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I am wondering about the timing of PPI effectiveness and what it feels like when it wears off for the dosage.
I have been off and on PPIs for around the last year and the first few times I stopped, I stopped cold turkey and didn't seem to have any immediate effects. Typically trouble in the form of burping would start about 2 weeks later but also seemed to coincide with bad eating so I don't know if it was rebound or diet or both.
For the first 10 of the 12 last months I never had any heartburn or even sign of LPR other than burping. I did get a bit of a warm feeling in my stomach early on before taking PPIs when I ate certain foods.
The last 2 months I ended up with a lot more severe problems (see my other post here if you want all the sad details:
Anyways, one thing that happened when I started to have all my stomach pains and issues was that about a week or so into it, while on 60mg of dexilant I actually felt some reflux while eating some ribs. Since then I have a lot more noticeable signs of some kind of acid related problems. Right now here is what it looks like:
I take my 60 mg of dexilant at 5:30PM because I wanted to maximize night time protection since I seemed to be having some pains after dinner and bad sleep..
My day usually goes like this now that all my other gut pains have drastically decreased in intensity and frequency.
Wake up feeling fine. Sometimes a bit of a metallic taste in my mouth. Sometimes not.
Drink a big cup of water and have breakfast 15-20 mins later.
Typically OK till about 3PM. Sometime between 3 and 5PM I typically notice a slight burning feeling in my stomach. I thought it was from food I was eating but it doesn't matter what I eat or if I ate recently, it comes on. It often also comes with a slight feeling of pressure in my throat and I start getting an occasional dry cough. This feel lasts 30-60 minutes and then seems to calm down a bit with or without taking a PPI. I usually am drinking some water throughout this time though.
I take my 5:30PM PPI and usually things feel a little better. I have dinner around 6:15 to 6:30PM. After dinner, I often have a cough and a slight feeling of having a harder time taking in a deep breath. When I go to bed around 10:45 to 11PM I feel fine when I lay down (on my left and head elevated on a medcline pillow). This includes breathing in which feels totally fine..
So my questions are:
Does this sound like LPR?
Is the slight burning feeling that comes on around 3PM or so my stomach starting to produce or over produce acid because the daily dosage of dexilant has worn off enough? If so, should I do something to protect myself from reflux for this short period? Like take gaviscon or something at 2:30 or 3PM? Or make sure my stomach has something in it? (and if so, what?)
Does this mean I definitely have a reflux problem that would exist even without the PPIs or is there a chance that it is acid hypersecretion and weening off the PPIs would eventually produce less acid? I am scared to ween off at this point because I don't want to aggravate any other issues that I had but I am also worried that the PPIs are the cause of some of the other issues..
For reference some of the issues I have that I am wondering if they are caused by PPIs or the acid are:
- greatly increased sensitivity to foods. It's almost like I have oral allergy syndrome as things are starting to irritate my throat shortly after eating them that didn't even 2 weeks ago. Bananas, cantaloupe, etc..
- I used to be able to handle dairy fine but tested high lactose intolerant about 6 months ago. This was after being on PPIS for about 4 months
- I seem to have digestive problems. Possibly gluten sensitivity (tested negative for celiac though) and I get full pretty easily and it takes more than 3 or 4 hours to not feel full. (slow emptying?)
Any thoughts would be appreciated. My GI doc didn't have much to offer at this point but I have an endoscope schedule for next month. I am seeing a new family doc on Friday and will see what she says as well.
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