Q. I know PPIs have tons of side effects, but the trouble is I’ve taken them for years. Now I am stuck with them.

I’ve tried to get off of them several times, and each time it ended in failure. Please help!

A. Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid) or esomeprazole (Nexium) can be extremely difficult to quit. The problem is rebound hyperacidity that can last up to four weeks after the heartburn drug is stopped (Scandinavian Journal of Gastroenterology, May, 2013).

We are sending you our Guide to Digestive Disorders with suggestions on how to ease the discomfort as you withdraw from your reflux medicine. These include using DGL (deglycyrrhizinated licorice) or persimmon tea to prevent heartburn symptoms. Sometimes it helps to use an older-style heartburn pill such as ranitidine or cimetidine to get through the worst of it. We have included advice from Tieraona Low Dog, MD, on how to overcome this difficulty, but you might also be interested in her in-depth book from National Geographic, Life Is Your Best Medicine. We offer it together with a CD of our one-hour interview.

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  1. fbl
    Reply

    DT, let me tell you how a friend of mine got off the antiacids. First I made sure she was drinking lots of water, 1/2 her body weight in ounces, and then I had her start with just one digestive enzyme. I like the one I use because it has a reasonably low dose of Betaine HCL (200 mg) but also has the other digestive enzymes.
    After several meals of taking this, and a bit of acid stomach quenched with water, she started backing off her antiacids. At this point the Super Enzyme caused no acid stomach reaction. Once she was off the meds I had her take two of the Super Enzymes with each meal. She did this with no problem. We increased gradually a few more times until the acid stomach came back. She took the water to douse the acid and went back to the last good dose. She wound up taking one of the Now Super Enzymes and one 650 mg.(I think) Betaine HCL.
    My friend has done very well on this regimen for quite some time. Unfortunately, not everyone is willing to try this system. My nephew needed digestives quite badly at age 14 (he was living with us at the time) and I suggested to my brother that he try digestives as well. Not only a NO! but a hell NO! Unfortunately he’s had a lot of joint, back and bone problems. Many years later he still won’t consider any remedies…but will take the Dr. prescribed meds…sigh.
    Be very careful and patient. Yes, the burning gut may get worse immediately but take lots of water to calm it down. I have other friends who have had no problem at all getting off the stomach meds and taking the digestives. Every body is different. Water and maybe a bit of candied ginger will help the transition.

  2. DT
    Reply

    What is a challenge test? And I’ve been told digestive enzymes are good because as you age, you don’t produce the ones you need anymore. I don’t understand how they would help with acid reflux but I’m very interested in the improvement of your nails. My hair seems to be fine but my nails have always peeled. In the last two years, it has gotten progressively worse though. They are constantly peeling and paper thin. And my toe nails are showing signs of doing now too. Why do the enzymes help? And where can you go to have your hair tested?? Will my regular doc do that?
    Thanks for any answers you can provide. DT

  3. sharonj
    Reply

    I have used those ppis and I now use, famotidine & dexilant. Do you use the same methods to stop using these drugs as well?

  4. K. Smith
    Reply

    After taking Prilosec for longer than recomended, I was afraid I was doing long term damage, and decided to stop. Interesting how one’s body adapts, and it wasn’t easy to change until I finally figured it out. I enjoy starting my day with two cups of good coffee, (no sugar or cream) and then I am through for the day.
    Then I learned that the acid in the coffee is in the caffeine!!! I switched to decaf for about a month or two (order decaf K-cups from Amazon, 80 count) until I felt the acid was under control, and am now back on regular coffee. I do watch out for symptoms, but I no longer swallow Aloe, Tums or Pepsid for relief.

  5. JA
    Reply

    Recipe for persimmon tea;
    Recipe for persimmon tea mentioned above
    1/2 cup fresh ginger, sliced thinly
    1 cup dried persimmons (ordered on-line from nutsonlinedotcom)
    3 sticks of cinnamon
    1/4 cup sugar (original recipe had much more)
    8 cups of water
    Gently simmer water with ginger, persimmons and cinnamon in covered pan.
    Simmer for 1 hour.
    Pour through stainer. Sweeten with sugar.
    Drink warm after meals. Refrigerate any left over and reheat as necessary.

  6. BG
    Reply

    More information please from anyone who has found something to alleviate the pain of going off these PPI’s. I would love to be able to stop the Prilosec. I use asthma inhalers and was put on prilosec to alleviate any potential esophageal problems.

  7. Lou G
    Reply

    I’ve used many remedies as suggested on this site to great success. After my back surgery 2 years ago, I began to have heartburn again after many years being free of it. The gastroenterologist I saw put me on omeprazole, and it worked well enough that I started decreasing usage day by day. Then I read here or somewhere that aloe vera juice will help control heartburn. I use 2 tablespoons in a glass of orange first thing every morning, and I seldom get heartburn. When I do, I eat 4 or 5 almonds and the heartburn goes away almost instantly. The almond remedy I did read about here.

  8. Catherine
    Reply

    It is noted here above “persimmon/ginger/cinnamon tea” to drink warm after meals to wean off prilosec, it does not quote the doses of each ingredient, and if it is one cup of tea. Can you buy persimmon tea? if so where? Does it come with ginger & cinnamon in it, or do you add it, and that would have to know doses. Thank you “People’s Pharmacy” for your helpful website and newsletter. Catherine

  9. MH
    Reply

    How did you make the tea?

