Switched off of Omeprezole at 4 month post op visit and have raging reflux now

[writegirl]

I had my 4 month PO visit last week. The nurse switched me off of Omeprezole 20 mg, citing it is linked to Alzheimers disease with long term use, etc. and put me on Famotidine 20 mg twice daily. Tonight I have reflux for the first time since surgery. It's very acidic. I've got to wonder whether it's the switch from Omeprezole to Famotidine that is doing this. Anyone else ever have this kind of reaction to Famotidine? Should I ask for a change? Or a higher dosage? Or?

Any advice is much appreciated.

 

[Clematis]

Eiyiyi. I feel your pain.

It's not the fantadine.

Google PPI rebound effect. It's BRUTAL. I've been battling to get off them the past year -- nearly impossible. I'm working with a gastroenterologist now to see if it is possible.

You should have slowly gotten off PPI by switching to 10mg and a H2 (like famotidine or rantadine), then moving to H2 after several weeks. Supposedly H2s are easier to get off of.

Carafate suspension can help (maybe, a little). You swallow a teaspoon 4x a day and it helps coat the stomach and esophagus. (It's prescription.)

Also go back to reflux 101 while you're trying to get off PPIs: Avoid acidic foods; no food after 8pm; sleep with upper body elevated; avoid caffeine and chocolate.

PPIs should never have been made OTC.

 

[DianaCox]

I take 40 mg of Protonix twice a day. I can't imagine getting off of it, but ... I'm not thrilled about getting Alzheimer's either ... UGH.

 

[writegirl]

Eiyiyi. I feel your pain.

It's not the fantadine.

Google PPI rebound effect. It's BRUTAL. I've been battling to get off them the past year -- nearly impossible. I'm working with a gastroenterologist now to see if it is possible.

You should have slowly gotten off PPI by switching to 10mg and a H2 (like famotidine or rantadine), then moving to H2 after several weeks. Supposedly H2s are easier to get off of.

Carafate suspension can help (maybe, a little). You swallow a teaspoon 4x a day and it helps coat the stomach and esophagus. (It's prescription.)

Also go back to reflux 101 while you're trying to get off PPIs: Avoid acidic foods; no food after 8pm; sleep with upper body elevated; avoid caffeine and chocolate.

PPIs should never have been made OTC.

Oh, I have prescriptions for both the PPI and the H2 since I demanded that because my insurance will pay enough for them that it makes it much cheaper for me to purchase. I was told pre-op that I would have to be on Prilosec or Pepcid for the rest of my life as a post op. It's actually in the paperwork from our pre-op dietician meeting. Are you saying we can get off of them?

Should I call and ask them to take me off the PPI slowly? I am afraid of stomach damage from this acid. I had a very severe case of h-pylori post op and that did some damage to my stomach and intestines. It healed, but I don't want to re-injure the tissue again. I'm so irritated by this. I was doing so great and had no complications at all. Now, I'm afraid to eat.

 

[writegirl]

I take 40 mg of Protonix twice a day. I can't imagine getting off of it, but ... I'm not thrilled about getting Alzheimer's either ... UGH.

Yes, the relation to Alzheimer's scared the shit out of me. I hope my body adjusts to the stupid famotidine. I wonder if I need a higher dosage of it for now.

 

[chevtow]

Everything is killing us. I'd rather enjoy the years I have than suffer with reflux ever again.

 

[writegirl]

Everything is killing us. I'd rather enjoy the years I have than suffer with reflux ever again.

Yeah...but Alzheimer's...that's a fate worse than death. In our cases, since self-care is so vital, I can't imagine suffering dementia as a DS patient. It's a fate too cruel to contemplate.

 

[southernlady]

I tried coming off a PPI a couple of years ago, lasted a month. Developing dementia is preferable to 1) not sleeping, 2) getting esophageal cancer from GERD, etc. And mine got worse over the month, not better.

I also found this: https://www.medscape.com/viewarticle/881978
Study was a large one and unlike the previous ones, included younger patients.

I currently use OTC Prevacid. Getting a prescription for a PPI is damned near impossible now that most are OTC.

 

[Clematis]

I know many with DS/VSG who went off PPIs without incident. In fact, Mexicali Bariatric Center (Dr Esquerra) recommends stopping after 3-4 months (I can't remember) as do many other American DS surgeons.

And then there are others like me.

