started to get symptoms I drank lots of water, non-sparkling of course!

The first 6-8 weeks I really was questioning if I could go through this and if I ever could manage to live without the drug, but I persisted and today I am very happy about it since I am now feeling so much better. I do still get symptoms, but not every day after every time I have eaten, now I even can eat some of the troublesome food sometimes without problems, but I am cautious and dont over do it.

I hope this might help you in any way.

best regards
Discussion is closed