older man with heartburn, acid reflux or indigestion

Q. I have GERD and I have been on Nexium for several years. Before Nexium I took Tagamet, Zantac, and Prilosec, in that order.

I have tried to get off of this medicine several times, and I have been unsuccessful due to the symptoms returning. I saw on the news recently that people on Nexium might be at higher risk for hip fractures. This has me worried.

Will I have to keep taking some form of GERD medication the rest of my life? Or can you recommend some kind of herbal or alternative treatment instead?

A. Millions of people take acid-suppressing drugs such as Nexium, Prevacid or Prilosec for heartburn or gastroesophageal reflux disease (GERD). While these drugs are often very helpful, there is growing concern that they may have unexpected side effects over the long term.

Research has linked such drugs to an increased risk of fractures (Osteoporosis Int., online March 31, 2009), pneumonia (Annals of Internal Medicine, Sept. 16, 2008) and intestinal infection (American Journal of Gastroenterology, Sept. 2007). They can be hard to stop (Gastroenterology, July, 2009).

We are sending you our  Guide to Digestive Disorders with tips on quitting acid-suppressing drugs and natural solutions for heartburn symptoms. Many people report less reflux with a low-carb diet, persimmon-ginger tea, over-the-counter antacids, mustard or chewing gum.

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  1. Elizabeth Allemann, MD

    I have now had two patients who experienced bloating, gas, and constipation when stopping PPI’s-not any return of reflux. Any ideas about why or what to do about it?
    Thanks for all the great work you do.

  2. Betsy

    I’ve had stomach issues for years, ever since going on a medication for migraines (topirimate) in high school. I have IBS and GERD, and they flare up every few months when I’m stressed or sick. This summer I got very sick after a round of heavy-duty antibiotics for a bad kidney infection.
    I’ve been diagnosed with gastroparesis, which is hard enough to manage on its own, nevermind the awful GERD that accompanies it! I think that the medications I am on may be the root of a lot of my stomach problems, but don’t know how to get off them or which I should get off first.
    I’ve been trying to wean off the topirimate very slowly, but the withdrawals are awful. Constant nausea, and I have a hard time battling that when I’m already so sick from the gastroparesis.
    I’m also on 80mg daily of protonix, and think that it may be contributing to the problem. Does anyone know if protonix can cause gastroparesis? I’m afraid of trying to go off it because of the relapse GERD.
    Lastly, I became addicted to xanax over the course of the kidney infection. I know that the longer I’m on it the harder it will be to wean off, but my doctor and I agreed that getting me off the other meds first is a priority and that the xanax will help the anxiety through all of this.
    I am not sure what I should be eating or doing-I can barely digest food right now at all. I’m on a liquid diet, and occasionally can eat some “mush” (think baby food) but nothing more substantial than that. I have mostly been drinking fruit juices and broths, and sometimes eat mushed vegetables or fruits. I find mashed potato to be soothing, but wonder if it’s too much of a carb? Does anyone have any ideas or help?
    I’m very worried. I’m not sure how to get better. I am too sick to deal with withdrawals, but I think these meds are causing at least part of the problem and I won’t be truly healthy until I can get off them. I’d like to stabilize to the point that I can eat again before weaning any more, but I don’t know how long that will take or if it will even happen.

    • ann

      Betsey if this helps I suffer from Gerd and my consultant told me not to eat any citrus fruit or drink any fruit juices it does help,, but I notice that you do eat and drink these items,, I was also told not to eat after 7pm because of lying down and acid burning my throte, hope this helps you Betsey.

  3. db

    Be careful with the fish oil capsules. At the advice of a concierge doctor, I quit taking them and my GERD has dropped significantly. It is one of the possible side effects of fish oil capsules. Good luck.

  4. KTN

    I can only go by what I believe helped me rid of my GERD when I was informed by some health food site to take aloe water as a homeopathic cure or arrestment to neutralize the acid and smooth out the throat irritations that made swallowing difficult thereby causing significant weight loss. I lost nearly 20 lbs. I was on Nexium, Dexilant, Omeprazole and Metopromide before that for about 7 months.
    I drank about 2 fluid oz. of aloe water daily and imperceptibly over the course of 2 weeks my GERD symptoms disappeared. However, I am still taking omeprazole and quit taking the others to make sure it doesn’t return. I couldn’t be happier with the results and the only thing I avoid eating and drinking is coffee. I regained my weight back and my appetite is normal.

