Kicking the Omeprazole / Nexium / PPI Habit

So, lately I've been wondering if it would have been better to not stop my nexium/omeprazole (started on Nexium) medication.  I went on a hunt to see what other people found to work best.  In reading, I found that simply stopping the PPI or H2 blockers because this may cause a sudden and nasty rebound effect.  It seems that gradually stopping may work best.  Take a look at the following schedule that was suggested for stopping Omeprazole:

1.

Week 1: Alternate 20mg of Prilosec (Omeprazole) with 100mg Prilosec
Week 2: 10mg Prilosec
Week 3: Alternate 10mg of Prilosec with 80mg Pepsid (Famotidine)
Week 4: 80mg Pepcid
Week 5: Alternate 80mg Pepsid with 40Mg Pepsid
Week 6: 40mg Pepcid

2.

Week 1 : alternate 10 mg Prilosec with 20 mg Pepcid
Week 2 : alternate 20 mg Pepcid with 10 mg Pepcid
Week 3 : same as week 3
Week 4 : 10 mg Pepcid
Week 5:  Use Apple Cider vinegar, DGL Licorice & ginger.

3.

Week 1: 40mg Omeprazole
Week 2: 20mg Omeprazole
Week 2: Alternate 20mg of Prilosec (Omeprazole) with 10mg Prilosec
Week 3: Alternate 10mg Prilosec, 40mg Pepsid
Week 4: Alternate 40mg Pepcid (Famotidine), 20mg Pepcid
Week 5: 20mg Pepsid, 10mg Pepcid
Week 6: 20mg Pepsid, 10mg Pepcid
Week 7: 10mg Pepsid
Week 8: 10mg Peps, Off (take DGL Licorice, apple cider vinegar at night, ginger)

4.

Take your Omeprazole/Nexium/Etc. capsule and begin to remove 1, then  2, then 3,  then 4, etc., of the capsule's content every day, until you're down to none.  This takes some effort, but has been known to work.

Mornings without GERD

I love mornings.

It is only in the mornings when I feel 100% normal, almost every day since my GERD struggle begun. I generally feel light, like perhaps I'm ok.  Better yet, perhaps today will be a symptom free day.  I feel so good!

So why are my mornings better?

I've looked online and can only guess that it's because of my behavior at night.

1. I stop eating 3-4 hours (preferably 4+ hours) before I go to sleep.  I don't get into bed unless I feel my stomach is already empty.

2.  No more snacking after dinner.  At most, I drink water. I know this is hard but every time I put something in my mouth, I wonder how it will affect my GERD.

3. I have changed my diet, I'm now on a paleo diet.

4. I stop drinking glass fulls of water before going to sleep.

5. I try to sleep on my back, this helps to eliminate pressure on your esophagus.

6. I raised the head of my bed 5 inches from the ground.  This makes my bed look quite funny but it does help; it's also better than buying tons of pillows.

Take a look at other recommendations people have for minimizing night GERD.

GERD Hell / Symptoms / Suffering

So my Nexium medication ran out, except for 1 pill I had in my bag, a few weeks ago.  I took my last capsule on a Thuraday.  I went out with friends that night.  I tried to be good but we ate quite late.

The next day I felt ok.  Saturday was not too bad, but I started to feel like I couldn't eat as much.  By Sunday, I was already feeling stomach distress.  That Thursday I had to take off work.  I was trying hard to keep things under control.  I ate tiny meals, every two hours.  But at some point it wasn't enough.  I was quite weak.  I weighed myself and I had lost almost 4 pounds in what was about 7 days.  That's virtually impossible for me.  I rushed to get Pedyalite.  I recommend Pedialyte for anyone that thinks they might be dehydrated.  It works fast, and to me, it doesn't taste horrible, bad yes, but not horrible.

It was probably Friday, so 1 week after I quit Nexium that the pain started.  It's hard to describe pain that never goes away.  I had the following symtoms:

Stomach pain
Stomach burning
Lightheadedness
Head pressure (from the back of my head to my skull)
Shortness of breath
Nausea
Constantly clearing my throat
Taste of acid in the back of my throat or slowly rising from my stomach
Painful bloating for hours
Extreme weakness
Sore Throat
Constant burping (particularly after eating or drinking)

I rarely felt hungry because I was in almost constant pain.  It was agonizing that when I did feel hunger, I was too scared to eat.  I knew I had to, so I forced myself to eat, but always with the same consequences.  Worse, even water made me sick!!

I realized after the first few days of being at home that whenever I drank water with my meal: before, during, or immediately after, I felt the acid in my stomach rising up my esophagus.  This is torture because I love water.  I only drink water or alcohol.  So, I did some researched and found out that  water is actually not good to have during meals if you have GERD.

As soon as I read this, I stopped drinking water, which did cut down on my feeling all the acid flowing up my esophagus.  However, I needed to do more, and so I set out to look on the internet for natural ways of curing/treating my GERD.

GERD Doctors - The Gastroenterologist

After ending up in the hospital twice during the same week of New Years Eve (quite the beginning for the year), I went to 2 gastroenterologists.

A gastroenterologist is a physician who specializes in disorders and conditions of the gastrointestinal tract. Most gastroenterologists are board-certified in this subspecialty. After completing the same training as all other physicians, they first complete at least two years of additional training in order to attain board certification in internal medicine, then gastroenterologists study for an additional 2-3 years to train specifically in conditions of the gastrointestinal tract.

