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Stopping Omeprazole Provoked Unbearable Pain

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Q. For years my doctor prescribed Prilosec and then Nexium for my reflux. He never mentioned anything about side effects and made it sound like a super-safe drug that I could take indefinitely.

I lost my insurance, so I switched to omeprazole that I buy over the counter. When I read the label it said not to take it for more than 14 days in a row. As soon as I stopped, the pain in my stomach was unbearable. I have to keep taking it. Is there any way to get off omeprazole without going through hell?

A. We have heard from many readers that stopping acid-suppressing drugs suddenly can cause terrible rebound heartburn. These drugs include esomeprazole (Nexium)
, lansoprazole (Prevacid), omeprazole (Prilosec)
, pantoprazole (Protonix)
 and rabeprazole (Aciphex).

We are sending you our Guide to Digestive Disorders with tips on weaning yourself gradually from such medications along with many non-drug approaches to easing heartburn. Although many prescribers think of such drugs as perfectly safe for long-term use, there is growing concern that they may increase the risk of hip fracture (BMJ, online Jan. 31, 2012). Problems absorbing vitamin B12, iron and magnesium are also worrisome, and so is increased susceptibility to infections (Digestive Diseases and Sciences, Apr. 2011).

Persimmon-ginger tea, antacids, probiotics and deglycyrrhizinated licorice (DGL) can all be helpful during the withdrawal process.

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Dependency on acid-suppressing drugs creates a vicious cycle - more acid, more drugs. When my gastroenterologist rxed doubling my Nexium to 80 mg/day, I had occasion to quit cold turkey to have a procedure performed. It was indeed hell, but once off, I determined never to be so dependent again. I quit the acid-suppressing drugs altogether. No home remedy has really solved the problem, including antacid calcium chewables, papaya, and Prelief tablets, but I juggle among them. I find some food heavy in fat, junk food such as tortilla chips, chocolate, and ice cream, all ease my pain.

It is possible to get off these drugs, but a challenge. I made several attempts which ended like yours--unsuccessfully, as the discomfort would send me back to the Prilosec after a few days. The more I read about the possible results of long term use (and, as you pointed out--it is recommended for SHORT TERM use) --the more determined I was to stop. I used a very slow taper, over several months--until I was down to no Prilosec. Now, if I feel a hint of heartburn, over the counter Zantac, Tums, or Pepto-Bismol do the trick.

Also, have raised head of bed, don't wear tight clothes, don't overeat--am especially careful with fats or spicy foods, etc. The first couple of weeks, there was some discomfort as I did the taper, which I hope isn't true for you, but I was determined to stick it out this time. It was easier and easier as time passed. Good luck, and by the way, my doc didn't believe the "rebound" effect--I'm not sure he is convinced yet. Said he never heard of it.

There are lots of other hints here on The People's Pharmacy if you search about--it was very helpful to me both before I began the process and during.

Good Luck! I used the Guide and was able to get off the drug successfully. I originally had an ulcer caused by another drug which I have also successfully eliminated.

The same thing happened to me when I stopped taking Nexium, with my doctor's OK. I had been taking it only for a few months but when I stopped, the pain was much, much worse than it had ever been before I started it. When I told my doctor about it, and that I'd read a lot about "Nexium rebound" online, he just sort of rolled his eyes. He apparently did some research between then and my next visit, though, because he did ask me if the Nexium rebound had improved.

I think it took a couple of weeks before the pain went away after stopping Nexium. It was absolutely miserable, but I didn't want to keep taking it, so I stuck it out. I would never take one of those drugs again.

My wife was on Prilosec for a very long time. When she decided to stop Prilosec we found out that all of the pharmacy ones were set and 20 mg, but with a prescription you can get a lower dose. This helped her quit using Prilosec. she kept cutting down on the the days she would take it. She finally got off of it.

