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Q. As a nurse, I'm concerned about the widespread use of acid-suppressing drugs like omeprazole. I've heard many patients talk about how bad their reflux is when they stop these drugs. Until recently I was not aware that there is a rebound effect. Do you have any suggestions about how people can discontinue such medicine?
A. Rebound hyperacidity is now recognized as a potential complication of stopping many powerful acid-suppressing drugs. Proton pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex) can trigger severe heartburn symptoms when people stop them suddenly (American Journal of Gastroenterology, July, 2010). One reader noted: "I have been taking Nexium for about three years. I tried to get off it and got the rebound effect. Now what do I do?"
Gradual tapering might be beneficial. Less potent acid-reducing approaches including antacids or natural compounds may also help get someone past the most difficult stage.
We are sending you our Guide to Digestive Disorders for more details on getting off PPIs and other ways to deal with heartburn. Visitors to our website report that deglycyrrhizinated licorice (DGL) may help, along with ginger and persimmon tea.

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My wife had been on Omeprazole for years. The Dr. discovered she low iron test. He put her on iron tablets for about 2 years. It did not bring her iron test back up. I had read that it could keep your body from absorbing vitamin B.
We ask the Dr. about iron also, He said no. We saw an add that said that it could interfere with Plavix, that she takes. We took this as a good time to get off Nexium. Within 2 weeks her iron test were normal . Her Gastro. Dr. and her PCP. both said that was not the trouble.
F.W.
Last year I stopped the Omeprazole that my husband was taking, slowly, at the Dr's suggestion. The result was so bad, that he was choking from the reflux. I put him back on the omeprazole, and he takes two before breakfast, and two before dinner, on an empty stomach. At 89 yrs of age, I really don't care if he is addicted to this drug. He is blind, and a shut in, has trouble walking and has dizzy spells, which none of his doctors can explain, even after brain scans and other neurological tests. If Omeprazole keeps him from the terrible belching and reflux so be it.
I have successfully cut back my use of Nexium to 1 every 3 days. Sometimes the evening before my next tab I will get heartburn, but I can usually control it w/ Tums or digestive bitters. Incidentally digestive bitters, which I found out about on this site, are very effective and work quickly. There are many brands and I don't think one is more effective than another.
I have tried all the suggestions to get off PPIs as well as drinking freshly-made cabbage juice from my juicer. That juice made me feel better immediately but I finally had to give up and go back on the PPI. My doctor insists I need it. I never had ANY pain before trying to stop the PPI--no pain even before I started it.
I started it after having an stricture widened due to scar tissue from life-long reflux. Doctor says I had no pain since nerve endings were damaged by reflux. I ended up with another stricture after trying to get off the PPI. I guess there is no hope for my situation but surgery, and maybe I am not a candidate for that. But I urge everyone NEVER to start with PPIs. I am still wondering why I had horrible pain trying to get off the PPI although I had no pain before starting.
Many physicians are not aware of the rebound effect, either, so you are far from alone. I also am a nurse, and had no knowledge of it until I tried (after a very long term use of a PPI) to stop it. The rebound was ascribed by my physician to a "return of symptoms" requiring re-starting the PPI. After much research--a lot of it right here in the People's Pharmacy--I worked out a plan for discontinuing myself. I gradually reduced the amount (every other day, every 3rd day, etc), a month for each step down, until it was once a week, then stopped.
Since an occasional Tums or Zantac keeps symptoms well under control. Of course, common sense must prevail as well--no large meals, minimal rich food, and all the sensible changes re: diet, as well as environmental choices like raising the head of the bed. No tight clothing, or bending over post meals.
taking nexium for 3 weeks. helping a bit. concerned already about when can stop and how to get off.
see dr. next week
Just have to share. I had what felt like an ulcer, very painful especially when my stomach was empty (caused after taking celebrex for several weeks) also had reflux. After reading on P.P. about licorice, I researched it, and decided to give it a try.
IT WAS AMAZING! It made a difference almost immediately, I felt relief almost from the first piece. I ate just a tiny piece before bed, and several times during the day, it only took about 3 days for the pain and reflux to completely stop. I continued for about another week then stopped the licorice altogether.
