Burning pain, shaking, side effects or symptoms ?

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I am on 20 mgs esomeprazole twice daily and 150 mg ranitidine twice daily.  My symptoms were burning pain behind ribs going through to my back, sore throat, from reflux, gurgling stomach, wind.  I am now shaking internally, feel weak and the pain comes and goes.  Feel a little nauseous at times.  I had ulcers due to HP over 12 years ago, triple and quadruple therapy to eradicate it.  Havent had endoscopy for about 3 years.   Does anyone else have this horrible shaky feeling all the time ?  Not sure whether it is intolerance to the PPI or symptom of stomach problems.

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  • Posted

    hi, Sounds like you need an endoscopy to look at if anything new is happening with you. l was told l,d a bit of gastritus following scope, done due to severe peristent nausea, put on omprazole, but had gone off food, though now on small plain eve meal, so no ready meals or tinned food, also stopped with dairy products, went off them anyway, and use, spring water, and finally after months the nausea settled, still get a bit of bloating and wind time to time and still get full easy, but dont have symptoms like yours re pain shakiness, There is more info advice on the gastritus thread, hope they can help you. 
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    • Posted

      Thanks Lynne.    Pleased to hear you are recovering.   I think you are right, and I need another endoscopy to see what is going on.   Hope you continue to get better.
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  • Posted

    That is an extemely unusual regime that your Doctor has put you on. I have never before seen a PPI and an H2 Receptor Blocker given at he same time and in those quantities to a Gastritis sufferer.

    For long term treatment  I can understand the use of Ranitidine rather than a PPI because of the possible long term problems of PPIs.

    In the short term your PPIs gives better results than Ranitidine. Not likely to give you any harm or problems. And I very much doubt you are suffering intolerance to them.

    That regime you are on will result in a huge drop in your gastric acid concentration. That in itself could give rise to difficulties.

    Have you never been on the PPI alone to see if that gives relief ?

    You say you had both triple and quadruple therapy previously. Was that because the initial therapy did not eradicate H.Pylori ? And, if so, presumably you had one of the two tests post therapy to prove that.

    Hence the second therapy. Just interested to know what eradication testing you have actually had.

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    • Posted

      Two doctors at the practice both prescribed the dose.   I had the triple therapy for HP but it didnt work, so I had the quadruple therapy which fortunately did !

      I am also on steroids for an autoimmune disease, which are likely to be causing my present stomach problems.   I have been taking PPIs on and off for the last 12 years for mild gastritis, but the pain and discomfort is far worse this time.   I think I probably need another endoscopy.  I wonder if anyone else has been prescribed the ranitidine and the PPIs together.   I have been wondering if it is too much and makng me feel worse.

      i have been on the esomeprazole on its own.

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    • Posted

      hi thanks, l  am so relieved the nausea has settled, only posative was losing 2 stone being l was oweight, but wouldnt want to experience it again.  lve still intersticial cystitus but its not too bad, but as you know the constant tiredness fatigue and little energy at all as such an impact on  your lifestye, and so many the same, for different reasons, But read Dereks reply, l knew the omprazole were ppi,s, not sure of long term affect, though read its problematic, but l didnt know rantidine was a h2 blocker and is bought in chemists, but l was prescribed cimetidine years ago for reflux. which l guess is and h2, l knew it was histamine receptor used for ic also, being inflammatory condition and histamine causes it in part, mast cells.  l did ask docs about whether to stop taking cimetidine when gi prescribed omprazole, they suggested l could, but it didnt seem a big deal to them or gi, But again l was prescribed anti b kefalex years ago as a daily use to prevent ic flare ups, new finding, and l think it did help, but then wonder if it led to gastritus few year later, so stopped taking it, Along with the nausea, l had thick coated tongue, speculated it was thrush, overgrowth, and know thrush can cause serious problems if systemic, you wonder and some dr,s only tell you so much, and often evasive, not lying just witholding some of the facts, treat you like children at times, infuriates,  Anyway mini rant over, l just fell asleep sat upright for an hour, wake up feeling worse, now trying to loosen up the parts and motivate, If you go on gastritus thread l think lnez knows a bit about gastritus, and maybe derek will get back, Hope you get advice that helps
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  • Posted

    Hi Jan

    I thought that might be the case.

