As more long-term users of proton pump inhibitors (PPIs) such as Nexium and Prilosec become aware of the dangers of continued daily use, we are getting more questions about how to reduce or eliminate the use of these medications. We always highly recommend that this be done under the care of a specialist or GERD expert. As highlighted in this visitor’s question, following the PPI step down approach designed by RefluxMD’s medical advisors will require additional professional assistance.
I need to come off of my acid reflux medicine. I take omeprazole, it’s a capsule of pellets (10mg). I take 4 pellets of the 9 pellets within the capsule and I have found that is my minimal dose. If necessary, I take Tagamet; I will use a 1/4 dose when I have a flare up. I have been on these medicines for 20 or more years and I supplement with magnesium and coQ10. I have tried to taper the dose downward by alternating days of each dose. When I did this for a week it sent me to the hospital with horrible gastritis. Please, I am desperate to come off these drugs. There is a strong physical need for these drugs to control the “acid hell” that comes when you try to quit or taper off. Heart attack is now a reason to come off of PPI meds.
Thank you for your question. After 20 years of taking proton pump inhibitors (PPIs) such as omeprazole, it will be a challenge to reduce your dose or eliminate them by yourself. It sounds as if you have experienced acid rebound, a reaction to PPI withdrawal that can be extremely painful. If it has been more than 4 or 5 years since your last endoscopy, this is probably a good time to consider scheduling another exam. Reflux disease is a slow developing chronic condition and it can evolve into an erosive form of GERD. A complete examination by a GERD expert as you attempt to step down from your medication is something you should seriously consider.
It is time to see a reflux expert
I do not know if a primary care physician (PCP) or a gastroenterologist diagnosed you with GERD. PCPs are unable to accurately diagnosis GERD since they do not have the equipment or training to perform proper diagnostic tests. As a result, they diagnose based upon a symptom discussion and/or using the PPI Test (sending their patient home with a PPI prescription and asking them weeks later if they “feel better”). Neither of these are accurate. Since you live in the Los Angeles area, you have a top expert in your area. For others seeking a GERD expert, feel free to use our DocMatch service or our Find-a-Physician online search tool.
There is a very talented GERD expert in LA who can coordinate a full workup and provide you with all the available treatment options to find relief and improved health. Dr. Steve DeMeester MD FACS works at the USC Keck School of Medicine, Los Angeles, CA. Dr. DeMeester has all the diagnostic capabilities to fully evaluate you and provide you with every treatment option, including surgery if that is appropriate. He is also one of the few surgeons certified to perform the LINX procedure. You can reach his office at (323) 865-3984.
For many, the best option may be antireflux surgery
Twenty years is too many years of suffering with GERD. Perhaps it is time to consider antireflux surgery to eliminate your symptoms and halt the potential for progression to Barrett’s esophagus or esophageal cancer. We have written about many success stories on our website and each individual interviewed agreed that they wish they had taken action to have the procedure sooner. I encourage you to discuss this with Dr. DeMeester if you choose to consult with him.
Your acid reflux medicine is only one element to managing symptoms
We have hundreds of articles on our website about the importance of proper weight management, a GERD-friendly diet, and beneficial lifestyle changes. We encourage you to spend more time reading about the personal choices you can make to manage your disease. I wish it were as simple as just taking a pill daily, but unfortunately it is not. In addition to our website articles we developed a very comprehensive resource that many have found useful, RefluxMD’s Recipe for Relief, which provides all this information in one place.
I hope this helps and all of us at RefluxMD wish you the very best on your path to relief and good health!