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PPI Stepdown pt 4

UPDATED May 13, 2021! New info about PPIs and my current health. Made into new post as well.

Another update in my ongoing battle with GERD. Sigh.

While I am glad I’ve rid myself of PPI use, I can’t say that it’s been without its issues. I have bouts of GERD every single day, while awake and while asleep. I typically get a flare after eating (doesn’t matter what it is) and occasionally with wine.

I was AM using Pepcid, an H2 blocker with antacid (10mg famotidine + 750mg calcium carbonate) when GERD was really bad or it was flaring before bed – and it works GREAT! I was having some issues with the H2, but they planed out. I do have some constipation issues, but nothing that a senna caplet can’t handle.

I looked up famotidine and it has the best track record for long term use. There are no long term health issues from using is, as there are with PPIs. I discovered that PPIs have been DIRECTLY LINKED to liver damage with long term use. That is in addition to the potential kidney issues. Here is the NIH article on liver damage.

I do use Tums (calcium carbonate) A LOT to manage the breakthrough GERD that I get during the day and sometimes at night. I was looking up the details of calcium carbonate, such as safe amounts to take daily and found that it’s generally 2-3 grams per day for old people like me. Each chew is 750mg, so that’s 3-4 per day. Sometimes I am within that, sometimes not. The long term overdosing on calcium carbonate can cause kidney stones, but that’s about it. Constipation is a common side effect, which I manage with senna.

BUT overall, I feel that famotidine and calcium carbonate are my long term solution to VSG induced GERD. I use calcium carbonate (Tums chews) during the day if I need it and I take one Pepcid (famotidine + calcium carbonate) before bed. I’ve been on this regimen for about a year and it is OK. Not as good as PPIs, but I just can’t justify the potential organ damage that is caused by stopping stomach acid production. I think there is going to be a huge wave of people with organ failures from taking PPIs for years. I don’t want to be one of them.

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PPI Stepdown, pt 3

It’s been about 5 days since my last dose of esomeprazole. I got myself a care package of aloe juice, alkaline water, stomach tea (with similar ingredients to the Ibrogast formula that is too pricey) and the Target brand of Pepcid (famotidine 10mg + antacids).

The day I got the supplements, I didn’t use anything at all and made it through the night. The next day was rougher, with more breakthrough GERD and I took the Pepcid before bed. The day after that, fine.

So it’s been very uneven as far as the breakthroughs are concerned, but overall, I’m doing pretty well without the PPI. I think I’m done. I am so relieved!

I take Tums for minor flares, aloe for worse ones and occasional Pepcid at night. I’ve taken a tums before bed a couple of times when I feel that there *might* be a GERD incident. So far, so good.

I’ll update again if there is any change, but I think this is probably where I’ll be from now on. I think I’ll always have some sort of GERD flaring up, simply because of the shape of VSG making the stomach basically a turkey baster that pushes acid up to the esophagus. No particular foods have any effect, nor does alcohol, it’s all very random. I’m hoping the volume of my Lil Tummy™ goes back to about a cup, but if it doesn’t, no big deal. I think the overall inflammation is getting better.

So, I’m living proof that you CAN get off of PPIs. From start to end it took me about 6 weeks. Perhaps 8. With the quarantine of Covid-19, my sense of time is a bit distorted. I think it’s about 8 all together. It was not too bad for the most part, I did lose some sleep here and there, but I have to say, it’s been easier overall than it has ever been in the past to stop the PPI. I think it’s because I did the stepdown slowly this time. The first step was a month or so, then the second and getting off was quicker. I actually feel that the half tab at night made things worse than just not taking it.

I hope this roadmap might help others who want to be off of PPIs before they find out they have kidney damage or other issues.

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PPI Stepdown pt 2.5

I went out yesterday and got some things to try for the ongoing PPI stepdown. I picked up:
– aloe juice
– more probiotics (I’ve added these to my daily supplements.)
– alkaline water
– Gaia Gas and Bloating tea with similar herbs as Ibrogast (caraway, fennel, chamomile, star anise, licorice, peppermint)
– Target brand Pepcid Complete (calcium, magnesium and 10mg famotidine)

The Lil Tummy was pretty well behaved yesterday, but I got a little GERD-y in the late afternoon, so I took a Pepcid chew. Worked immediately and I felt fine. I did not drink any wine last night to get a good read on what Lil Tummy was up to. You’re not supposed to drink alcohol with oral famotidine, but there are not as many restrictions for the antacid/famotidine chews. I took another one before bed, since I’d had two nights in a row of horrible GERD.

IT WORKED!!