I started PPI 2 months before DS for "silent" GERD. And it remained silent... until I tried to get off PPIs about 6 months post-op. Before DS, I was told I'd have to be on it forever unless [doctor stares at me up and down] I made SIGNIFICANT lifestyle changes. So I got DS and lost 110+, slept on bed wedge, avoided acidic foods, gave up coffee and tea, etc. I did wean myself down to 20mg vs 40mg. But when I tried to get completely off... AGONY. So I returned to 20mg only now even THAT didn't work so I was taking 20mg PPI in the morning plus 75mg rantadine at dinnertime. (One step BACK!) Months passed and after researching protocols for how to slowly wean oneself off, I tried again. I got off PPI (briefly) and was taking two 75mg rantadine 12 hours apart. I was miserable but tried my damnedest to stick it out until the reawakened acid producing cells stopped acting berserk and settled down. I added fistfuls of Tums (calcium carbonate) to help ease the pain and in 6 weeks developed the most gigantic kidney stone. (Turns out calcium supplements were the cause of my kidney stones post DS, but that's another story.) I gave up and went back to 40mg PPI until the gastroenterologist completes his tests in two weeks. (I suspect I just have a "lazy" esophageal sphincter due to age.)

Be aware that H2s have the same dangers such as dementia, higher infection rates, especially c-diff, as acid fights infections, and kidney stone production as calcium metabolism is impaired. PPIs have all of those dangers and also add possibility of swift and permanent kidney failure. Your body needs acid to work effectively. The only reason to go to H2s (if they work for you) is that they are supposedly easier to get off of than PPIs.

Google PPI withdrawal and you will find the methods for getting off the drug. It should be a s-l-o-w process -- maybe as long as months.

Good luck

 

[LynneV]

I was given a PPI after my surgery but never took them. I felt I had no need for them.
No one has ever asked if I was still taking them, I had no idea they are a standard part
of the DS recovery. OOPS

 

[JackieOnLine]

PPIs should never have been made OTC.

I do kind of feel damned now that I take 20 mg twice a day and still have some reflux.

 

[KathrynK]

First, there are data on both sides of the PPI-Alzheimer’s link, and there hasn’t been a randomized controlled trial, so it is not absolutely certain PPIs cause dementia. But, I agree with the opinion that it’s best not to mess around with brain cells. I also think that severe reflux is so debilitating that what works is hard to give up. But be aware that these drugs affect vitamin B12 levels so that might be responsible for the potential link to dementia.
https://jamanetwork.com/journals/jama/fullarticle/1788456

There is a surgical treatment for reflux. I was lucky enough to have reflux surgery—fundoplication—before my bariatric surgery and I have never experienced reflux since. Preop patients should discuss this, because there is a surgeon doing fundoplication at the same time as sleeve gastrectomy. (I don’t think you can do it after DS or sleeve gastrectomy, since it uses part of the stomach.)

You might have a hard time finding someone to do it, and I don’t know if insurance companies approve it easily, but I see there is an FDA approved device that is like fundoplication, the LYNX. It is a ring of magnetic beads that open when eating and close after eating to prevent acid from refluxinginto the esophagus. And it only involves the esophagus, so your DS may not be a contraindication. I don’t know. They do it at NYU in NY and USC in California and I am sure other places.http://www.surgery.usc.edu/uppergi-general/gastroesophagealrefluxdisease-linx.html

 

[Clematis]

Regardless of whether they can or cannot do fundoplication or beaded ring both involve lap scArs and I just paid $15k for lower body lift. Ain’t no one carving me up!! I’ll suffer PPI consequences

 

[Susan in Tennessee]

I stopped taking my ppi a couple months post op and have done good without it, as far as I know. I hear silent gerd mentioned, hope I don't have that! My voice is back to normal also.

 

[writegirl]

I stopped taking my ppi a couple months post op and have done good without it, as far as I know. I hear silent gerd mentioned, hope I don't have that! My voice is back to normal also.

Wait...you had voice problems? I have had terrible voice issues since surgery and I mentioned this to the nurse during my post op visit last week and she kind of shrugged and told me to go to my PCP since it can't be surgery related. Do you think the PPI gave you voice issues or the GERD or both?

I've also had a weird issue with my urinary tract (also since surgery), but they just tell me to go to my PCP. I guess that I will, eventually. Right now, I want the reflux to stop and I hope the transition off of PPI mellows. I can't believe they put patients on this crap that is so hard to get off of and don't warn us that it's going to be like this. What the actual hell?