I remember from a couple of years ago Dr. QtM’s advice to take PPIs on an empty stomach, and have been doing so for a long time, first thing upon getting up in the morning. Does a cup of tea with milk, drunk about a quarter of an hour later, negate the effect?
I’ll try doubling the OTC lansoprazole for awhile before I go the Canadian pharmacy route. And I wish I still did have a GI, but he retired a couple of years ago. My GP took over prescribing Dexilant for me, but as I said, coverage for it came to a halt early this year.
Mama_Zappa, I hope this discussion is useful for you.
It could well reduce the effect. I’d really try to go without anything but some water for at least 30 minutes. Take the med first thing as you get out of bed, is my usual recommendation. And if you have worsening symptoms despite proper treatment, your primary should be willing to have you follow up with a new GI doc. have you had an Upper scoping of the esophagus and stomach before?
You’re welcome. Tums or mylanta are what my patients always reported as best for quick relief when PPIs and H2 blockers failed.
You could consider trying nexium (esomeprazole) too, and see if that works better. Some studies report that it does. It too is an isomer, the S or levo isomer of omeprazole (prilosec)
Any love for pantoprazole for teela? (Aka Protonix) I started my GERD journey with Dexilant, Nexium and Prilosec and the one that ended up working for me is pantoprazole.
I didn’t realize how much my heartburn was bothering me until my doctor put me on this and it just went away. A miracle. My husband won’t listen, swears his heartburn is “occasional”, but keeps Tums by the bed.
I’m curious–since one of the possible side effects of PPI drugs is osteoporosis, is taking a calcium antacid for breakthrough symptoms a good choice? And maybe a magnesium supplement as well?
And anecdotally, I find that my tendency to experience acid reflux is strongly linked to carb intake–when I’m sticking to my keto friendly eating plan I almost never have it, but some bread or other simple carbs and I’m snarfing down Pepcid like nobody’s bidness. Definitely incentive to stick with my diet.
Many of the so called Canadian pharmacies are bogus. Make sure you do your research. If you PM me I’ll give you the name of one my brother-in-law has been using for years.
Also, have you tried rabeprazole (Aciphex)? It’s available as a generic now. Works great for me.
Well, here’s a thing. Last night I was trying to think of what I might be doing differently since about four months ago, when this latest bout of GERD starting plaguing me. It finally occurred to me that I had started taking wild fish oil capsules about then. I’m doing so on my ophthalmologist’s orders, as this somehow combats dry eye.
I looked up side effects for fish oil gel capsules, and right at the top of the list: acid reflux and heartburn. Bingo. I’m going to call my ophthalmologist in a little while and see what he says about this. But I’m still doubling up on the lansoprazole and making sure I delay morning tea for half an hour afterwards.
According to my dry eye specialist, it helps the quality of the tears being produced so they cover the surface of the eye better, and don’t evaporate as quickly. I take them too, for the same reason.
(The dramatically improved lipid panel results are a happy side effect.)
For anyone interested in this thrilling GERD tale, I’m employing two strategies, and one of them or both are working:
Doubled up on lansoprazole and made sure to consume nothing for half an hour afterwards; and
Stopped taking fish oil capsules.
I’ve had no GERD since I started doing these. In a few days, after my esophagus has had a good rest, I’ll slowly re-introduce the fish oil capsules. The ophthalmologist’s assistant says to take them just before dinner so that they don’t cause so much backup. We’ll see.
This is cheaper than about $100 a month for Canadian Dexilant.
Taking pills while lying on the right side was by far the best, sending pills into the deepest part of the stomach to achieve a dissolution rate 2.3 times faster than even an upright posture. Lying on the left side was the worst.
and of course lying on the left side helps with reflux.
When are you taking them? I find that matters a lot with stuff that can cause heartburn. I believe the reason fish oil can cause heartburn is that fat slows down stomach emptying. So you’d want to take it while you’ll be upright for a while afterwards, to avoid any stomach contents spilling out.
The other advice I have is sucralfate. It forms a barrier in your stomach. I rely on it whenever I eat thing that can exasperate heartburn. You just have to take it an hour before eating or bed, and 2 hours after any other medications, with the exception of antacids and similar, which you can take 30 minutes before or after. (Also, you can take it 30 minutes after a PPI, but not before.)
It’s an older drug that doctors don’t prescribe as much anymore, so sometimes you have to ask about it.
My doc keeps telling me to take fish oil, and I know I would very much benefit from fish oil, and I think I’ve even taken fish oil in the past. But something has kept me from actually taking it. Maybe my ridiculous and slow stomach is sentient? This thread is reminding me to read up on alternatives, though. Good tips about lying down, @rocking_chair and good reminder about sitting upright @BigT
Glad you found some relief @teelabrown!! Daily GERD symptoms are just terrible. Terrrrrrible!