I experienced the horrible pain only after stopping Prevacid. I finally bought a juicer and juiced cabbage. One swig of cabbage juice and I felt unbelievable relief. I kept it up for a while, but even though the juice itself is not horrible if you just swig it down right away, cleaning the juicer and airing the house due to the smell of crushing cabbage made me stop.

I have had three doctors look at me as though I were crazy and laugh at me, but I wonder why the gastroenterologist thought there were HEALED ulcers in my esophagus.

Recently read your article on Omeprazole. I've have taken this for approx. two years. I take every other day instead of every day. Is this better or just as bad? Should I stop taking altogether? Just use anti-acid tablets etc.

Thank You

I have precisely the same issue. I've found that chewing sugarless gum helps a great deal when trying to taper off Omeprazole (increased production of saliva). Gaviscon (either chewable tabs or liquid--but non-aluminum formula if possible), helps more than "regular" antacid tabs because it coats the lining of the esophagus and helps promote healing. I haven't yet done this but I have also heard that raising the head of the bed a few inches is helpful for night-time protection and healing.

I began by limiting Omeprazole to 3 x/week for several weeks. I am now trying to use it only 2x week with some success. It requires some patience to wean oneself off this.

I want to speak to my Dr. about the balance between preventing erosion of the esophagus (which might lead to the development of a more serious condition or even cancer), and the need to better absorb calcium and other nutrients which may be hindered by taking acid-suppressing drugs. Are there any research papers on this topic?

Most people who experience indigestion don't have too much acid in their stomachs-they have too little.

It seems that this problem is getting worse every year, especially if one watches the TV ads for the acid blocker meds. Yes, it is a problem and one that is affecting children now as well. We need more digestive enzymes, not to kill the ones we have. It is a vicious circle to take these products as it is difficult to get off them.

It is best to ease into digestive enzymes very slowly. You can use this system for children too that get stomach aches. Try to find a product that has a little bit of Betaine HCL as well as the other digestive enzymes. For young children it is more difficult but one can try some of the chewable ones that have pineapple or papaya enzymes in them. When they get older then they can swallow the pills.

Why is this problem so prevalent now? My guess is that we have gotten away from all the fermented products that have been traditional in most of our predecessors lives. We don't make our own saurkraut, pickles or yogurt etc. anymore. Our food is over-processed so that our guts don't have to work at the digestive process anymore.

My spouse finally weaned himself off proton pump inhibitor drugs by (1) giving up grains and sugar and (2) gradually cutting the dosage down over the course of several months. He had been taking these drugs for over 10 years and had tried to stop them many times, giving up each time because of the horrible rebound heartburn.

Discuss with your physician before you do any changing. He knows you and your situation best, and should be able to offer advice. If he isn't familiar with rebound, copy some of the information from the internet to show him.

After reading your article on Omeprazole, my 89 year old mother and I would like to comment. We both suffer from a genetic history of extreme acid reflux, gas and non-specific stomach pain (neither of us has or has had any kinds of ulcers at all (maybe food sensitivities). We lived on low acid diets, avoided certain types of foods and food combinations, as well as fats that aggravated acid and gas production and kept the makers of anti-acids and Pepto Bismol in business. Nothing worked.

Then in 2000 along came a wonder drug called Protonix. Mom was put on it and has been on it and its generic equivalent Pantaprozole for 12 years and I for 10 years. Doctors and bone scan technicians have commented about our solid and strong bones. Neither of us has or have had any of the 'worrisome' concerns BMJ online or any of the nay sayers suggest could happen. I think all patients need to listen to their own body and not listen to all the hullabaloo/hype published about any drug. Use your own brain, work with your physician, listen to your body and do what works best for you. As for me and my mother..we will continue to take Pantaprozole, for without it, we would have only pain in our stomachs.

Raising the head of the bed does help, as does limiting evening eating-- at least these changes worked for me.

