How is it possible that PPIs are speeding up my gastric emptying?

Posted by gina97 @gina97, 2 days ago

So, long story short, two weeks ago I took an antibiotic course + esomeprazole to treat my H pylori infection. Throughout the ten days of treatment my digestion improved a lot, as before that I was dealing with severe delayed gastric emptying with food sitting in my stomach for as long as 8 hours. I was barely able to eat, cause I would get extremely full and bloated just after a few bites, throughout the day I would keep regurgitating food, constant acid reflux and the nausea was unbearable. It was a total nightmare that caused me to become severly underweight and malnourished. So during treatment all these symptoms had improved a lot and as soon as I finished the treatment, my digestion slowed down again so I started thinking what could be the cause of it and I realized that my digestion had improved on the same day I started taking PPIs which was a few days before starting the antibiotics. So I tried taking then again and guess what, digestion improved again. But this makes zero sense to me, because two years ago I tried taking PPIs and they made my digestion way worse which makes sense since that’s actually a known side effects of PPIs given that they suppress the acid needed to digest food. The only theory that I came up with is that since I have severe diffuse gastritis (diagnosed through endoscopy and biopsy) the PPIs might be calming down the inflammation and allowing the stomach to digest better and faster… does this make sense to anyone? Has anyone experience anything similar?

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samclembeau | @samclembeau | 2 days ago

Not a doctor and don’t have gastroparesis, but my understanding of it is that it is related to the muscles that move the food along, not acid production . If your stomach is full because food is not moving seems to me that the acid is building up behind it and you have an excess in smaller space? Which would then cause acid reflux et al. Just thinking. I could be way off.
Is your slow stomach emptying due to low acid or paralysis of the muscles?
Would think that would make a difference.

jlsgt | @jlsgt | 2 days ago

Makes sense to me. Gastritis is inflamation and the PPIs might very well be helping with that. Talk to your doctor as it sounds like a daily dose is a good idea for you.

lamd | @lamd | 18 hours ago

That is interesting. I went to a GI for random lower abdomen pain and diarrhea. For other reasons they did an endoscopy and said I had esophagitis…this being unrelated to what I went there for. Anyhow, they gave me pantoprazole for the esophagitis, but it immediately resolves my lower abdomen issues. With the PPI, I no longer had bloating right after eating, no more stomach pains and no more diarrhea. However, I was very concerned about long time PPI use and stopped after 3 months. I then had awful acid reflux. I seem settled down now, taking kefir and Pepcid or tums as needed. Still feel much better than I used to, but not as good as I felt on the PPI. Wonder if there’s something similar that has the anti-inflammatory and antioxidant properties of a PPI without the acid suppression?

linh | @linh | 3 hours ago

I was on antibiotics for other health reasons, but relate to many of your symptoms (primarily due to a history GERD). As antibiotics are known to affect normal bacteria flora too (And my guess is G.I. preps do as well), I just assumed that my normal flora was undergoing rebalancing to some degree. I turned to seasoned acupuncturist for help with this, and have been feeling more like myself.