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Getting Off Prilosec Is a Challenge but Reduces the Risk of Recurrent C Diff Infection

People taking acid-suppressing drugs are at higher risk for repeated intestinal infections with Clostridium difficile, aka C diff.

Proton pump inhibitors (PPIs) like omeprazole (Prilosec) or esomeprazole (Nexium) were originally designed to help heal ulcers, but before long doctors started prescribing them for gastroesophageal reflux disease (GERD). Once such drugs became available over the counter, many people began taking them to ease heartburn. They can be quite effective for that purpose, but there is a dark side. Not only can long-term use of PPIs result in some serious side effects such as C diff infections, people who stop taking them may experience rebound heartburn that is extremely unpleasant. Many readers would like to know how to get off a PPI.

Getting Off Prilosec with DGL and Diet:

Q. My doctor said that I would need to take Prilosec for life due to my hiatal hernia, Schatzki ring and GERD. But once I started reading about long-term side effects, I decided to wean myself off the drug.

An elimination diet and DGL helped enormously. I also discovered that I was lactose intolerant and went dairy-free.

In addition, I made notes of when I had any attacks. Eating steak, salad with oil-based dressing and baked potato with sour cream was a guaranteed trigger. So I swore off high-fat meals.

My husband and I became semi-vegetarians and gradually became vegans. Reflux is now rare for me and responds to antacids.

I highly recommend elimination diets and keeping a food diary. By the way, the vegan diet lowered our cholesterol and allowed my husband to drop those last few stubborn pounds he was carrying around.

The Benefits of Food Diaries:

A. Thank you for sharing your success. Many people with anatomical conditions like yours, with a narrowing of the esophagus and displacement of the stomach, suffer severe heartburn.

A food diary can be very helpful. Some people find a low-carb diet reduces their reflux, while others do better on a low-fat regimen. Keeping track of your symptoms will help you discover which pattern helps you most.

What Is DGL?

DGL (deglycyrrhizinated licorice) is licorice with the ingredient glycyrrhizin removed. This component of the licorice plant contributes to some serious side effects. They include high blood pressure, potassium depletion, irregular heart rhythm, fluid retention, headache and lowered libido.

Herbal expert, Tieraona Low Dog, MD, recommends DGL for people who prefer a natural way to control reflux. She has also suggested it to help those who are trying to wean off powerful acid-suppressors such as omeprazole.

Learn More:

For more information on controlling heartburn naturally as well as the pros and cons of medications, you may wish to consult our eGuide to Overcoming Digestive Disorders.

Can Stopping Prilosec Reduce the Chance of C Diff?

Q. I have been on Prilosec for the last ten years. I was recently diagnosed with C diff and decided after doing some research that I should stop the Prilosec.

I’ve been off it for about a week now and I am suffering from terrible heartburn. Should I go back on Prilosec? I’m scared that the C diff might come back.

A. C diff is short for Clostridium difficile, a bacterial infection that can indeed be difficult to treat. It frequently causes serious diarrhea.

You are right to be concerned about continuing on omeprazole for a long time.

A study showed that 29 percent of patients hospitalized with a C diff infection had a recurrence if they were taking a drug related to Prilosec (JAMA Internal Medicine, May 2015).  In this study, 20 percent of patients not taking an acid-suppressing drug such as esomeprazole (Nexium), lansoprazole (Prevacid) or pantoprazole (Protonix) got a repeat C diff infection. The difference is significant, so if you can find another way to ease your digestive distress, you should use it.

Do not stop Prilosec suddenly, though. Rebound heartburn is common. A gradual reduction in dose under medical supervision is advisable.

Other readers have experience withdrawing from omeprazole.

Here is what CM had to say:

“Six days ago I stopped taking omeprazole. I was only on it for a month. The first five days were fine but now on the 6th day the rebound, burning and upset stomach are a problem. I didn’t have this before I started taking the medicine. I am deciding if I should take one tomorrow and go every other day, weaning off more slowly.”

Moira has tried many tactics:

“I was on omeprazole for 4 years and went cold turkey with no problems. I had nocturnal reflux with acid rattling and wheezing in my chest usually relieved by getting up and vomiting. I used a slanted pillow which helped a lot but eventually it caused my legs to ache so I stopped that about 2 years ago.

“I’ve been existing on careful eating at dinner time, eg nothing too heavy, and keeping Gaviscon by the bed. I was finding I was taking Gaviscon more frequently so came back here to check out some other treatment …..and I think I’ve found it!

“I take one DGL licorice capsule at most meal times (no drama if I miss one or two) and one before bed. I religiously go to sleep on my LEFT side…….AND I can eat what I want, although nothing after my main evening meal. I’ve shoved the Gaviscon into the drawer.Thanks to this I’m in heaven with undisturbed sleep at long last. “

The DGL that Moira is referring to is deglycyrrhizinated licorice. This botanical product is licorice that has had the glycyrrhizin removed to prevent side effects such as elevated blood pressure and fluid retention (Hospital Practice, Aug. 15, 2001). It has been used to treat gastric and duodenal ulcers, although double-blind trials have been less than impressive (Gut, Sept., 1973). It appears to be helpful in calming the heartburn that may arise as a person discontinues the use of a proton pump inhibitor such as omeprazole or esomeprazole (Nexium).

You’ll find more details on how to get off omeprazole and similar acid-suppressing drugs in our Guide to Digestive Disorders.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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