I was on Prevacid, protonix, omeprazole, omeprazole with sodium bicarbonate, pretty much anything that has been on the market since 1994. When I went on these medications, I gained 40-80 pounds and after ten years of being on them daily, I started getting really sick. Then came five or six years of progressively worse pain- I thought it was my joints but really it was my bones. I had IBS so bad that I thought I would have to go on disability. Plus I was depressed and suffering from anxiety and insomnia.

In Jan of this year I went off the acid drugs. I tried Apple Cider Vinegar, DGL, and other things. I had no choice but to cut down how much I ate because overeating caused the acid to be worse. I then found out that being on those drugs all these years caused me to be deficient in Vitamin D and Vitamin B12. Now I am on shots, eating well, still heartburn after eating certain things but I can control it with Aloe Vera Juice or chewable calcium tabs.

My vitamin levels are going back up, my pain is absolutely vanished and I am off ALL medication- no more depression or anxiety.

Not everyone has acid reflux because of the same reason. Some people actually don't produce enough acid and need to- I think that was my problem. With eating right, eating less at one time, and avoiding caffeine, alcohol and carbonated drinks, I am doing well. I have my life back.
The book, "Your Inside Tract" is helpful.

I discovered that the best "natural" remedy to omeprazole is evening primrose oil 1000mg taken every day. Coming off Omeprazole after 3 years was a nightmare, depression, anxiety and paranoia! However evening primrose oil helped considerably as well as balancing the stomach acid.

You folks would be better off doing some scholarly research than following the tips here. There is very little evidence to support many many claims being made here. It's easy to do the research, it's a bit harder to read the dry journal articles. There is not sufficient evidence at all that long term use of ppi's is dangerous. There have been people on them for decades with no ill effect.

This site appeals because it's the people's pharmacy, dammit, it's for the people. It's for the people who believe what they are told by a non scientific site.

PEOPLE'S PHARMACY RESPONSE:

Dear SN,

You may find the article, "Overutilization of proton-pump inhibitors: what the clinician needs to know," published in the journal Therapeutic Advances in Gastroenterology (Jul, 2012) of value. Here is a link. It is a free article if you click through.

http://www.ncbi.nlm.nih.gov/pubmed/22778788

The conclusion of this study: " PPIs have been linked via retrospective studies to increased risk of enteric infections including Clostridium difficile-associated diarrhea, community-acquired pneumonia, bone fracture, nutritional deficiencies, and interference with metabolism of antiplatelet agents. Reducing inappropriate prescribing of PPIs in the inpatient and outpatient settings can minimize potential for adverse events, and foster controllable cost expenditure."

There are numerous references to research should you be inclined to verity.

One final point about rebound hyperacidity. The authors point out:

"A randomized, double-blind trial over an 8-week therapeutic period yielded similar results, with symptom scores significantly higher in the PPI therapy group compared with placebo, as nearly 22% of subjects reported symptoms of dyspepsia, heartburn, or regurgitation at weeks 10–12 post therapy, suggesting rebound acid hypersecretion [Reimer et al. 2009]. Thus, a potential consequence of prolonged PPI therapy is the increased risk of long-term hypergastrinemia, ECL cell hyperplasia, and parietal cell hypertrophy, leading to symptomatic dyspepsia."

If you are a health professional you should know that "CL cell hyperplasia" and "parietal cell hypertrophy" are not desirable.

We hope you will follow your own advice to read the dry journal articles and be objective. If PPIs cause rebound hyperacidity and heartburn symptoms, these can be challenging drugs to discontinue.


Barb H, you and your mom are either blessed or lucky. I can't tell you how many people I know who have been on these meds that have thin bones and or other chronic problems.

Many have eased into digestives very successfully at my suggestion. It will take years for their bones to recover but they are on the right path. Quickly their stomachs recover and they have no more pain or gastric upsets.

Acid reducers are NOT a natural part of human life. Mankind has found other ways to help digestion and health. As I stated above, fermenting used to solve our digestive problems.

