Side effects with omeprazole/Prilosec use

10 years ago or so, I had severe symptoms of having food stuck in my esophagus and not being able to swallow or bring food back up. This put me in the hospital a few times until an endoscopy diagnosed me with a schatzki ring. My gastroenterologist nipped it in one or two places and prescribed omeprazole 20 mg once per day. This worked fine for years. My current primary care physician wants me to come off of this proton pump inhibitor (PPI) and use an H2 blocker instead. I agree. I tried about a 10-day transition alternating between the two medications and then went to the H2 blocker (Famotidine) for 3 months with no omeprazole. I had swallowing difficulty symptoms almost every meal. They were mild to severe ( inability to swallow or bring food back up for 20 minutes with a production of fluid [saliva?] which required spitting and some small amounts of food coming up). So, I went back on Omeprazole about a month ago. Now I have obtained a prescription both. I would like to try to wean myself off of the PPI and onto an H2 blocker again. Here is my plan:● Alternate omeprazole 20 mg /day early am with famotidine 20 mg before breakfast and dinner for 14 days. Then alternate with PPI every 3rd day for 14 days. Then alternate with PPI every 4th day for 14 days.Does anyone have any experience with this transition? Any suggestions.

Anything acidic will exacerbate GERD

I drank about 2 tbsp ginger juice mixed with about 12 oz hot water daily for the past 8 mos along with many diet changes and famotidine 20mg am and pm. No caffeine, low-fat diet, head of bed at 30 degrees, decreased alcohol, etc. It was a lot of work but worth it.

Are you treating GERD or damage to the stomach lining? I don't have GERD but damaged my stomach with NCAID use. Diagnosed with reactive gastropathy. I still take famotidine 10 mg. as needed. Did they try PPI with you initially? Glad to hear you also get relief with ginger. Have you tried de-glycerised licorice? I also try to stay low on acid diet but its not easy. Low acid coffee seems ok. Thanks for sharing.

I have been on Omeprazole for over 5 years now, it works well, why transition off of it? I had an esophagectomy with partial gastrectomy and a pull through for esophageal cancer at the junction. I know my anatomy is a little different, just wondered why if it is working for you.
Sue

@fatherofstickyrice, have you also had esophageal cancer? Like @susanmaa, I'd also like to understand why you wish to transition from PPI to an H2 blocker. Is your doctor suggesting this?

No, thankfully, I have not had esophageal cancer. My doctor has recommended that I transition from a PPI to an H2 blocker because of the association of long-term use of PPI's with bone density loss (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914803/).

Thanks for that background information. I moved the discussion to the Digestive Health group (https://connect.mayoclinic.org/group/digestive-gastrointestinal-problems/) so that you can connect with others like @jackiem95 @pines @ngorman25 and others who may be able to provide some input and experiences.

To help the transition I have done some other things as well:
- cut out possible triggers from my diet: chocolate, citrus, mint, fats, spicy foods. This was harder for my wife who is Thai and cooks for me.
- Reduced the size of breakfast, lunch and dinner and incorporated a morning and afternoon snack. I aimed for satisfied/not hungry but not full / stuffed. This was also difficult for my wife who always offers more.
- Made sure I did not lay down until at least 3 hours after any meal. This was difficult for me in that if I did not sleep well, I had no opportunity for a nap.
- did not exercise vigorously right after a meal
- Made sure that my phone was not at the table during meal time. Ate in a meditative way conscious of flavors and textures and swallowing.
- Elevated the head of my bed about 4 inches.

I"ve been tapering off of the PPI since 13 January. On 24 February I took my last dose. Six days later, having taken the H2 blocker morning and evening, I had a severe swallowing incident while eating cubed fresh mango. I renewed my vigilance and have not had another incident.

I don't even know where to begin.