The first one of these that I went to said he thought it was an ulcer, so to schedule an appointment.  Due to health insurance issues (surprise surprise), I had to switch to another doctor so I scheduled another appointment.  This time I was prepared, though swearing this had to be an ulcer, and had a list of questions:

1. What's the most likely cause of my symptoms?
2. Are there other possible causes for my symptoms?
3. What kinds of tests do I need, and how do I need to prepare for them?
4. Is my condition likely temporary or chronic?
5. What treatment do you recommend?
6. How quickly will I start to feel better?
7. What if my symptoms don't improve?
8. What are the alternatives to the primary approach that you're suggesting?
9. Are there any dietary restrictions that I need to follow?
10. Is there a generic or over-the-counter alternative to the medicine you're prescribing me?
11. Are there any brochures or other printed material that I can take with me? What websites do you recommend?
12. What caused me to develop this ulcer?

I think I got this list from a website.

The second doctor right away said she thought I had IBS ("Irritable Bowel Symdrome") and gave me materials.  I read the materials and they pretty much said this of IBS:

Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS doesn't cause permanent damage to your colon.  

Now, I that point I had a long list of symptoms I carried with me for my doctor's information.  However, I absolutely knew I did not have IBS.  The only time I had ever been constipated was during my first "GERD Episode."  Otherwise, I have always been very regular, have had normal movements, and my symtoms were more like an ulcer if anything.

However, she said I needed to change my diet.  I read but dismissed her diagnosis, though I did make the appointment for the endoscopy, after much haggling with my insurance.  She also gave me a 3 month prescription for Nexium.  I read about PPIs, about how they have a million side effects.

During that time, I was eating every two hours and more like a bird.  I resented this change in eating.  I complained to everyone I could.  I did not want to fill the prescription because I hated drugs.

Finally, I went in for the endoscopy and all they found was inflammation around my lower esophageal sphincter. The doctor told me that was it, no ulcer, so I started to take the Nexium.

My GERD Beginnings

After living with GERD, I have taken a long look back at my life and my relationship with food.  I now realize that I've had a bit of a love/hate relationship with eating.

I love food.  I love eating food.  I've never been much for cooking, but I'm the first one knocking on my friends' door to see what they have on the stove.  I always say yes to dinner outings, and I rarely turned down a pizza after a night of drinking.  Please note that I'm from New York City.  One thing we have is restaurants and cuisine from every corner of the world, so over eating super wonderful food is quite easy.

This was exactly what happened when I had my first "GERD attack."  I call it this because before that, though I may have had GERD symptoms, I never truly thought there was something wrong:

I drove my family to the mall and ran some other errands.  I think I had maybe breakfast.  I got to my mother's house and she said she would make food.  This was around 9 pm.  I said no, I wanted to go home.  I drove myself home, but before that I stopped at Popeyes.  I'm a big Popeyes fan, never cared for KFC.  I bought a couple of chicken pieces, two servings of large cajun fries, a rootbeer (though I'm really not a soda drinker), and a couple of M&Ms almonds from the 711 next door because I love those and rarely saw them.  I went home, ate it all, and about an hour later I found myself bloated like I had never been.  I thought it would go away so didn't pay it any mind.  2 Hours later: my belly had grown more and I was shocked at how much it hurt.  4 hours later, my belly had not come down.  I read something online about walking to relieve bloating.  I walked for like 30 minutes.  I came back and I was still bloated.  I was a little scared, particularly because I couldn't lay down at all.  My breathing was shallow. I considered paramedics but knew this had to get better.  I sat on my couch and stayed there, barely sleeping.  The next day I was better but constipated, which is quite unusual for me.  I spent the next 4 days eating tons of fiber, but nothing helped me go.  I finally took a couple of different laxatives and that helped.  I could barely eat though, and felt weak.  On the 7th day (New Year's Eve by the way), I went to my family's for dinner and after a few bites of food was dizzy, had hot flashes, and my stomach got so big that my family rushed me to the hospital.  

What is GERD?

So, out of nowhere I have had to ask myself the above question.

This is the answer, according to the Mayo Clicnic's website:

Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into your food pipe (esophagus). The backwash of acid irritates the lining of your esophagus and causes GERD signs and symptoms.

See also Wikipedia, the National Library of Medicine, and many more out there.

They then list GERD symptoms as follows:

Acid Reflux
Heartburn

When these symptoms occur more than once a week, this is GERD.

Additional symptoms include:

• A burning sensation in your chest (heartburn), sometimes spreading to the throat, along with a sour taste in your mouth
• Chest pain
• Difficulty swallowing (dysphagia)
• Dry cough
• Hoarseness or sore throat
• Regurgitation of food or sour liquid (acid reflux)
• Sensation of a lump in the throat

However, I assure you, I have suffered much more than just Acid Reflux and Heartburn.  Worse yet, it's a day to day struggle.  I very much feel I have lost my life to GERD.  Every day, my first thought is how bad will my GERD be today, and at the end of the day "how bad will my GERD be tomorrow?"

I'm writing this blog to document my experience with GERD.   I hope this helps someone.  Good luck!