I am now almost 67 and my bones are good and strong. Yeah, I know that for a fact as I took a pretty bad fall a week ago. The Drs in the emergency room were worried about my hips but nothing was broken-not even my owie big toe. I've been taking digestive enzymes for over 20 years!

I took nexium for around 10 years, and was taking it daily up until recently, when I started having heartburn in spite of it. I decided to investigate the competing theory of the cause of heartburn and acid reflux, namely that it is caused by not enough acid, not by too much acid.

My decision was inspired by the logic of the situation: If I was taking Nexium, which supposedly reduced my stomach acid to nearly zero, how, then, could my heartburn be caused by too much acid?

So, while actually experiencing heartburn, I took a tablespoon of a 50-50 mix of balsamic vinegar and honey. The heartburn went away in about 15 minutes. Later in the day, when I got heartburn again, I took some more of the mix, which again quieted my symptoms.

Starting that day, I began to increase the interval between Nexium doses, from 24 hours between pills to 25, then 26, etc. (this is not the same as taking it an hour later each day, which is a simple 25 hour interval. You have to work it out on paper, it's not very intuitive....)

At the same time, I took a tablespoon of the honey/vinegar mix at each meal,or more if I felt symptoms, and at each snack, and whenever I had either reflux, heartburn or roiling of the stomach. For the first few days, I felt like I was guzzling the stuff, but I persevered.(I also stopped taking atropine, which I was taking for stomach roiling). I was very comfortable and able to eat normally. By the time I got to a 36 hour interval, I started losing track of the process of tapering the Nexium off, and just stopped taking it.

Now, 2 weeks since my last Nexium pill, I feel very well. I have also started taking probiotics, reasoning that they can live in my stomach now, now that the pH is correct.

If I could swallow pills easily, which I cannot, I would prefer to take the Betaine HCl pills, just for the convenience, and also to avoid the extra calories of the honey. I am thinking about trying to take straight balsamic vinegar, but haven't worked up the courage.

I have to say, I was skeptical of the "caused by not enough acid" theory, but now I am convinced. I feel like an addict cured.

Have you read the way to take pills that was published years ago in this column? It works!

My GP suggested I used a different PPI to Nexium 20mg about 12 months ago on grounds of cost to the National Health Service. I was given lansoprazole then omeprazole and I also tried reducing dependency on these drugs. This worked up to a point. I had infrequent bouts of GERD but I began to feel agitated, suffered dizziness and generally felt unwell.

I then developed a pain under my rib cage to the right of the sternum which became ongoing and very distressing. Gallstones were expected but ruled out after an ultrasound scan. A follow-up CT scan revealed a slight irregularity in the stomach which was investigated with a gastroscopy. This was found to be a harmless polyp caused probably as a result of long term (6 years plus) use of PPIs. Whilst the results of all these investigations were comforting as they ruled out any serious condition, I was still left with this chronic abdominal pain.

I re-presented myself to my GP about a month ago asking what other causes may be giving me this pain. It was suggested that, even though I had little GERD symptoms, I should try going back to taking Nexium daily as the onset of my pain seemed to be linked to my withdrawal from PPIs. A month in to this treatment, I am pain free. I would like to come off Nexium particularly as I now rarely experience symptoms of GERD, but I do not want to suffer this chronic abdominal pain as a consequence. I am a 53 year old male, not a smoker, not overweight and drink alcohol moderately.

I hope everyone will please remember, as we try to wean ourselves from the PPI's, that erosion of the esophagus is, indeed, a serious matter. It happens when stomach acid splashes or backs up into the esophagus--especially as we get older and the hiatal sphincter gets a bit looser. Persistent erosion from stomach acid is not only uncomfortable (downright painful) but it can lead to esophageal cancer--NOT a good thing, obviously.

Please do try Gaviscom. It works differently from a usual antacid because its action is to coat the esophagus and the hiatal sphincter. This reduces the pain of acid-reflux and doesn't interfere in a major way with the acid balance of the stomach. You may need to do a bit of searching to find Gaviscom that doesn't contain aluminum if you are concerned about that (as I am). But it can be found.

