older man with heartburn, acid reflux or indigestion

Q. Do you have a diet for helping me survive omeprazole detox? Your book Best Choices alerted me to the dangers of the drug and I want to end my addiction. When I forgot to take the drug two days in a row, I experienced heartburn hell.

Earlier I tried to take myself off the drug, but I could only stand it for a week. Now I can’t skip one day without wanting to die.

A. Stopping powerful acid-suppressing drugs like omeprazole (Prilosec), esomeprazole (Nexium) or lansoprazole (Prevacid) can be tough. (We have written about this problem before.)

In one study, even people who had never had heartburn before developed it when they abruptly stopped taking omeprazole  (Gastroenterology, July, 2009). The fact that rebound heartburn symptoms can be even worse than the initial problem being treated explains your difficulty stopping the medicine.

In another study, some healthy volunteers took placebo pills while others took pantoprazole (Protonix) for a month. When they stopped their medicine, those who had been on placebo had very little change in their digestive symptoms, while those who had taken pantoprazole had significant digestive distress (American Journal of Gastroenterology, July, 2010).

Company in Your Misery

You have plenty of company. Many visitors have reported trouble getting off omeprazole or other PPI drugs. KH reported:

“A few months ago I went to my doctor complaining of occasional nausea and stomach pain a few hours after going to bed. After having a blood test done to ensure nothing serious was going on, she suggested that I take Prilosec OTC for a 28 day cycle to repair my stomach lining. It seemed to work great! Last week was my first week Prilosec free and even though I only took it for 28 days my body was a mess.

“I had nausea and stomach pain frequently, had bad headaches, felt weak and generally had no energy. I went back to the doctor at the end of the week and she suggested I go back on the Prilosec. I have been really hesitant to do so because she gave me no end date, only told me I should keep taking it as long as I needed. I found this site just in time! I will definitely be looking up natural remedies to cure my issues.”

Joe discussed this phenomenon with NPR reporter Richard Knox several years ago. Gradual reduction of the dose, if possible, is a good tactic.

Tips for Getting Off Omeprazole

Diet

The effort to stop the medication is worthwhile. Such proton pump inhibitor drugs (PPIs) have multiple frightening side effects, especially when used for a long time. The most recent bad news on this front is that such medications can increase the risk of a heart attack by about 20% (PLoS One, June 10, 2015).

In addition to avoiding the foods that generally cause you heartburn, you might want to experiment with a low-carb diet. One small study found that when obese individuals followed a very low-carb diet, similar to Dr. Atkins’ recommendations, their reflux symptoms improved and they had less acid splashing up into the lower part of the esophagus (Digestive Diseases and Sciences, Aug. 2006).

Almonds

A number of people have reported that eating a small quantity of almonds after a meal can ward off symptoms of heartburn. Dr. Crystal wrote:

“I have a new patient with severe heartburn. (I find taking a person off their allergens usually clears it up permanently.)

“I saw her yesterday and she had a strong aggravation during our visit. I watched her stop it almost immediately with 2 almonds. She says it works every time.”

We should caution that some individuals report almonds make their symptoms worse, although many report that it helps as much as medication, if not more. Stella suggests sipping almond milk for reflux relief.

Vegetables

Some readers are enthusiastic about broccoli as a heartburn remedy. One fellow who calls himself Luke Skywalker reported that cutting out meat, flour and sugar and drinking a cup of freshly made vegetable juice twice a day was his ticket to alleviating heartburn symptoms. Another visitor wrote:

“During the first two weeks I ate 1/2 cup of broccoli a day (sometimes raw, sometimes cooked). I was able to stop taking Prilosec.

“Now I make sure to eat broccoli at least twice a week. I haven’t had any problems with reflux in more than a year.”

Probiotics

Other possible dietary remedies include fermented foods. One person wrote that drinking homemade sauerkraut juice eased symptoms quickly, perhaps due to the beneficial probiotic microorganisms in sauerkraut. Such bacteria have been shown to relieve digestive symptoms (Gut Microbes, Nov.-Dec., 2010).