I slept well and had zero GERD all night. I hope that this will continue to work for me. I’d like to NOT take it daily in any case, because famotidine has its own list of fucking side effects and interactions that I’d like to avoid. But it’s a good start at living a GERD free existence. Even if I have it sometimes, I really don’t want to take any drugs daily other than my supplements.

Here’s to hoping that I’ll be drug free SOON!

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PPI Stepdown pt 2

OMG. Terrible. I’ve been taking only one half a 20mg esomeprazole at bedtime for a week. Now I have breakthrough GERD randomly all day. For the last two nights, a couple of hours after I go to bed, I’m awakened by my stomach trying to crawl out my throat. I feel strangled and have a coughing fit. This is GERD at its worst. I have to go sit up on the sofa and eat TUMS until it stops, which is usually an hour or so.

I’ve got ranitidine and famotidine (these are H2 blockers) on hand and I’m heading to CVS and Sprouts for a variety of other products to try. Eating a handful of TUMS just ain’t cutting it.

My ability to eat has also been compromised. I can eat about 1/3 less than before I dropped the PPI. While annoying to get the foamies (what we call it when our VSG tummies get too full), I do need to lose about 10#, so THAT I’ll tolerate. I’m back to about 1/2-2/3 cup capacity with this GERD irritation. I got the foamies and was pretty sick after eating a small couscous stuffed pepper last night, so I’ll have to be very careful.

But basically, I am miserable 24 hrs a day right now. As I knew would happen w/out PPIs. ::sob::

I’ve added probiotics to my supplement regimen and I’m looking for something called Iberogast (STW-5) liquid to try as well. (Amazon is pricey, I’ll check Sprouts.) I am aware of aloe juice and will get some.

I hope I can live through this and Lil Tummy will self regulate. If nothing works, I’ll be forced to go back on PPIs. I can’t live like this indefinitely – I *do* need to sleep and eat!

Despite all this bullshit, I’m still hopeful I can get off PPIs. I really think if Lil Tummy has time to adjust, it’ll be OK. I’ve never in my life had any sort of stomach issue, so I hope I can get that back. I’ll post more as I implement various things.

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PPI Stepdown

I’ve been on PPIs (Nexium, esomeprazole) since my VSG surgery in 2016. My four year anniversary is coming up and I really don’t want to continue on PPIs. They are prescribed liberally and people are on them for YEARS, just like me, but now we’re starting to see some of the longterm problems of taking a PPI (Proton Pump Inhibitor) such as H Pylori, malabsorption of minerals and even kidney damage. This article is a good round up of all that PPIs can damage. You can’t just stop taking a PPI because of rebound GERD that is worse than the original. The proton pumps (digestive acid) go into overdrive without the inhibitor – which is what’s happened the last two times I attempted to get off PPIs.

I’ve been having more and more issues with the PPI in the last year. I started having intense histamine reactions to random foods a few months ago, so I found a histamine blocker (Seeking Health Histamine Block is AWESOME!) that worked. I had to take it daily to keep the reactions from happening. When I researched it, guess what was the culprit? Yep. PPI.

Next, I started having leg cramps. I know that PPIs retard mineral absorption, and after some research, I confirmed that the PPI was likely interfering with potassium as well as calcium and magnesium. So I got a potassium supplement.

THEN, I realised that the list of things I was taking to OFFSET the damn PPI was getting longer and longer. It made no sense to keep adding more and more supplements to offset a drug that has known issues for long term use.

So, I began my step down from 1.5 tablets a day (1 20mg in the morning and a half tab before bed; 30mg/day) about six weeks ago. First I moved the time I took the single pill to evenings so it would peak while I am asleep. Breakthrough GERD is worse at night when you’re laying down. I dropped the second dose entirely. This worked pretty well, there were random bouts of GERD at random times, but it was OK for the most part.

Last week, I changed to half a tab at 9pm ONLY. So far, so good. I still have random bouts of GERD that have no pattern. I can chew a few TUMS to tame them down. I have a bed wedge, which has helped with the occasional night time breakthrough GERD. But it’s the same as the one dose was, so I’m encouraged.

I’ll stick with the half tab for a few more weeks, then I’ll attempt ZERO PPI. It’ll work or it won’t. I’m hopeful that it will work and I can get by with random bouts of GERD that can be handled with TUMS. Or perhaps I can go back to an H2 blocker (Tagamet, etc.) at night if necessary. The H2s have far fewer side effects than the PPIs.

I hope I can be rid of PPIs once and for all. They are TERRIBLE for you.

I will post again with the results of the end of PPIs.