Rebound acid hypersecretion from short term PPI use that never goes away?

Edited , 4 users are following.

Over 6 months ago I was very briefly on Omeprazole (20 mg/day). I didn't even have a problem with acid reflux prior to this medication, I was put on it because the doctor thought it might help for undiagnosed stomach pains! I stopped the drug after just 2 weeks because it didn't help the pains. Ironically after I stopped the drug is when I started having acid reflux (approx. 4-5 days after I stopped it). I didn't taper off because the doctor said there is no risk for acid rebound as I wasn't on it long enough.

Well now it's over 6 months since I initially stopped it and I still have reflux (chronic). It's always best when I wake up in the morning, then the more I eat / drink, the worse it gets. By bedtime it's unbearable.

In desperation I have went back on it briefly for 1-2 weeks at a time, a couple of times during this 6-7 months time frame in hope for some relief but it never fully removes the reflux.

I was told rebound lasts usually 2-3 weeks, but no more than 3 months and I was completely off it for 3-4 months, and only took Pepcid, and I still had the reflux. I just cannot get rid of it and I believe Omeprazole caused it to start. I should never have been put on this medication but I trusted the doctor (big mistake!).

Now someone has told me there have been extreme cases where the rebound stuck around for 6 months, even after short term use. Is that really true? I cannot find any info on it.

So the doctor forced me to go try the medication again, or he would not let me undergo any further diagnostic tests (my country uses public healthcare so I cannot just pay for the tests, I have to just take what I'm offered). He told me try to up the dose to 40 mg. At this time I had been off it for about 4 months and only managed by taking Pepcid. So I went on it for 2 weeks and then he said since it's not helping, you can either stop it or up it to 80 mg a day. I refused to increase it further as I think it was already a mistake to go back on it at all, so I started to taper off the medication slowly.

So after eating 40 mg a day for 2 weeks, I've been eating 20 mg for one week. As of today I am trying one week where I open the capsule and remove approx. half of the contents (if I can stand it, the reflux was terrible last night).

I also don't fit the criteria for people suffering from reflux due to poor lifestyle. I'm not overweight (actually the opposite), I never drank alcohol, never smoked, I don't eat spicy foods or greasy fried foods. Since the reflux started I have also removed all acidic foods like citrus fruits, tomatoes, etc. Nothing helps.

I have had nearly every test under the sun. Been probed from top to bottom, three upper endoscopies, two colonoscopies, capsule endoscopy, CT scan, 24 hour impedance pH reading, Heidelberg acid test, EKGs, countless blood tests, several fecal tests, biopsied for h. pylori and celiac's disease on three separate EGDs (all came back negative), Crohn's disease, IBD, etc etc. Nothing that could be tied to acid reflux has been found. The only test remaining is a SmartPill motility test which is supposed to record the pH levels of the stomach and I am having that at the end of March, so I have to be completely off Omeprazole by then anyways.

Do you think this is acid rebound, just a very extreme case of it? Why else would it start right after I initially stopped the drug? Like I said I never had acid reflux before this! What should I do?? This has to stop, I cannot go on like this! Should I try to stop the PPI completely and be off it for 6 months, and maybe it will finally go away? What else can I do?

Is going around with this for 6 more months a bad idea? How do I manage? I've tried antacids like Pepto Bismol, Gaviscon (doesn't work at all plus gives me terrible stomach pains and diahrrea), Ranitidine, etc. Also natural remidies like apple cider vinegar doesn't work. The only thing that has worked somewhat is Pepcid but now I have to take the stronger one (Pepcid AC, 20 mg) for any kind of relief. Will reduce the chances of the rebound to ever go away? In other words, is taking Pepcid every day counterproductive for the rebound to finally go away? Even when I take Pepcid AC, I still have reflux but not quite as strong. I am worried about what harm this does to my esophagus if I don't do anything to protect my throat from the acid. This has to stop and to me it seems it must be an extreme case of rebound, why else would it start right after stopping the medication, when I never had reflux in my entire life before starting this med? Please any suggestions are welcome, this is living hell for me. I am really, really desperate and the doctors are now telling me I just have to live with this, they refuse to help me.

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  • Posted

    Sorry to hear about what your experiencing. There was a study done a few years ago. They put 10 healthy people on PPi drugs, then put 10 healthy people on a placebo. After 14 days they abruptly had everyone stop taking their pills. Most of the healthy people who actually took a PPi drug now complained of acid reflux and stomach burning.

    Unfortunately, doctors are still prescribing these drugs randomly. In 2014 I started taking Nexium for my acid reflux. At first I thought I was cured, but then started having random pin like pains in my upper stomach. I thought that maybe I had swallowed a sharp piece of metal. I was also diagnosed with osteoporosis in my feet. I did some research and found it was all the Nexium. However, Nexium is very mild otherwise. It does work short term. I actually had to open the capsules and take the tiny pills. That then allows you to easily reduce the daily dosage so you can wean off very very slowly, like 3 months.

    You could also try my carbonated water treatment. It will help strengthen your esophageal sphincter.

    Buy 4 bottles of low sodium CW, plain or flavored. 5 times a day drink 6 oz of CW. Now just sit and focus to hold down the burp. It may be uncomfortable at first but will be easier after a few days. Start off holding down the burp for 5 minutes. Do this same amount for a week. Each week add 1 oz of CW and add 5 minutes to each session. By week 4 you should be at 20 minute sessions and 10 oz of CW. This low cost and worth a try. everybody is different. But for me it was a cure. John

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    • Edited

      While weaning off of a PPi drug, you can use regular antacids to deal with stomach burning issues. Liquid antacids like Gaviscon can last all night. You can also add organic low acid olive oil and vitamin E.