Other remedies that people have tried and liked include eating half a banana, drinking bitters in club soda, swallowing a spoonful of yellow mustard and chewing sugarless gum. There are even studies demonstrating the value of chewing sugar-free gum to fight reflux symptoms (Journal of Dental Research, Nov., 2005; Journal of Dietary Supplements, June, 2015).

Herbal Remedies

One very helpful botanical medicine is deglycyrrhizinated licorice, DGL. Glycyrrhizin is one of the active compounds in licorice and gives licorice root its sweetness, but it can cause side effects such as high blood pressure. Removing the glycyrrhizin allows other ingredients in licorice to go to work calming heartburn symptoms. The usual recommendation is to take DGL twenty minutes before each meal.

Cayenne pepper extract is less common as a heartburn remedy, but a number of readers have testified that taking cayenne pills or adding Tabasco or other hot pepper concentrate to a beverage can prevent or reverse the discomfort of heartburn.

Another botanical medicine that is often very helpful is ginger. Ginger has been used for centuries to ease digestive distress, especially nausea but also reflux symptoms. We suspect that ginger is responsible for the benefit so many people have noted from using “Persimmon Punch.”

The Amazing Persimmon Punch Story:

Q. I have been taking acid-suppressing drugs like omeprazole for more than 20 years.

After reading about the side effects of such drugs, I am ready to quit. I understand that this can be painful.

I read about persimmon punch on your website and would like to try it to avoid heartburn. How often should I take it?

A. People who take proton pump inhibitors (PPI) such as esomeprazole (Nexium), lansoprazole (Prevacid) or omeprazole (Prilosec) may experience rebound hyperacidity if they stop their drug abruptly (Gastroenterology, July, 2009).  Symptoms of reflux can last for weeks.

One reader phased off omeprazole over seven months by reducing the dose gradually. According to people who have used persimmon punch in this effort, it helps to drink two ounces before each meal.

The first time we heard about persimmon punch, it was from a woman who had eaten in a Korean restaurant:

“Someone ordered Persimmon Punch, a concentrated cinnamon-ginger drink, for dessert. A few sips later, I felt fantastic. After a month of adding 3 tablespoons of the cinnamon-ginger drink to my tea morning and night, my heartburn was in control.”

You can find the more details on the Persimmon Punch recipe along with Tips from Dr. Tieraona Low Dog for getting off PPIs in our Guide to Digestive Disorders.

DGL (Deglycyrrhizinated Licorice)

Q. Stopping omeprazole (Prilosec) is really hard. When I tried, my heartburn came back worse than ever. I heard a report on public radio last year that when people stop this kind of medicine they experience rebound acidity that leads to bad heartburn.

An Internet search revealed a number of folks using deglycyrrhizinated licorice extract (DGL) to manage their reflux. When I asked at my local health food store, I learned that many people claim DGL has helped them get off omeprazole.

I went cold turkey off the omeprazole and chewed two 400 mg DGL tablets before each meal. If it was a particularly spicy meal (garlic is a culprit for me), I used an additional tablet after the meal. I followed this regimen for several months and then stopped altogether.

Today I seldom need the DGL, but when I do, I chew a single tablet for immediate relief. I continue to be amazed how effective this is.

A. Licorice that has not had glycyrrhizin removed could be dangerous. People who overdose on natural licorice may experience hypertension, headaches, hormonal imbalance and reduced libido.

DGL, on the other hand, appears much safer. It has been prescribed in Europe and South America to treat ulcers (Gut, June, 1985). Others tell us that DGL can help in gradual withdrawal from acid-suppressing drugs such as omeprazole.

Apple Cider Vinegar…Really!

Surprisingly, many people find that taking apple cider vinegar in a glass of water alleviates symptoms quickly.

