Here are some thoughts about getting off of PPI meds --
1) Even tho' your dr and most websites won't (or won't yet) tell you about this, there was a study done that showed that subject who did not have GERD and then took PPIs for 8 weeks, had GERD symptoms when they stopped the meds. THese symptoms went away over time. So there is medical evidence that there IS a rebound effect, even though everyone says that these are not long lasting and you don't have to gradually decrease the dosage.
2)I personally have experienced EXTREME reflux when I've switched from a PPI that was effective for me to one that wasn't -- basically, trying to quit the meds cold turkey gived me reflux that is 10 times worse than I've ever had it.
3) my naturopath tells me that one of the signals to the esophagael sphincter muscle to tell it to work is acid -- so there is a viscious cycle effect of this muscle never getting strong enough again if you are on the acid reducing meds. I don't know what studies support this (haven't searched for them).
4) I have been trying to get off of PPIs b/c I experience crappy side effects when I am on them over time, and there aren't any other ones left for me to try. I was on nexium at 40 mg/ day. Then I cut to 40 mg ev other day with 20 mg on the off days. then down to 20 mg each day. right now I am at 20 mg every other day. I spent about 2-3 weeks at each dosage change; the first week was a bit rough in each case, definitely some flare ups and I had to take a lot of malox. But it now seems to be about as controlled at 20 mg ev other day as it was at 40 mg every day.
5) I should also say that before I tried getting off the meds as above, I did take limonene for 2 months (the recommended length). THere is a very very small study suggesting that limonene can help strengthen the esophageal muscle, and a resultant patent on limonene for treatment of acid reflux. I don't know how much the limonene helped me -- it certainly did not suddenly enable me to eat fatty foods without an attack, that is for sure. But it did seem to shift my reflux symptoms from silent with sore throat and cough to simply mild hearburn. I wonder if that means the acid isn't shooting up as high? (utter hypothesis, I don't know, and don't know if the limonene really was responsible for this change either)
6) I also have removed all trigger foods from my diet and keep the head of my bed raised, and rely on malox if I have any semblance of an attack starting.
Hope this info is some help to you...
nij
I'd ask your dr and discuss rebound effects, too. If you don't do it cautiously enough, you run the risk of it being worse. Is there OTC for Nexium? I'd lower the RX dose if ok with your Dr and then wean down from there vs switching meds IMHO.
C~
HI and welcome to the GERD forum.
May I ask, do u know the root cause of ur GERD?
It sounds like u might have post nasal drip.....and reflux. Have u tried elevating the head of ur bed?...avoiding dairy products later in the day?
Are u having digestion problems while taking the meds?
Not everyone will have heart burn.....u can have silent reflux....
Can u sleep while taking the meds?
Talk with ur dr about ur concerns...or ur Pharmacist...they know side effects and what u might subsitute for similar effects.
U might want to read thru the Health Pages here on MedHelp
"selma"