I had a baby in May 2020. Had a lot of reflux while pregnant but I figured hey, that's what happens. And it seemed to go away after the baby came. Fast-forward to Feb 2021, I had been slowly getting back into jogging and experimenting with intermittent fasting to lose the baby weight. Suddenly started to not be able to tolerate exercise - was feeling short of breath as soon as I started moving. That was weird, I thought, and then came the lightheadedness...waking up every morning feeling slightly hungover despite not having any alcohol. And it stuck around most of the day. Also found myself extremely tired most of the time. So ok, I head to the doc. First thing they did was check for anemia and electrolyte imbalance...nope fine. Well then it must be your intermittent fasting (at that point was only trying 16hrs...come on). I stopped that, no change. Well you must not be drinking enough water. Starting sloshing down a gallon a day. No improvement. Well it's probably just acid reflux. Started taking pepcid. Symptoms stuck around stubbornly. Finally had some referrals and testing--was really put through the ringer...no inner ear issues according to the vestibular physical therapist, no cardiac issues (believe me, I had the full rundown), no neurological issues (had brain MRI, EMG), even saw the pulmonologist. Everything unremarkable. I thought, maybe it's in my head...started therapy. I've been on wellbutrin for over 10 years and feel my emotional well being has been mostly in control (besides, ya know, becoming a new parent)...psychiatrist suggested adding prozac anyway. I said, I don't think I need it but if you think it will rule out anxiety as a cause of my issues then sure, we'll do it. (spoiler alert: it didn't help) Meanwhile I stopped exercising or really paying much attention to what I was eating. At some point I stopped the pepcid because it didn't seem to be doing anything for me.

Fast forward again to several months later...many of the original issues seemed to have resolved themselves, and I learned to live with the lightheadedness. It sometimes is better, sometimes worse, but sure ok, I guess I can deal with it and feel better knowing that nothing dire was going on. In October 2021 I decided to try working out again with the goal of completing a sprint triathlon this June. Additionally, I was going to PT for an SI joint issue that I was told had a lot to do with having been pregnant/having a c-section/not having strong core muscles. I started with swimming and worked my way up to a half mile in the pool. I added jogging on the treadmill in January and toward the end of the month completed my PT stint--I was feeling great. I was still getting dizzy but trudging through it, and at least the other stuff I had experienced wasn't an issue anymore. But I started having more digestive issues in January...constant bloating the worst by far. I saw someone from integrative medicine and she suggested an elimination diet (and of course a ton of supplements). Did that for 2 weeks--very strict, very miserable existence because I very much enjoy food. It didn't help. I tried a longer fast--made it 4 days before quitting...despite taking adequate amounts of electrolytes (I research everything before I do it), I felt worse than ever. I had my first appt with GI. She suggested trying low-FODMAP diet, testing for SIBO, and an xray to make sure I wasn't just constipated. The xray was neg for excessive stool and SIBO test was negative (though I've heard it can be unreliable). Didn't get a chance to really try the diet because within a week after seeing the doc, for some reason I started getting nauseated...like all day, unrelenting nausea. No vomiting, no terrible abdominal pain...just kind of the same old intermittent diarrhea and gas pains I've had my whole life. And the day after this started I woke up with excruciating lower back pain. The pain made it impossible to do much of anything...but it did ease somewhat after a few days so I thought maybe I just pulled a muscle or something. The pain didn't let up after 2 weeks so I dragged myself back to the orthopedic folks. She said my SI joints were flaring up and prescribed a short course of steroids. Meanwhile, still super nauseated and bloated. Back started to get a little better but unfortunately that improvement didn't last. Started wondering if the back pain and digestive issues are related--have been making sure to take only tylenol since Feb. I haven't worked out in like 6 weeks so I feel like a super slug. Saw the GI again last week, she recommended an ultrasound to check for gallstones and starting omeprazole. No stones on US so she recommended abdominal/pelvic CT, which I had this week and already came back normal. Have been taking omeprazole for a full week now. Nausea is maybe a little better but still bloated AND now I have more overt symptoms of reflux--always feeling like something's in my throat...woke up with a sore throat today that has not gone away, shortness of breath, regurgitation, chest pangs occasionally...eating a lot of tums. The GI's comment on my CT results were that she wanted me to message her in 1-2 weeks if symptoms have not improved and we'll discuss doing endoscopy.

So...I guess I really have two questions...1) can taking drugs like omeprazole actually make your reflux worse (NOT as rebound reflux--I'm still taking it daily) and if it does eventually help, how long should it take? I mean...do I really need to give it 1-2 MORE weeks to do its thing? And 2) how the hell do I figure out what to eat? I know certain things I absolutely have to avoid because they make me super sick (coffee and chocolate so far)...but looking at low FODMAP foods that are also good for GERD and that will help me lose a little weight (I am still overweight by about 30 lbs--thanks, grad school)...just doesn't seem to be a lot of options. Salad and oatmeal every day, apparently? Have considered just fasting but then...that didn't work before either.

It's really weird to think of all of my issues (besides maybe the back pain) could be due to acid reflux..particularly because I basically only have heartburn when I'm taking the GD pills to prevent it. But...bodies are wacky.