And of course, dissolving a half teaspoon of baking soda in four ounces of water and drinking it is an old-fashioned but effective heartburn remedy. Don’t overdose, though and don’t combine the baking soda and vinegar; that would create a dramatically foaming concoction reminiscent of a grade-school volcano project.

Our book, The People’s Pharmacy Quick & Handy Home Remedies, has details on many of these remedies.

Revised February 19, 2016

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  1. Pierrette
    austin Texas
    Reply

    i was on. Omaprozole for 10years my MD told me to use Zantac I hope it s ok. No problem so far

  2. Kim
    NY
    Reply

    I have been taking Omeprazole for about 9 years. A couple of years ago I started have trouble with bloating and diarrhea. My doctor sent me to a specialist to have an upper and lower done. They found I had Barrettes Esophagus. I had several Halo Ablations done, and the BE is gone. The GI doctor told me to stay on the Omeprazole to avoid getting BE again, but I really want to get off of it. I am having EXTREME bloating. It seems as though my food is not digesting. I think the lack of stomach acid is causing more trouble. At this point I don’t know what is the greater risk.

  3. April
    CA
    Reply

    I forgot to take my morning dose of Omeprazole yesterday. I went to bed last night eating tums like crazy. I was woke up all night from the intense heartburn.

    Here it’s almost 24 hours later and I still had the WORST heartburn. I started gagging & coughing and I felt like I was going to vomit. I read through this page and decided to try 2 tbsp of apple cider vinegar in a glass of water. I drank a few gulps of it and immediately felt relief. I am not sure how long this will last, but for now I am better.

  4. Hope
    Indiana
    Reply

    I wish I had read all this before I stopped taking Omeprazole 3 weeks ago. I had been prescribed this years ago and I only took it for a few months because of stories of long term side effects. Then I was put back on it about a year or so ago because an upper GI showed stomach lining wear. Again I started reading about more long term side effects and decided since I had already had changed what I was eating to have a more alkaline body environment. I was going to stop taking it. I didn’t realize you had to “ween” off of it. Now I understand why I was getting nauseous so much the first 2 weeks. I had some episodes of reflux (not heartburn) just pressure in the esophagus when eating salsa and drinks with lime. (Margaritas) Now I know not to mix the two. Everything seems to be ok now. Hopefully proper food pairing will keep everything in check. I already take a supplement with cayenne, apple cider vinegar extract & cinnamon and some other things to help keep an alkaline environment. Anything I can do holistically to avoid long term medicine usage, I will do.

  5. Linda
    Exeter UK
    Reply

    Started taking Omeprazole about 7 years ago due to high gastrin levels, before I had an operation to remove a non-cancerous tumor in my stomach. Suffer from low B12 and have injections every 12 weeks. Heard that taking Omeprazole can cause problems with low B12 so stopped cold turkey over 3 weeks ago but getting some nausea and some cramps. I’m fine up until lunch time (no problems after cereal for breakfast) so maybe it’s down to what i’m eating. Never had a problem with indigestion or heartburn before taking these. Going to keep a food diary over next couple of weeks. Hope it settles down as I really don’t want to go back on them. Should I persevere ?

  6. SGH
    MO
    Reply

    My plan is to lose another 20 pounds in addition to the 25 pounds I’ve already lost – before approaching my Doctor about going off Omeprazole. Being overweight is what got me into trouble with reflux in the first place. Thank you all for your ideas, which I’ll try when I start the withdrawal. I think being at a healthy weight will make it easier.

  7. Karmel
    Australia
    Reply

    Have been on PPI for 20+ years. Nexium last 15. Decided to come off it. This is my fifth day. Day one take 1 x 20mg Nexium second day take half 10mg Nexium with 1 teaspoon Apple cider vinegar + l/2 glass water before meals. So far so good so will continue. Kraft make an almond paste/spread which I have every morning with Manuka honey on toast.