      Ice smoothies and chewing ice can actually turn off the stomach temporarily. Buy a bag of crushed ice and keep some in a cup to chew. Wait 1 hour after eating.

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    • Edited

      @Jonathan57679 Thank you for replying! This is the 5th day that I am opening the 20 mg capsule and removing approximately half of the contents. It's very difficult as these are microscoping little pellets so I have to basically guess at it. I haven't decided yet if I am doing that for two more days, then remove 3/4 for a week and then stop, or if I should keep removing half for another week before lowering to 3/4 for a final week.

      I'd like to taper much slower, but unfortunately I have to be without Omeprazole completely and all antacids one week prior to a test I'm doing on March 25, a SmartPill motility study. These drugs, including many others, can cause incorrect readings on this test and this test is crucial as it can diagnose many things and it took a long time before I finally convinced them to let me have the SmartPill test.

      Now I read an article by the doctor Chris Kresser that some people are dealing with this acid hypersecretion for 5-6 months and the permanent effect of PPIs is not well studied so it's possible in some rare cases these withdrawals might be "long lasting". But does long lasting mean like forever? Or just a really long time?

      Thanks for the tip of the carbonated water, I will try it. Were you finally completely freed from the acid rebound? No issues at all today? And did you notice a gradual improvement or was it pretty much constant and then suddenly it just went away all at once more or less?

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  • Posted

    I don't really have an answer because I'm going through a similar problem. Several people have told me to try betaine (a digestive enzyme)at meals where you are having protein. The reflux is actually due to not having enough stomach acid. I cant wrap my mind around that one but... I dont think the Pepcid is bad because it is not a PPI so using that and then slowly lowering may be a plan . Like REALLY gradually over a month or two. You are right to want to protect your esophagus. I'm not sure if you have access to Traditional Medicinal Teas but Throat Coat has been suggested I plan to try it. Obviously make sure your not sensitive to any of the natural ingredients. Also finding a good quality probiotic might help. So many doctors are useless. It's crazy to need to go on line for any validation or practical advice when they're supposed to know. Good luck.

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    • Posted

      @jaisa Thank you for replying! I have read about low stomach acid and I actually did buy a betaine HCL with pepsin supplement and I was taking that for 2-3 weeks. It was very painful and made the burning sensations worse. I managed to finish the whole bottle of capsules but I decided to not continue past that because I was worried it was making it worse. If I could be diagnosed with low stomach acid then I suppose I would toughen it out and try it for longer, but I hate to add more acid if it really is an over production of acid my problem is.

      I am hoping the test I'm having at the end of the month will reveal something but I'm really starting to lose all hope.

      I looked in my records and I noticed I was actually totally without PPIs for over 4 ½ months and just used over the counter antacids. And nothing was showing any signs of improving, not even a little bit. It really makes me lose hope that maybe this is permanent and never will go away. 😦

      I don't know which teas as good for this but I recently bought something called DGL (deglycyrrhizinated licorice) which is supposed to coat the throat and stomach lining and help against reflux, but even at the maximum dose so far no luck with that either.

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  • Posted

    I'm so sorry you're going through all of this. Maybe the testing will help. You say it gets worse as the day goes on so that could be a motility issue. You initially went in with stomach pain due to something . But that never resolved either I assume? Let me know if you get any relief. I read you're trying reducing the granules in the capsule. I think that's a good idea but go very slowly. Like take out 4 granules and then one more each day as long as you get relief. You may need to hold at one level for a week or two.Some progress is still progress.

    Also going back to the beginning (stomach pain) have you looked into food sensitivities. A friend who had reflux found out she was testing positive for a sensitivity to spinach . Stopping that resolved her GERD .

    I know you're feeling frustrated and losing hope. Hang in there (oh how I hate that expression). You are addressing the problem as best you can that's all you can do. Try to keep your stress levels in check, acid can make you feel panicky for some reason.

    Keep me posted.

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  • Posted

    There are two separate issues that can be called acid reflux. One is a weak lower esophageal sphincter and the other is the stomach actually releasing too much acid. The carbonated water treatment started helping my reflux in about 1 week. But, I kept it up for the full 4 weeks. Some people have benefited from it, others who have hiatal hernias did not. But a stronger LES will always be a good thing.

    I was sleeping on a wedge for 10 years, but now I can sleep flat again. But, if I sleep on my right side, I build up pressure in my stomach and it is uncomfortable, so I sleep on my back or left side. That allows any gas to escape. It is due to the anatomy of the stomach.

    I did not do the camera pill. It sounded interesting, but I was also having intestinal obstructions and they said it could get stuck and require surgery to remove it. I did not want to risk it. I have rejected other options too, like exploratory surgery. My doctors marked me as uncooperative.

    Now, I can eat anything, as much as I want. Even a buffet. Pizza, spaghetti. But, my stomach is not able to make enzymes, so I take them with every meal. They speed up transit time. When food stays in the stomach too long it can cause an over acid condition. Most foods should exit the stomach in 30 to 90 minutes. If you can't make enzymes the stomach will just make more acid. I also chew sugarless cinnamon gum quite often. It help with digestion. The DGL did not help me at all. But, marshmallow yea does coat the stomach. Keep us posted at to your results. John

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