Transitioning from a PPI to an H2 blocker
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.
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Exactly. I’m terrified I’ll have it. I’m on keto also
It's been about a year now and I feel successful. I do have an occasional mild to moderate swallowing problem. But very rarely.
Welcome, @gird66. I noticed that you wish to post links to research articles with your message. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the links you wanted to post are not spam. Allow me to post them for you:
– Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study https://gut.bmj.com/content/67/1/28
– Long-term use of PPIs linked to stomach cancer https://www.europeanpharmaceuticalreview.com/news/68840/ppis-stomach-cancer/
– Proton pump inhibitors and risk of gastric cancer: population-based cohort study https://gut.bmj.com/content/71/1/16
Have you talked to your doctor about weaning off PPIs?
I've read about the iqoro. How do you like it?
I think the Iqoro has made a difference for me. It's been over a year now and I'm using it 3 times a day for 30 seconds each time. I found a pamphlet from Iqoro where I had done their swallowing test at the beginning. Time yourself drinking 1 dl (deciliter, about half a cup) water. I wrote 15 sec. Tested now and I can drink the same amount in 10 sec. My swallowing is better!
Oh wow, that's fantastic! I'm very glad to hear it actually seems to work for you. I'm thinking of getting one to hopefully strengthen my lower esophageal sphincter. But like you I live in the US and luckily have a relative in Spain to help me purchase it.
I have only been on PPI for 6 weeks and curious what long term means. Do I have to wean off if only used for this period of time. Doctor has me on for 90 days right now but uneasy about medication. Any feedback appreciated
Not sure what long term means. I was prescribed and hesitate but my doctor at the time said “we don’t worry about use until the one year mark.” I was I going to do it beyond a year. At 6 months, not feeling a lot better, I went back to my doctor. She had retired and the new doctor listened to me and contacted GI. Within two days I was scheduled for an endoscopy. Afterwards, the GI came in and told me to never take a PPI again. My digestive cells had become hypertrophic (enlarged). That was the point where I had had it with prescription drugs treating only my symptoms for a number of years. I turned to Functional Medicine, where the goal is to find the cause or causes of symptoms. I found an exceptional doctor and finally feel I’m healing.
Take a look at a book, Super Gut, by Dr. William Davis. He talks about SIBO and how to self treat. He includes a four week plan and includes recipes. It’s worth $30, on Amazon, if you’re on prescriptions and want to get off them. Prescriptions can help while you’re on them but return once off. So what’s the point if the drugs don’t heal your gut and symptoms don’t return?
You should discuss with the doctor. The question is why you were put on the PPI. If you're feeling better now after taking the PPI I think it pays to already ask if you can either reduce the dose (if you're taking 40 mg, to take only 20 mg) or try to wean off it.
On the other hand, if you need the medication to prevent esophageal irritation, then taking the medication is important, but you can see if an H2 blocker works for you, and then that's preferable.