  8. Deb
    Arizona
    Reply

    I have been on prilosec daily for over 2 years and tried to go off it cold turkey several months ago. I didn’t know about the rebound effect then and so I promptly got back on the prilosec when my reflux was intolerable. Then last month I read several people’s comments on this site that mentioned DGL licorice tablets. WOW! I weaned off the prilosec for two weeks, and have since taken the DGL tablets, starting with 6 per day, and now only as needed. I’d absolutely tell anyone to give it a try! They are low-cost, low-risk, and work like a charm. Thanks again to People’s Pharmacy for a wonderful remedy.

  9. Carol
    Reply

    A very important step, in getting off PPIs, is SLOWLY, GRADUALLY, tapering down the dosage, even if this means taking a week or 2 to finally get off the PPIs!

    GRADUAL and SLOW weaning down of the PPI dosage is KEY to preventing the “rebound” extra stomach acid production that forces so many to get right back onto PPI’s!

    My “tips” (suggestions) for using non-PPI ways to fight reflux, are similar to your suggestions.

    I sincerely hope that you will ADD the point, that GRADUAL, SLOW, TAPERING/WEANING down the PPIs, over several days to weeks, is VERY IMPORTANT, for preventing the “rebound” hyperacidity that you wrote about!

    I agree that DGL (De-Glycyrrhizinated Licorice) and Apple Cider Vinegar (if one doesn’t have a bleeding ulcer!) can be very helpful for fighting reflux! I use these myself!

    An additional herb that helps, if one is not allergic to elm trees, are SLIPPERY ELM throat lozenges, or one can mix some slippery elm bark powder with water, and drink it between meals.

    By the way, more adverse effects of PPIs include osteoporosis (by interfering with digestion & absorption of vital bone building minerals (Calcium & Magnesium, etc.), and also NERVE DAMAGE, caused by the following cascade of events:

    In order for the stomach to be “allowed” to make Intrinsic Factor molecules, the stomach needs to have ACID in it. Many people who are not even taking PPI’s, may have decreased stomach acid production (HCL/Hydrochloric Acid), due to aging.

    But, in order for dietary Vitamin B-12 to be absorbed into the bloodstream of the small intestine, the Vitamin B-12 molecules that arrive in the stomach, must be escorted (carried) by INTRINSIC FACTOR molecules over to the last part of the small intestine (the “ileum”).

    Then, if one were NOT on PPI’s, the “Intrinsic Factor” molecules would then release (let go of) their “precious cargo”–the Vitamin B-12 molecules, and somehow would facilitate (make happen) the entering of the Vit. B-12 molecules, into the villi (tiny, microscopic finger-like projections that line the interior of the small intestine).

    The Vitamin B-12 molecules would then enter the capillaries (one capillary per villus), and this is how Vitamin B-12 enters the bloodstream.

    Then, the Vitamin B-12 molecules would travel in the bloodstream to the heart (in veins), and the heart would pump out blood into arteries, thereby carrying the Vitamin B-12 all over, including to the liver, where Vitamin B-12 is stored!

    Animals too, store their Vitamin B-12 in their livers, so organic liver (to avoid pesticides) is a good food source of Vitamin B-12.

    When one is on PPI’s, no INTRINSIC FACTOR molecules can be made by one’s stomach, so the result is that dietary Vitamin B-12 does NOT get absorbed into the bloodstream, and the following then occurs:

    If a person’s peripheral nerve or nerves of 1 kind or another have been damaged by actual trauma, or surgical damage, or from an infection, etc., the injured nerve(s) cry out to the liver, to please send some Vitamin B-12 over to the injured nerve(s), to help the nerve(s) repair their injured myelin sheaths (cholesterol/fatty coatings).

    Since being on PPI’s results in a person’s liver using up its storage areas of Vitamin B-12, the person eventually gets a VITAMIN B-12 “DEFICIENCY” (No Vitamin B-12 left in the storage areas of the liver!).

    Then, injured nerves cannot heal their damaged myelin coatings, and the result is PERIPHERAL NEUROPATHY (Nerve Damage!).