Please, all you people, give it a try. I found the Aussie style licorice at Walmart, which are 1 1/2 inch pieces, and I didn't even have to eat a whole piece, just half. That was a year ago, haven't had a problem since. Just make sure it is made with real licorice extract.
Keep me posted on this concern.
I managed to get off Prevacid by taking 4 almonds at night time. It worked.
Why do you think that eating 4 almonds at night worked?
I thought this remedy was strange, as I've discovered that eating peanut butter (a favorite snack) w/in a couple of hours before going to bed is a sure-fire recipe for reflux!
I too had reflux for many years. Before I even knew what it was I would wake up at night thinking I was having a heart attack. From that I was getting anxiety attacks and one was so bad my husband had to rush me to the emergency room one night. Finally I was diagnosed with acid reflux and put on Nexium... at the time even water was giving me reflux.
Then I started reading PP every week and was made aware of how bad this medication can be for you. This summer for the first time in my life I had a fracture (I am 49). It was just a hairline fracture in my foot but I needed 6 weeks to recover and had to sit around all summer.
I decided then and there that I needed to get of Nexium. (I believe my bones were not getting enough calcium because of the Nexium) I bought a big jar of almonds which I munch on during the day and I also bought fresh ginger root. I have a cup of white tea with honey and ginger root every morning.
I am now down to taking Nexium once a week with barely any reflux and when it does act up a bit I take some tums... I still eat pretty much everything I want. My hope is to be completely off the Nexium and to think twice when a doctor wants to put me on meds.
I've had acid reflux for several years and have been on all the over the counter treatment products. Finally, my doctor prescribed Nexium, which I have been taking one a few hours before bedtime, for about 2 weeks now. If I don't take one, "as soon as I doze off to sleep", acid comes up in my throat so bad I practically jump out of bed...It's so painful, I've prayed to God, to please make it stop burning. It feels like someone poured hydrochloric acid down my throat.
If I drink a coke, or take a little bit of baking soda in water, to make me belch, numerous times, it eventually starts to get better. I also take sips of a liquid acid reducer I get at Walmart in their brand, to sooth the burning in my throat and throughout my chest. Has anyone else tried the licorice and ginger root and if so, does it really work???? It would be nice to be able to fall asleep and not worry. The "only" snack I can tolerate in the evening is an apple...they do not give me reflux. Thank you for your help.
SAA: Have you tried all the environmental and life-style changes that might help? Raising the head of the bed and extra pillows, no tight clothing, no large evening meals, no high fat or spicy meals. No bending over post eating. If you are overweight, losing weight. No smoking and minimal alcohol intake. Try relaxing routines at bedtime--no TV, soft music, regular times, dark room, etc. etc. Anxiety and worry encourage swallowing air, some gentle relaxation may help, and make the coke/soda less necessary. There are all kinds of reports from folks about different "home remedies" that are helpful, almonds, licorice, etc., all documented in PP comments.
Do discuss with your physician both the PPI and other suggestions that may help + am sure other readers can chime in with suggestions.
Doctors keep trying to put me on Prilosec and I don't have heartburn or any other symptoms. I think they push the drug too much and a lot of people are on it who don't need to be. Even poor little babies are on the stuff. I will never take it! If I need anything, I'll take a Tums.
I have been on Prilosec for a number of years. I am concerned about my bone health so I decided to quit the Prilosec. I now munch a few antiacid tablets and take Zantac at bedtime if I am still having heartburn. I take my calcium supplements at breakfast and or lunch. I eat my big meal at lunch and do not eat in the evening after 6PM. This is not perfect but it seems to be working more than not. I very occasionally have to take a Prilosec if all other measures fail. I weaned off the prilosec before I started the Zantac. When things settle down (I hope) I will wean off the Zantac too.
I have been taking Omeprazole for about two years or more. My doctor prescribed it because another prescription, Metoperol was causing heartburn. Recently, my doctor did a blood test and found that I was low in iron. He gave me iron pills which I took for 8 weeks and then was retested. My iron was still low. I am going to stop taking the Omeprazole and then a few months after stopping, I will ask to be retested for iron levels to see if my iron levels go back up like F. W.'s wife. I am hopeful it will work the same for me.
Here I go again, another night of pure misery. Again, within an hour of falling asleep, I awake with acid in my throat. This will take hours to subside so that I may return to sleep only to reawaken at 4AM for my daily job.
