Why PPI's stop working?

[JIH22]

I have been taking Omeprazole for around 10 years.

In the last 6 months it has become ineffective and I have increasingly sore throat. I have severe bloating as well.
I have recently seen a number of claims that the problem is not actually excess acid but not enough stomach acid.
PPI's inhibit the production of acid but this actually only addresses the symptom rather than causes such as H Pylori
This seems very consistent with my experience and I was wondering if anybody had any views on this.

If it is the case and PPI's are actually making the problem worse then there really needs to be some advice on this to suffers.

[Flycaster305]

Keep in mind, you had to fast for the Endoscopy.  It's very probable that the act of fasting reduced your GERD symptoms on Monday and Tuesday. I doubt it had anything to do with stopping the PPI, but I'm not a health professional so take what I suggest with that in mind.  

I think that our bodies tend to 'reject', or ignore natural and pharma medications taken over a long period of time.  As a long time heart patient, I can assure you that is what I have experienced, and it isn't guesswork with the heart, you KNOW when medications become ineffective and need to be replaced or increased.  I managed my minor GERD issues for years with OTC meds until I had a bowel obstruction and had some violent vomiting moments.  I had life-saving surgery, but the vomiting destroyed the LES valve, and my vocal chords were burned and my teeth turned black very, very quickly.  I had to have an acid test to qualify for surgery by my insurance company, but the stomach acid level was very high.  I had very, very successful Nissen Fundoplication surgery to correct the problem.      
I'd suggest you look at your problem with a very broad scope, and if you continue to have problems request a test of your acid level in the stomach as well as the esophagus.  The fact you felt so much better after a fast suggests to me that you might look carefully at your diet to see what is causing your issues.
Thanks for the update on your procedure, and best wishes.  

[selmaS]

  Hi...I was told to step off the meds to avoid what is known as rebound...PPIs stop the production of acids and when u stop taking the meds u end up with too much acid and in a vicious cycle, I was on 2 pills 2x's a day. I cut them back  to a single dose 2x's a day then to a single dose once a day, then every other day, to  only when needed ...to not at all....

I did not have ill effects doing it this way....and I still do not take GERD meds unless I am going to eat pizza  or tomato sauce more then once a week...other then that I am fine.

  

[JIH22]

Just by way of update - in case there is anybody else who may benefit from the experience - I have now had the endoscopy.

My oesphegus and stomach are fine - no sign of GERD or ulcer etc. I had stopped taking the PPI on Sunday of last week. The endoscopy was Monday. I also had a biopsy taken for H Pylori and I am waiting for the results of this.

However, Monday and Tuesday were the first relief that I have had from the bloating and sore throat symtoms. I put this down to stopping the PPI. But by Wednesday I have started to experience stomach ache. Less bloating and less throat but a dull uncomfortable and persistent stomach ache.

In the interest of avoiding medication I have taken nothing for it to see what happens. But this seems to be consistent with other reports of over acid production after stopping PPI's. At this moment I cant decide which is worse - the bloating and sore throat with PPI or the stomach ache without.

I sincerely hope to hear that the H Pylori test is positive as there needs to be some explanation for the situation. Does anybody have experience of coming off PPI's - how long does the over producion of acid last for before things settle down? Many thanks for all of your comments above and in advance.

[selmaS]

  Agreed a good probiotic can be very helpful...especially if u had H.Pylori and were on a few rounds of antibiotics, they kill all bacteria the good along with the bad and u can not digest ur food with out the good bacteria....the probiotics will restore the natural balance.

[LazyMoose]

Over a period of 10 years your bodies chemistry can obviously change. Could be that you did have to much acid if PPi's actually worked for you back then.

And maybe now you have less acid (this is also a natural part of..well.........aging).

I was one of those people that PPI's made me worse - all brands almost stopped my digestion, even though the DR said to keep taking it. Drs are not always right, not all are good health detectives, even though they should be.

It is important for people to understand all the possible causes of reflux, and explore them. For those that truly have to much acid, then the standard medical treatment program is best.

For those with low acid, standard medicine will not be able to medicate but the PH test is helpful.

Usually digesting red meat is difficult with low acid levels and digestive enzymes for meat help. Many digestive enzyme mixtures also have HCI acid too.

Endoscopys are very useful, but don't see every thing either. Bacterial overgrowth (types of digestive Candida seldom discussed here) is another common ailment from slowed digestion, from low acid, which will cause reflux from improper digestion and will not show up in an endoscopy. In this case probiotics (good bacteria) taken at **opposite** times of herbs that irradiate the bad bacteria will show increase comfort levels with in a month.

Bloating after sugar, gluten, carbs is a symptom from bacterial overgrowth and thats a give away that one has it. There is a huge gluten free craze going on in the states. Many of these people are not celiac, but claim gluten intolerance. OK, that still doesn't fully describe why they are supposedly gluten intolerant. Well many times the cause is actual bacterial overgrowth, but they dont know this (yet)!

Dividing up meals into specific foods, noting any symptoms, will help figure out what is going on. Hopefully this info will help you figure this out.

[JIH22]

Thanks for the comments guys - I will do as you both suggest.

Low acidity makes a ton of sense to me. As far as I understand lower acidity will fail to trigger the closing of the valve at the bottom of the esoph and will also result in food being less digested - food for H Pyolri.

My symptoms are gas from partial digestion and sore throat from milder acid being persistantly in my throat. PPI's will only serve to make this worse.

I have an endoscopy tomorrow and will try to ensure that they test my ph level if I can. Are you guys in the US? I am in the UK and I am concerned that the NHS may perform a slow series of tests one at a time.

[selmaS]

  Hi, it is very possible that LazyMoose is right....u may want to get a PH test done to see if u still have high acid or low acid....Low acid will feel the same so it is hard to tell from symptoms.

If u still have high acid, u may need to try different meds....I was on a PPI for many yrs as well and it stopped working for me too...then my Dr tried a H2 blocker and it worked great.

  I am to the point I only need it on occasion and not on a reg basis nemore.

    Do check with ur Dr for acid levels with a PH test and let us know what u find out.


   "selma"

[LazyMoose]

Sometimes low acid production is the case.

I have addressed this issue in the last month here. Page thru, read my comments on others posts and my own post, about treating this.

Suposudly when stomach PH is not acidic, the LES valve will not shut, and even low adic levels will then move up the throat.