  5. Sammy

    Until recently, I had used omephrazole for 20 years, having started when diagnosed with small ulcers. The ulcers healed but I was able to get omephrazole very cheap in Mexico since I traveled full time in a MH and daily use of this drug allowed me to eat spicy foods, along with other foods and drink that would have caused an upset stomach.
    When I read in People’s Pharmacy weekly newspaper article that people trying to stop taking the acid inhibitors suffered “heartburn hell.” I decided to stop but did lots
    of online research to hopefully stop without the horrors others have experienced. I
    modified my diet, eliminating all spicy foods, resorting to a very bland diet. I
    used liquid probiotic acidophilus containing 20 billion organisms taking 2 tablespoons
    after each meal. On occasion when I thought I could ‘cheat’ a bit on the very bland
    diet, I resorted to a swig of maximum strength Maalox.
    Three months later, I am still eating cautiously to not have to find out what
    “heartburn hell” is. This is working for me.

  6. EMH

    Over 10 years ago my doctor prescribed Prevacid but I don’t know why – I’ve never had acid reflux. I’ve seen three doctors since then but only when it became too expensive did our insurance company stop paying for it. After that my current doctor changed it to Prevacid, over the counter. A few months ago I started questioning why I was on it and talked to three pharmacists, my doctor, and the two companies that make/sell/Prevacid and asked about any problems I might have if I quit it.
    The Prevacid Company that still sells it in prescription form said I might get a little indigestion but to take something like Tums. None of the others I had talked to could tell me anything that might happen. With my doctor’s OK I quit taking Prevacid and within a few days started feeling terrible all over. The minute a bit of food hit my stomach it hurt, I lost my appetite and within a month I had lost 25 lbs. My doctor and the pharmacists suggested I go back on Prevacid which I did and within two days felt better.
    That’s been more than two months and I can’t gain the weight back. I have had severe sciatica for two years and had no pain when I stopped the Prevacid but when I started it again the sciatica came back with a vengeance. I still want to stop it and asked about taking it every other day but a pharmacist told me yesterday not to try reducing the dosage. Do I have to take this for the rest of my life?

  7. Christina

    So nice to hear about others (DW and Terri) who too, had to figure out things on their own. I have been suffering for a year with what I thought was Esophageal reflux (though it was mild). I’d been prescribed first 40 mg a day of Protonix, once a day. Since being on it I have worse problems than when I started them. Mostly severe bloating, my stomach literally swells like I’m pregnant.
    When I’ve tried to go off it I get rebound acid, with excruciating pain in my mid section under ribs right above my stomach. So, I have started to wean myself off slowly. I’m down to 20mgs and this week I am going to try taking one every other day instead of every day. I only went on it because I was having this horrible problem with swelling in my neck/throat, felt like it was hard to swallow and it gave me facial pain and throbbing.
    It was so scary, and no one knew what it could be. After numerous doctors, tests etc. one doctors told me was reflux. Bear in mind I never had any heartburn or stomach problems. I knew I didn’t have reflux but tried the meds anyway, it seemed to help with the swelling and throat problems. But now, that swallowing stuff is still lingering on and off.
    And I’ve come to the realization that it may be due to Gluten/ wheat. Allergy or intolerance I am not sure, but when I don’t eat it I can swallow better. So, after all the CT’s MRI’s, blood tests, specialists visits, I figured it out on my own. No one even gave me a clue. In retrospect I had been consuming so much wheat based products. I would eat cookies, breads, pasta, pizza and pretzels all the time all day long (no joke). So, now I am trying to relieve my symptoms and get the heck off these reflux meds (they are not good to be on for long anyway).
    I too have changed my diet, cut my coffee intake, cut out chocolate, all wheat products, and only eat minimal dairy. I feel better except for the bloating. It’s only been a week with the gluten free so I am hoping it gets better. I also started taking Probiotics 2 months ago, and recently fish oil for inflammation. I tried the digestive enzymes briefly, perhaps I’ll give them another try. Glad to hear I am not alone.