    While one is slowly withdrawing off the PPI’s, a way to supply injured nerves with some Vitamin B-12, is to take the Methyl Cobal Amin form of Vitamin B-12, sub-lingually (under the tongue), to bypass the digestive problem of not having the stomach making any INTRINSIC FACTOR molecules that would have “facilitated” small intestinal absorption of Vitamin B-12 molecules, into the bloodstream.

    From what I’ve read, the “Methyl” form of sub-lingual Vitamin B-12, which is called Methyl Cobal Amin, works better than the cheaper “Cyano” form of Vitamin B-12, called Cyano Cobal Amin.

    If one looks at forums of folks having various peripheral neuropathies, a pattern emerges–and that is, that many of those folks have been taking PPIs for extended periods of time.

    Sincerely, Carol (retired RN/nurse)

  10. Lisa
    Chicago
    Reply

    I had a terrible time with withdrawal symptoms and ended up going back on the med each time. Finally, I caught a stomach virus and reasoned that after days of throwing up, my body would be natural resetting its acid production as I recovered. So, I stopped cold turkey, with zero rebound symptoms. I will never take this kind of medication again.

  11. Mattie
    Dorset, England
    Reply

    I have been taking Omeprazole 20mg for more than 20 years. Having recently heard about side effects I decided I would come off it permanently.
    Is it Ok to take ‘ranitidine’ instead. I have not taken Omeprazole for 3 days but today I have ‘Heartburn’. Can I take an alternative which is not a “ppi”
    Such as ranitidine. I really don’t want to take “Omeprazole” any more.

    • Margaret
      Cornwall
      Reply

      I have checked this out with my Doc. after being on Omeprazole for 18yrs, apperently Ranitidine is a diffent type of drug, and (so far) safe to take. But, you should not just stop taking Omeprazole, you have wean off gradually, otherwise the stomach goes into overdrive, so, something like 1 every other day and then just stretch it out over a few weeks, and other kinds of heartburn relief, then go on to Ranitidine, well, that’s what I’m just started to do myself. Good luck.

  12. Dorothy
    Reply

    Two tablespoons of raw apple cider vinegar in water or juice works great.

  13. Lynn
    Manchester uk
    Reply

    I have been using omeprazole for a few years now having been diagnosed with an hiatas hernia but in the last few weeks I have been throwing up after each meal, I have been doing some looking into it and now find out all this bad press, now I am really wondering what I should do. Any ideas? thanx

  14. Leosrme
    Canada
    Reply

    A lot of this is anecdotal evidence. Some people are suggesting that taking something spicy will alleviate heartburn symptoms when in fact heartburn symptoms would be exacerbated by spicy food. Suggesting that mustard, sauerkraut juice, tabasco, cayenne all worked? I cannot think of anything I would avoid more while having acid reflux.

  15. Jackie
    England
    Reply

    I was on omeprozole for years and I have a hiatal hernia. I have decided to stop taking the medication because I don’t trust it. I’ve decided to change my diet. No red meat, eggs or dairy. Plenty of greens and fruits etc. I get light bouts of reflux still…but I’m so used to them now, that they go on their own. No more omeprozole

  16. Problem is acid reflux
    UK Bershire
    Reply

    Problem is all drugs have side effects and are different within each person. Just stopping medication is and can be very serious for the individual. Some have no choice but to take them, take Omeprazole, if you have acid reflux that returns it directly to the lungs because of a faulty valve then you take the drug or have a not so successful operation. So much scaremongering on the net these days. You just have to make sure your decision is safe to action or you could be making your illness far worse. Long term medication is now being highlighted, when you take it for 20yrs it does make you wonder why at times other issues start? What is the answer to it? ( take another pill).

  17. Aine Ni Nuallain
    Ireland
    Reply

    Interesting read. I had treatment last year for Pylori Helcobacter (the treatment for the bug that is responsible for must gastric problems) and have been told to stay on the PPIs esemorapraszole twice a week until April. Just wondered if by coming off would cause gastric again. The bug has gone so I will try it and see!!!