If I cough, the burn in the back of my throat gets worse and OMG the mucus.... where does it all come from. I have been on so many drugs I can't remember them all... the latest DEXILANT.... before this NEXIUM.... before that prilosec and NO INSURANCE.
I'm over weight by 50 pounds, have been for three years since a hysterectomy. I can’t seem to get the weight off and bloated stomach all the time. I went from a size 5 to size 18. I'm 49 years old and every joint in my body hurts... but back to the acid. Diagnosed with hiatal hernia in my early twenties.... was told if I ever gained weight it would be a problem for me and it is. This burning feeling in the back of my throat is horrible.
I have taken 4 GAVISCON in the last hour and drank a bottle of water and chewing on ice chips. God how I want to go to sleep. When I do return to my bed, I will have to sleep sitting up with 5 pillows. I will wake up with a neck and back pain as a result. My trigger foods, TOMATOES, chocolate, caffeine anything spicy, coffee, tea...
I have not found anything that will help reduce the burning in the back of the throat once it happens other than time.... several hours. I will now have phlegm for several days and a runny nose. God how I wish I didn’t have to deal with this.
Key West, I know full well how hard it is to lose weight, but that extra 50 pounds is doing you no good at all--not only with the reflux, but with the achy joints. I would make a renewed effort to shed the pounds, first. If you can, consult a dietician for some guidance how to best accomplish this--if not possible, read all you can on the internet and make a plan for yourself. Get out and exercise, if only walking.
If you haven't raised the head of the bed, that may help. Do not eat in the evening. Stay way away from your trigger foods! Limit alcohol, and stop smoking, if that is a problem. Make your bedtime as pleasant as possible--soft music, dark and cool room, and whatever else helps with relaxation and good sleep. I personally have some Carlos Nakai cd's that I turn on at bedtime, and they help a lot. The more you worry about the reflux, the more your body will respond in negative ways--amazing the mind-body connection. Many home remedies have been suggested on this site--review them and test what sounds to you like it may work. If the above doesn't help, best go back and consult your physician again.
So glad I found this forum. I've been on either Aciphex or Prilosec for about 15 years. I've tried stopping in the past to no avail. The last time I stopped I developed canker sores (hadn't had any since I was a kid). My GI doctor told me there was no correlation, just a coincidence. As soon as I started the Prilosec again the canker sores went away and I haven't had any yet. Has anyone else ever experienced this?
I really want to try again. I'm going to taper off and try the licorice remedy. I hope it works! Thanks to all.
Hi Key West,
I've been investigating taking prilosec from 20 to 40 for over a month now; after a clean scope I don't want to take this anymore for the side effects and developing worse heartburn After going off from this. I also read that these medications (Prilosec, and perhaps other PPI's) CAUSE weight gain? I don't need to gain any extra pounds either as I'm over more than you so this should be our first line of defense.
I've also lifted with risers the head of my bed and haven't had nighttime reflux. I try not to do all the laundry, etc. after eating like I used to as well as bending over caused a lot of mine; plus tighter clothing (don't cinch your waste at all). I'm going to try and get off from my 40 mg by cutting back to 20, and then as a nurse said one every other day to one every three days and use tums or find some real licorice to try as well.
If these meds cause so many side effects, and weight gain we are in a losing battle. I ate really small meals and drank water in between meals and that took me down seven pounds in two weeks, and its seemed to already help.
I do believe docs put us on these too quickly as we expect "quick fixes," but I think with weight loss, elevating the head of our beds 4-5 inches, wearing non-binding clothes and trying ginger tea or licorice the natural ways to alleviate our suffering is better than taking something which only covers up the initial problem. I hope not to go through these rebound side effects, and might have to suffer again for awhile once I start, but taper off slowly and make healthy changes. If I have to stay away from coffee and wine, etc. for a month or so it will only go away faster so good luck!!!
I have been taking Omeprazole for over 5 yrs.. suggested because of a morning barky cough and some acidity. No real "heartburn" .. yes raise the bed, etc.. NO WARNING THAT CONTINUED USE CAN BE LIFE CHANGING AND STOMACH CHANGING. Thinking that I could just stop taking them I gave it a go.. YIKES.. by 3pm afternoon, I experienced the most horrific stomach pain.. acids galore!