Interestingly enough, once I slowly tapered down the Prilosec that I had been on for years, and completely stopped it--I find that I rarely have heartburn, or reflux (as long as I use common sense and don't lay down too soon after eating) Contrast this with the heartburn I had while taking the Prilosec, in spite of it. A miserable process getting off the stuff, but worth it, at least for me. The person who commented about the splashing into the esophagus is right on target, so this is a topic to discuss with your doc before stopping a medication.

I do think awareness is spreading that there IS a rebound effect for many when trying to stop these drugs. I don't overeat--always stop eating when I feel full, don't wear tight clothing, have the head of the bed elevated, and watch those foods that can cause heartburn, and only eat them in moderation. Don't drink or smoke either. An occasional Zantac OTC works fine for any intimation of problems.

I read all the comments and think this is an excellent site.

After a small gallbladder "attack" I was given the 40 mg Omeprazole that comes in a 30-day supply. After a couple weeks, I was dizzy, fatigued and my skin felt like tiny hot needles were poking me. The last couple of days I have had pain on the outside of the breast and under the arm and I felt feverish, yet didn't have a fever.

I already have osteoporosis. The entire situation is scaring me. I want to get off this drug safely. To read that some people have been on this drug for a long time, I realize that I am in a good place to act now, as I only just started (a month).

Why don't I go see my doctor? Because I have terrible insurance. It costs over $100 every time I go. Plus, I am not in agony; I'm just moderately miserable.

I have jotted down some of the suggestions and will investigate further.

Thank you everyone.

how long did anxiety last after you stop taking it???

Moongirl, I am so interested in your comment on no more anxiety and depression after quitting omeprazole. I am suffering with severe anxiety and depression since taking them, I am an anxious person but these drugs have sent me into orbit. Can you tell me a bit about how it affected you?

The depression and anxiety was from the vitamin B12 and vitamin D deficiencies I had gotten due to taking the PPIs. Get your Vitamin D and B12 levels checked by your doc. Don't let them tell you "it's normal." Ask for the exact number. Because in the US normal B12 is considered 211-911 or so and in reality you can still get symptoms at anything under around 450.

Mine was 350 when my symptoms were getting bad. Then, if you are deficient, don't get Vitamin D shots, take liquid vitamin D3 (not D2 which is synthetic) and always take Vitamin D in the morning and with food or drink that contains fat. Look into a Paleo or Perfect health Diet way of eating. Heal your gut. You'll feel better all around in the long run.

My heartburn for taking off omeprazole only four months is quite troublesome, it changed my diet and live in miserable life. My heartburn still present. Let's hope it will be off soon. I am never taking this pill again for the rest of my life. I hope everyone aware of this Pill. Besides this pill cannot really help my ulcer for me.... I think/hope my ulcer will heal when rebound wears off.

I know that pain. Get a juicer and juice cabbage and drink it down. It really helps, instantly. The worst part is cleaning the juicer. If you just swig the juice down fast you don't taste it much.

I was prescribed Omeprazole by an ENT specialist because I had developed a hoarse voice. Having looked at my vocal chords, which were fine, he felt that my high caffeine intake was probably the most likely cause and told me to reduce the amount of tea I drink, but he would also prescribe Omeprazole and Gaviscon Advance, in case I had acid reflux although I had NO symptoms whatsoever!! My Pharmacist commented on the high dose I was given, and as an ex nurse I decided to take only half the dose prescribed.

After 2 weeks I decided to come off the meds as I was unhappy taking something when I had no symptoms and also as I am a frequent visitor to USA where my son lives, I did not want to have to declare a 'condition' which didn't even exist! As soon as I stopped the Omeprazole I began having indigestion, dyspepsia, acid reflex and abdominal pain!!!! I am now beginning to see a reduction in my symptoms after 2 to 3 weeks. I am furious as I feel I should never have been prescribed them and a 'bogus' condition added to my medical history!