  18. Paula
    Wales UK
    Reply

    I am trying to reduce my dose of lansoprazole from 30mg to 15mg at the moment. I have been on high dose ppi’s for a long time, maybe 15 years for a diagnosed hiatus hernia. It is so difficult, really bloated, bad pain and acid indigestion. I also have a conclave chest which makes me feel like my stomach is in my throat a lot of the time. I am taking a liquid antacid which does help a little bit. Just starting my second week on the lower dose, I’m hoping I can stick to it and gradually wean myself off them eventually. I am amazed at how many others are stuck on these meds…felt like I was the only one! Thank you for making me feel not so alone 🙂 Will update with how I get on

  19. Lee
    Scarborough uk
    Reply

    I was on omeprazole for years.. Great drug for me as it stopped my acid reflux problem. I could guarantee what time of day I would get the unbearable pain at and like clockwork it appeared..
    Then one day at 9 am the pain started and I took a tablet and started my journey… but the pain didn’t go away… I continued on and did what I had to do and found myself at the last drop off and 40 miles away from home… I was in severe pain and discomfort with a very worried passer by asking me if I was ok!!

    I decided to go to hospital bit as I got close the pain eased slightly so I decided to make a dash for home. I hadn’t eaten for around 6 hours but strangely felt full and not hungry. I managed to get home and immediately took another tablet, got in the bath and went to bed hoping the pain would ease.. At this point my wife asked if I wanted my steak and I refused so she became worried.. At around 11pm the bearable pain intensified to a point I couldn’t take and I decided to go to hospital.. As I sneaked out of the house so not to wake my wife although I had left a note saying where I was going, I noticed she had blocked me in and there is no way I’m leaving her the keys to the audi.. so I was in a dilemma.

    I decided to forget about the hospital and resorted to drinking a full large bottle of gaviscon thinking (well at least I’ll sleep) and crept upstairs, put a cushion under my stomach and laid flat..I went out like a light!!

    To my suprise I awoke with no pain and went down stairs and had my usual breakfast of coffee and a cigarette.. 9am came and no pain..2pm came and no pain..9 years later and drug free I still have no pain…My doctors are puzzled

  20. maud
    Leicester
    Reply

    I have been taking this medication since Oct 2010 after having an operation that took away ⅔ of my stomach. I take Naproxen for back and joint problems so I was prescribed Omeprazole to protect my stomach . Bit concerned now.

  21. Lindsey
    Reply

    I started on omapraze three years ago when I was diagnosed with a Haetus Hernia
    They didn’t suit me so GP changed it to Nexium 20
    These were great i could eat almost anything I wanted with no ill effect
    After a while I started to have serious memory lapses suffering confusion lethargy
    Mood swings
    I’ve realised that it’s more than likely the Nexi are a contribury factor

  22. Maria
    Stirling
    Reply

    I have been on them for about 20 years and can’t get off them I am trying again this is day 2 felt it a we bit today took two gaviscon it helped but wait see how the recast of the week goes fingers crossed

  23. Laural
    Maine
    Reply

    Wow, came on to find help. I stopped my pantoprozole 4 days ago after hearing the latest reports . Just spent all afternoon spitting, throwing up, battling burning indigestion, bile in my throat….awful. I have been proud that I am still quite active and ” healthy” until now. Reading how ppi’s can lower magnesium levels in the body too. Wondering if that has any relationship to my lower levels of D. I heard that magnesium. And D are co related?
    Anyways, I am stopping this cold turkey and now I am wondering what is in store for me? More episodes during the next hours, days, weeks?!

    • Dee
      Pittsburgh
      Reply

      I quit cold turkey 3 weeks ago and I’m still having terrible heartburn, though it’s not everyday now. I’m hoping this settles down soon. I was interested on how you were doing.

    • Catharine
      Ontario, Canada
      Reply

      I just weaned myself off Pantoprazole after 4 mths of gastritis. I have been off Meds for 1 week but am still very nauseated and pain in bowels. How long does should this pain last.

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