    After two doses inc quadruple therapy it becomes much more difficult to specify the next treatment. I suppose it depends on how long it was since your last therapy. It is very very unusual, particularly in the Western world, (Arica and the Far East are different) for someone to reacquire H. Pylori from external sources. In this country a resurgence of H Pylori normally arises from a false negative test. This does arise sometimes when therapy reduces the bacteria to very small numbers which do not show on retesting. Unfortunately they can grow and repopulate to give you the same problems. You could ask for a retest breath test though even if confirmed, you will have somewhat of a problem in the decision to further eradicate. There is some evidence that a new drug has seen good eradication results when two episodes of therapy have failed.

    Coming back to your prescription. PPIs are wonderful in the short term.

    But they can be extremely detrimental in the long term. The American Food and Drugs Administration has recently issued a public warning to this effect. The two Doctors in your Surgery will be well acquainted with what the other has first done. You cannot therefore be sure that your regime has been arrived at from two independent sources.

    If you've been taking PPIs for that long better to get off them and onto Ranitidine or Cimetidine or the like. They don't work quite as well as PPIs but they act quicker. So, in my experience, they work much better from a pill popping point of view.

    I think if you could get an Endoscopy it would be worthwhile to find out if you have had a recurrence, and just importantly from your point of view to get a totally independant consultation by a Gastroenterologist and an indication from him (with the latest information) of what regime you should be following.

    From  lyfestyle point of view I take it you are not smoking which is a real no no in terms of Gastric healing - as is too much alcohol.

    Scientific studies have proven the effectiveness of Yogurt, Priobotics and Green Tea sweetened with Honey.

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    • Posted

      Hi Derek, I have just got an appointment with my gastroenterologist next Wednesday.  Yes, I have heard that its possible to get HP again, although 12 years ago I was told that once it was eradicated it wouldn't come back !  Obviously things have changed since then.

      I am not very happy with taking ranitidine and esomeprazole, but have tried each of them on their own and the pain doesnt go away.  I did have a chat with the pharmacist who didnt seem too concerned about the combination.   

      I would prefer to just take the ranitidine, I have read about the increased risk of heart problems with long term PPIs, not to mention osteoporosis, hair loss and so on.  I have also been on quite a rigid diet for years, only slipping occasionally to have something sweet, no smoking or alcohol 

      etc.  very boring !   The steroids are unfortunately thought to be the cause and I shall be on them for some time, so I do need to take an acid suppressant all the time.

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  • Posted

    Well that is really excellent news !

    No - things have  not changed re eradication (though the technology has grown immensely since then).

    If H.pylori is eradicated in the Western World it is very very unlikely to return.

    Hence the possibility that it was not eradicated even after quadruple therapy.

    Sorry that the steroids are causing a problem - I know nothing about them.

    But it does seem strange that you are still not getting relief even after all that medication.

    Very often the quickest way to relieve acidic pain is with cheap and cheerful antacids such as Calcium Carbonate from Boots.

    Though if your PPIs and H2 Receptor Blockers are not working one wonders what will.

    Glad to hear that you are aware of the PPI situation.

    I did not want to start worrying you on that matter.

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  • Posted

    PS  Just a thought. It would be very interesting and of value to sufferers on this site to learn what the Consultant has to say about your condition together with his regime for your further treatment (of course he will not express any criticism of your previous treatment).
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    • Posted

      I did the breath test which apparently showed it had been eradicated after the quadruple.  Also I have had a couple of gastroscopies since then which have been clear, apart from gastritis.   I will report back when I have seen the gastro man next week.   Meanwhile I will get some calcium carbonate.  Is it liquid or tablets?  Is it the same as Tums?