What are your thoughts on using apple cider or aloe vera while trying to get off Prilosec? Do they help? If so, which one would be best?

Do b-12 tablets work or do you need injections?

Esteban, how one gets their B vitamins depends a lot on one's age, digestive system and life experiences. Yeah, I know that sounds hokey but let me give you some examples.

My hubby is a Vietnam vet and suffered from what we now call PTSD. We were married about a year when I realized his moods were NOT temporary. My BA is in Psychology and my minor in Biological Sciences so my mind works in natural treatment paths. We of course had no name at that time, '73, for his moods. What I did was give him vitamins and minerals with a B50 breakfast and dinner. Was he a willing subject? Ummm, maybe the words "my way or the highway" helped? Yes, it did work but as we have aged I discovered it wasn't enough. For the last several years before retirement he carried a small B complex spray in his shirt pocket. He would do one or two shots under his tongue as needed. His mood got really worse recently and I discovered he wasn't using the sublingual spray. Our habits change during retirement so I'm going to have to be more "proactive".

My 14 yo nephew came to live with us. Fortunately I'd obtained my MA in Guidance & Counseling or the state wouldn't have allowed him to come live with us. He'd been in heavy duty psychiatric "care" for two years and was going to be permanently incarcerated in a psych facility. Guess what helped his problem? Yup, B vitamins and digestive enzymes. I'd give him supplements every day and he never knew what he was taking. I then observed behavior, mood and ability to learn. Yes, I home schooled him. He also needed zinc and magnesium. All the problems he had when he arrived here gradually disappeared-knee problem (Ortho said he'd grow out of it and is common for teenagers), stomach aches, canker sores, headaches, tiredness etc.

A college student friend had serious mood problems so I recommended she try the B vitamins and a digestive enzyme. She did and it worked!

If you have a cooperative physician the B injections are great. My Dr. uses what he calls a Myer's Cocktail for patients that have serious problems or trauma in their life. Yes, it is great but one must follow on with the oral for everyday. You may want to try a multiple B supplement with your daily vitamins and then use the supplemental sub-lingual spray like we do.

Hello all. I have taken Prilosec for almost three entire months. During these last months I have experienced some of the worst things in my life. After reading all your comments I was encouraged to call the FDA and submit a report. I encourage all of you to do the same. While on this drug I experienced hair loss, extreme dependency, severe anxiety, nervousness, and depression. I felt like I was going no where. I have decided to stop taking this drug and the withdrawal is awful. Please be careful with this drug or any other drug. Know what you are putting into your body. Please call the FDA and let's have this drug re-evaluated.

My experience with Prilosec (omeprazole) is very similar to Maria's (and also Elizabeth H.) In July of 2013, I too was referred to an ENT because of a hoarse voice. I did not have any symptoms of GERD, and I'm not certain that the ENT doc could, in fact, see any indications of GERD, either. But he put me on omeprazole, 40 grams a day, anyway. Soon, I started losing my hair! I hadn't made the connection to omeprazole until I began doing a bit of research. Aha! A possible adverse reaction to the omeprazole.

I, too, began experiencing depression and anxiety--a very bizarre sort of anxiety that was so bad, I began to think I was losing my mind. I have nothing to which I can attribute the sudden anxiety except the side effects of omeprazole. I've stopped the meds and am continuing with non-medicinal remedies--raising the head of the bed, not eating before bedtime, etc. My anxiety continues. I hope that it lessens, in time, and then disappears entirely. By the way, pre-July, my vitamin D3 levels had been adequate. When I had my physical exam this past January, the levels were low. I must now take 5000 IU's a day. After reading these posts, I wonder if the omeprazole could have been to blame.

I too think that perhaps this drug should be re-evaluated, or at least not prescribed so cavalierly. These sorts of drugs are so commonly prescribed that I think most of us don't realize that the side effects can be pretty frightening.

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