alternative to Omeprazole?

Not sure how to answer. . The microscopic colitis I was finally diagnosed with after 7 months of diarrhea has four or five known medication triggers - and PPIs such as Nexium is one of them. NSAIDs and SSRI antidepressants are also triggers. I went off ibuprofen and Nexium and after the treatment for it I haven’t had any more trouble.

That said, they do state PPIs are not intended or recommended for long term use.

I've been on Omeprazole for over 10 years. I have specifically asked my GI doc in the last two-year appointments, about the long term impact or side effects from taking this drug for so long. His standard response is do you want to deal with Esophageal cancer or keep taking Omeprazole. I was on the PMR forum when one of the members mention he was also on Omeprazole and that he had found a study that tied Proton pump inhibitors (PPIs), including medications ending in "-azole" such as omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole, have been associated with neurological adverse events, including peripheral neuropathy. That got my attention, so after a search on ChatGpt I found that indeed long term user have experienced adverse health effects using these drugs.

Here's what it said:
"A large-scale analysis of over 10 million FDA adverse event reports revealed that patients using PPIs had a significantly higher incidence of neurological adverse events compared to those using H2 receptor antagonists. Specifically, the odds ratio for peripheral neuropathy and related conditions was 8.68 (95% CI: 3.86–19.49; p < 0.0001) in the PPI group. This suggests a strong association between PPI use and various forms of neuropathy, including peripheral sensory neuropathy, neuralgia, and polyneuropathy."

"1. PPIs and Kidney Disease
Multiple studies now link long-term PPI use to both acute kidney injury and chronic kidney disease progression.
They may cause subtle inflammation in the kidneys over time (interstitial nephritis) even without obvious symptoms.
With stage 3 CKD, keeping your kidneys protected is huge.

2. PPIs and Neuropathy
As we discussed, PPIs are associated with vitamin B12 deficiency and magnesium deficiency, both of which can lead to polyneuropathy and worsen restless leg syndrome."

I have been diagnosed with Polyneuropathy, Carpel Tunnel, Kidney Disease, Vitamin B-12 deficiency, Magnesium deficiency and restless leg syndrome. I believe these are all caused from taking Omeprazole. Likewise, I have stopped taking it and will ask to be put on an H2 blocker, probably famotidine. I may have also had the microscopic colitis mentioned by pb50, as I suffered from explosive diarrhea for years.

Furthermore, I don't think the GI docs are familiar with these studies, otherwise I would like to think they would not be prescribing them. As we all know, we have to be our own best advocate, that's why we are on this forum. I appreciate so much everyone contribution.

The more research I do, the more I find how important our stomach bacteria is and that it may be the key to so many health issues. PPI may be destroying the good bacterial and creating additional inflammation in our bodies, possibly creating other health issues.

I have been taking 40 mg of Omeprazole twice a day for eight weeks due to gastritis and am now supposed to go down to once a day, apparently forever. I have osteoporosis and do not want to be on Omeprazole forever due to its effects on bones. I purchased Terra Health's Acid Relief and intend to try to use it instead of Omeprazole. Has anyone else used this supplement or any other instead of a PPI and found it to be satisfactory at reducing gerd and its effects on the esophagus?

I am in a similar situation as you, @janieben. I recently started taking a PPI after learning I need to protect my stomach from low dose aspirin I also take. I share your concern about osteoporosis and long term effects of PPIs.

My doctor prescribed pantoprazole for gastric protection while continuing aspirin, and recommends switching to famotidine twice a day as an alternative. I try to get consistent calcium in my diet but he also made sure I take calcium +vitamin D when starting the PPI.
- Famotidine: https://www.mayoclinic.org/drugs-supplements/famotidine-oral-route/description/drg-20072972

What discussions have you had with your doctor(s) about having osteoporosis and taking omeprazole long-term? Are you taking calcium or anything else to help your osteoporosis?

The dr who did the endoscopy insists that omeprazole is the first line of defense against esophagitis, wants me to take it forever, and acts exasperated when I mention any long-term effects. Her attitude is, "So, you want to get esophageal cancer?!" I do have a hiatal hernia, which is the main reason I have damage to my esophagus, I assume. I don't know if it is a large or small one, and I am not sure of the level of damage to my esophagus. I am researching a procedure known as TEF - transoral incisionless fundoplication to 'tweak' the hiatal hernia. As far as osteoporosis goes, I have been taking Vitamin D3 with K2 for several years. I have recently added Vitamin K - MK4, which I have read directs calcium to the bones more than MK-7 does. I also started a weight-lifting, exercise regimen several months ago at a local community health center. I go three times a week. I take selenium and try to eat prunes. I do drink some milk, eat lots of cheese, cottage cheese, etc. Interestingly, since I have been taking Omeprazole for the past eight weeks, I have had more incidences of GERD at night than ever before! Anyway, this is a lot of information. I hope some of it helped you. I am always searching for more information and experiences from others helps me a lot. Hope you have a wonderful day!

Hi, @janieben - just wanted to let you know I moved your post to this existing discussion on alternatives to omeprazole so that you could connect with members such as @murphy2370 @pb50 @brryz @riflemanz64 and others about your concerns with this medication, especially effects on bones.

Hi @janieben.

I was on PPIs daily for over a decade. The price I paid was that it became one of two drugs (the other being NSAIDs) that are known triggers for microscopic colitis. So there’s that.

Because that condition was so horrendous I made the difficult transition to Pepcid - aka Famotidine 20mg. Skip to the end of the story and that drug works just fine - now. But weaning off PPIs is not easy. Lots of tums and temporary diet change minimizing foods with high contents of fats and spices and alcohol and everything you know turns up your GERD, including reducing quantity of food in a single meal. . I took Pepcid twice a day for quite a while. And I slept with my head and shoulders raised.
But eventually for me it all smoothed out. I am on a maintenance dose of the steroid for the Collagenous Colitis. Bad that I need it - good that it is available. But Pepcid and managing my diet controls GERD.
Good Luck!!!

Please try to find a DR who is not a puppet of the powerful & greedy pharmaceutical companies. It’s not easy to find one but I lived to 85 with 5 incurable ailments by believing the TV drug commercials before most doctors. At least they tell you the dreadful side effects. Good luck for better health .

I started taking just one omeprazole last Friday. So far so good. I am trying Terra Health's Acid Relief once a day as well. I take it before bed.

If it works for me, I will transition to it and stop taking O after my second endoscopy and seeing the dr. Fingers crossed!

Thank you for your advice. You are so right! So difficult to find a dr who has not drank the koolaid of Big Pharma! I will probably try to find an integrative doctor around KC to discuss many things, i.e., BHRT to preserve bone in your 70's, GERD to prevent Barrett's, osteoporosis, Hashimoto's, and hypothyroidism.