      I felt much better yesterday evenin g, but I had a horrible reaction after breakfast this morning, my stomach felt like it was bubblng inside.  

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    • Posted

      Blimey Jan

      Here goes again.

      I think you mentioned three things.

      Your breakfast problems. You know to keep off Fries and Spicy foods at the moment – don’t you.

      Porridge is very good for the Gastric system, preferably using Almond Milk rather than Cow’s Milk.

      And we’ve talked about Green tea and honey. Think about caffeine reduction and even just drinking water at the moment.

      Eradication. Good to hear you took the right post therapy test. The technology of testing has improved since then and gives a 94% to 96% accuracy. Though that doesn’t help the 4% who are given the all clear when they are not. Testing after quadruple therapy for that 4% has proved to show good results.

       But any minute now you are going to find out from your Specialist Consultant what he finds so we don’t need to conjecture anymore. Just a point on Endoscopy. If you can get somebody to bring you away post Endoscopy,  try to get the Sedation – probably only a prick- rather than the local throat spray. They normally give you a choice. Try to get feed back from the Consultant. Often they don’t give it themselves but a staff member does it. I have been pretty unhappy when that has not even been a qualified nurse. Just a staff member, who when questioned appears to know nothing. Your Dr, of course will get the full report. Even then it is unbelievable to hear of people just being sent medication before feedback. You will need a quick appointment with the Doctor who will have the report on line and should give you a copy whilst he takes you through it.

       GPs can’t be expected to know the huge mass of technology that is being produced Worldwide on every medical condition under the Sun. That’s why they are called Generalists and why we are fortunate to have Consultants for Specialisms.

       Re Calcium Carbonate. These are tablets in small flat box and in foil sheets from Boots. They stock various flavours including Peppermint. They also stock at the side of them what I think they call Originals. Keep away from Peppermint. Though the tablets are quite large they are not unpleasant. Chew a couple for fast relief. (Quicker than any Inhibitor). They are non toxic and not habit forming – which can’t be said for the usual Inhibitors. Worthwhile keeping a little sheet in your handbag. You are told not to take antacids with the two regular groups because we don’t want the acid levels to become too low. If you are taking an inhibitor Morning and Night I have found the antacids work very well for immediate pain say midday or middle of the night. But I am particularly concerned when you are taking both groups of Inhibitors all day long. I just can’t suggest antacids on top of all that lot.

       Best wishes


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    • Posted

      Thanks for all that Derek!    I am just having oat flakes, raspberries and almond milk for breakfast.  Even that causes a problem.  I have looked up the acid and alkali ne foods and trying to stick to the alkaline.

      I havent had caffeine for years and no alcohol for over a year.   Life can be very boring!    

      I have just been back to my gp because of the pain and he hasput my nexium up to 40mg twice a day, and he still wants me to take ranitidine twice a day and gaviscon 4times daily.  He thinks I probably have an ulcer. It seems an awful lot to me.   I think I can remember taking double doses of omeprazole 12 years ago when I had ulcers with HP, but I didnt take ranitidine as well.  I certainly cant cope with the pain so will try the double dose for a day or two.   I have to ring him on Monday to let him know how I am. 


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    • Posted

      Nexium is a manufacturers name for Esomeprozole - a PPI.

      Gaviscon is just an expensive antacid.

      Well I doubt you can better your lifestyle - though you don't mention smoking.

      It's a shame you weren't given the Breath test a bit earlier if he thinks you've got an ulcer.

      But just think.

      With the help of the Gastroenterologist you will be starting to get better next week.

      Very concerned about that pain.

      If you see any blood call for an ambulance.

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    • Posted

      Apparently they cant do a breath test if you have already had Hp before and had it eradicated.

      i dont smoke, gave up 20 years ago.     Very clean living !!   I Am hoping the pain will now gradually get better with all the meds.

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