I have never, never had that. Went to a gastrointestinal dr and and asked "how do I stop and why the pain"... Oh, when you take for an extended period, your stomach gets used to a certain acidity.. and when you stop the pill it wants to make the acid in the stomach that was normal with the pill" OMG. and so...... how to stop.. "oh that is difficult.. so.... I'm addicted to these pills... "well, sort of"
This is a Dr. telling you this.. My GP that suggested it in the first place never gave a warning.. and this was before the huge ability of Google to find answers! A time when we believed the Dr. I did have an endoscopy done to make sure there had not been any damage done by acidity.
Wendy is a smart person. Keep up the good work. Self help is smart.
Hi All,
I have been on nexium for close to 15 years I am only 36 yrs old. I have been seeing the same GI md who I trusted for so long to treat me for my GERD. I would get endoscopies done every year now every 3 yrs and they come back with gastritis. Nexium was the only drug that helped to control my heartburn.
But now after developing low ferritin 3 yrs ago and being told it was due to the nexium for so long, I have just told my GI MD I want off nexium. I now have a chronic issue with my ferritin being low (which is a form of iron) and have to get iron infusions every few months.
My stomach MD was not too happy with me but he told me to go on carafate which is what I was on when I was pregnant. The liquid carafate helped when I was pregnant. Today is the first day off the nexium and I am not too happy, I already took one carafate pill that made me feel like I was going to throw up and 2 zantacs.
I think I am going to try tapering off the nexium and try the licorice.
Anyone else been on carafate?
I am glad I found this site.
We need to get off this medicine.
Thanks DM
I only had success getting away from long term Prilosec use by a very slow taper, and at that, the first week was a bit hellish. I took a month for each step down, and the entire process lasted from about March to July. Now, use only an occasional Zantac, or Tums. The encouraging thing--after a while it becomes easier, and if one is careful not to overeat, etc. minimally bothersome.
Hi All,
I am on week 2 of tapering off the nexium and it is going well not tooo bad. I was doing nexium one day and carafate next day, now this week I am doing every 3rd day nexium than go to once a week only and than gone. I have been watching what I eat very closely I can not tolerate chocolate any longer bad hburn, pizza etc things I could eat while on meds cant do anymore but you know what it is better for me. A healthy change!
I had my GI md check my blood work vit b12, magnesium and D. My vit d was low which I contribute to being on the nexium for sooo long. My GI md will not admit to that he feels the nexium will not do that but after researching it nexium can cause osteoporosis osteopenia etc.
I wanted to know if anyone has a GI md that has agreed that some of these meds are bad for you long term? I want to go for another opinion in NYork I live in Jersey. Does anyone have a good md in NY?
Thanks
Oh I found drinking warm water with lemon juice after meals helps relieve heartburn
DM
Hello there,
I haven't try yet warm water with lemon juice, but it does sense to me; since I started to reduce my acidic food intake and eat more alkaline foods the heartburn is decreasing. LEMON JUICE is very alkaline drink as a well ginger root or tea.
I bought urine test strip to test my pH level, the health marker, and was under the normal range of 7,3 this indicate an imbalance, unhealthy state. The problem is that I am not consequent with this new habit, the winters are cloudy in Germany and just want to eat carbohydrates!
I'm 48, and had taken Pantoprazol for 150 days, after taking strong antibiotics for Helicobachter Pylori that had cause severe irritation to my stomach. Then the Dr. told me that I have to take always this medicine. I don't think so!
I find out that movement and short time seated help better my digestion and have less trouble with acid re-flux.
I'm getting better little by little.
Liam
hi
yes the warm water w/ lemon works great. I also bought licorice black root from the health food section in stop n shop so I eat one after my meals and it helps control the h-burn.
I have been feeling better, I am off nexium now one full week and I can't believe it. I do have to watch what I eat very closely b/c if I eat something bad I know I will suffer w/ h-burn later on, and I find chewing gum helps w/ my h-burn as well
good luck
dd
Someone posted that lemon juice helps because it is "alkaline". Lemon juice is highly acidic, so this doesn't make sense. I would like to know more about this. I don't want to continue using PPI's. I'm told ginger root grated and made into tea helps.