  10. fbl
    Reply

    As one tapers off the drugs, it might be a good idea to start on some mild digestive enzymes. Our diet has changed so much in this country over the past fifty years or so I don’t think our bodies are getting what they need for proper digestion. Start with a digestive that has a low dose of betaine HCL and then once the fire in the belly is gone play around with the best dose. Increase very gradually. You may have to increase your dose as you age so do a challenge test every few years.
    I learned this lesson over 30 years ago. I went to a very old family Dr. and he looked at my hands and then did a hair analysis. I was low in the very minerals I was supplementing! I had split ends on my short hair and my nails were broken, cracked and peeling.
    My hair is now long without split ends and my nails need to be cut back regularly. My bones are also strong, much to the amazement of the orthopedic that treated me for a broken leg. It was a nice clean break after a bad fall. He said at my age, 68, the bones always shatter down the femur. It healed quickly as well.

  11. jas
    Reply

    Not sure if this will help for constant, heavy-duty heartburn problems, but if you chew on celery and suck only the juice out of it and spit out the fibrous part, heartburn will be neutralized. You might be able to do this with a blender or a juicer, but you would be getting the fibrous part as well so I’m not sure if it would work… I had horrific, about-to-vomit heartburn when I was pregnant and chewing on celery worked extremely well. Since I was preggers, I did not want to take any OTC meds.

  12. D Creery
    Reply

    The use of baking soda at 1/2 teaspoon for 4oz of water is good for heart burn.

  13. Judy
    Reply

    I too have been taking Prilosec for years. I even had the scope done to see if they could fix it but they couldn’t find anything but a hiatal hernia. So they were of no help. I read about taking the licorice root so I have been taking them. I am only a little over a week but am only taking 1/2 a pill in the morning and the licorice 3 times a day. Also eating plain almonds that seem to help also. A couple of nights I have taken a Zantac too. I’m hoping by next week going to 1/2 pill every other day. I love your column and have used a lot of your suggestions. I drink the grape/apple/vinegar mix and eat the raisins in gin in my yogurt at night. Thanks.

  14. KathK
    Reply

    I had very bad side effects from Nexium, including severe arthritis pain. I tried every recommendation I read: no food after 6p.m., small meals, chewing thoroughly, sleeping in a chair- nothing worked. Then I read that apple slices with the skins on would help with heartburn. Bingo– in less than a month, I was ‘normal’! At nearly 70, I can eat anything I want. I drink coffee, but avoid diet soda, and always follow a tomato based meal with an apple.

  15. dey
    Reply

    I weaned myself off Nexium by going on a 2 day with an one day without for a couple of weeks then went to alternate days, then two days without and one day with. After approximately 6 weeks I was “free” of heartburn symptoms. That was 5 years ago and I’ve very rarely experienced heartburn since I got off the Nexium. Eating moderately and losing weight also helped.

  16. oualum
    Reply

    Where do you get the tea, of do you make it? How?

  17. DC
    Reply

    I’ve been gradually tapering off by adding an hour on to the time I take my dose. About a year ago, I started with 30mg of Prevacid twice a day (1/2 hour before breakfast and before dinner); I was basically taking the doses 12 hours apart. So I just started taking it 13 hours apart. I had a little heartburn and discomfort for a day or so, but within a week was feeling fine. It’s taken me awhile, but I’ve managed to cut my dose in half with this method (tapering to 14 hours between doses, 15 hours, etc. until I’m currently at 23 hours between doses).
    Once I’m down to 1 dose a day, I plan to open one of the Prevacid capsules (I take two 15mg pills at a time) and remove a little of the medication, putting the rest into empty capsules I purchased at Vitamin Shoppe. The otc Prevacid are little balls rather than powder, so I plan to count them up and remove say 2 at a time, giving my body time to adjust, and then doing it again, and so on.
    This method, while definitely time consuming, has allowed me to taper off the medication with minimal discomfort. Unfortunately it also meant waking up during the night at times to take the medication, but I like that I’m controlling my symptoms while also getting off of a powerful drug so it’s worth it in my mind. And any time I feel that I’ve tapered too soon, I just wait until my symptoms level off before tapering again.
    My GERD was so severe I’d gone to the ER twice for the pain, so the fact that I can taper off this way gives me confidence that it would work for others. I also like that I haven’t had to supplement with any other acid reducing medication, even after being on such a high a dose (60mg a day to start).

  18. JA
    Reply

    I was able to wean myself from omeprazole by drinking the persimmon/ginger/cinnamon tea warm after every meal. I believe that is the key to this tea. A Korean friend of mine said that is what they do in Korea after meals. Drink it warm after a meal. I first went to a pill every other day, then to every two days, then to every three days, etc. I had to taper down slowly and the tea allowed me do that. I was off the pill in 6 weeks. Also I only put in 1/4 cup sugar! The sugar content of this tea is way too much.
    I also deleted trans fats from my diet. I cannot eat fried food anymore nor do I want to since it carries a risk of stroke and heart attack. So I have to choose between a momentary pleasure versus a happy, healthy and full life. I choose life.

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