  8. Terri

    My doctor suggested a gluten free diet for me to stop taking stomach meds. I was taking Prilosec 2x/day and Ranitidine at 1x/day was added. And even with that, the issue wasn’t fixed. The gluten-free diet really is not that bad. I had to adjust my attitude and stop the wimping. The stiffness in my joints is gone along with my headaches. I exercise every day both aerobic and weights. I drink lots of water. I feel SO much better. I would highly recommend this approach for anyone. I noticed a difference within one week. Hope it helps someone else.

  9. Greg Pharmacy Student

    I’m glad things are working for you, but surely there were doctors and pharmacists involved in some of the choices you made. I think if more patients would ask about natural medications or therapy without medications your doctor or pharmacist would provide the information. Surely most doctors would be delighted if all their patients’ diets looked like yours. The food pyramid was made by government funded doctors.
    We are what we eat. I’m so happy to see you eating up to your standard of health.

  10. DW

    I was on omeprazole 40 mg daily for 2 weeks and after finding out about the dangers of the medication, not to mention it wasn’t helping my gas, extreme abdominal pains, heartburn and sluggish bowels, I decided to look for alternative remedies… this is what I did.
    The last week of taking the omeprazole, I decreased my daily intake to 15 mg and started taking digestive enzymes with meals, dgl tablets before meals and probiotic pills in the morning before breakfast. I did this for 2 weeks and then added 1 gram of mastic gum daily.
    Although the severe symptoms were gone by now, I so badly wanted to be 100% normal again, so I increased my intake of mastic gum to 1 gram twice per day while continuing the above regiment. I did this for a total of 5 weeks and then removed the supplements 1 by 1 from my diet. First, I stopped taking the dgl tablets then after a week stopped the digestive enzymes and finally a few days later decreased my mastic gum intake to 500 mg twice a day for the final 2 days.
    I have not had any symptoms in at least a month and have since started a 10 day cleanse along with 1 garlic pill daily. The garlic pill is a 30 day supply and I figured to take it just in case I had any type of yeast or bacteria infection lingering. I am on my 6th day of the cleanse and feel so much better. The only thing I still take is the probiotic pill because it helps to maintain a healthy bowel and digestive system.
    Let me not forget to mention that my diet has drastically changed: no fried foods except in peanut or coconut oil, more fresh fruits and vegetables, no processed foods or sweets, and No alcohol.
    I suspect the overall cause of my problems was poor digestion. I am not sure what caused it, a yeast or bacteria infection of the digestive system, ulcer, or a bowel infection. But at the moment, I feel so relieved that progress has been made in my overall health.
    I am now back to exercising 3 days a week and drink at least 2 liters of water per day, not to mention most of my food shopping is done at the whole foods store… trying to eat 100% organic… All of this accomplished by prayer, research and diligence to be healthy, and ABSOLUTELY NO THANKS to the Dr.s Office.
    Be Healthy.

  11. NBF

    I weaned off Prilosec using a combination of Prelief, regular strength Rolaids, and chewing gum. The sugar free gum didn’t cause me any problems.

  12. Liz

    I also took Tagamet, Prilosec and Nexium for years, eventually developing some nutritional deficiencies. I was asked to add supplemental Betaine HCL with each meal (particularly with meat). At the same time, I was asked to try and wean myself off the Prilosec or Nexium, taking TUMS or similar antacids for symptomatic relief instead. To my surprise, once I started the betaine, my GERD and/or heartburn symptoms were almost entirely gone.
    The whole purpose of stomach acid is to assist in preliminary digestion of food. Without enough acid, the stomach takes much longer to do it’s job, thus the stomach lining is more likely to get irritated, and the contents are more likely to reflux out into the esophagus.
    Many people find that after a few months with supplemental betaine their own acid production returns to normal. Others need to continue to take it. Since stomach acid production decreases with age, it seems to me that more people should consider whether their acid indigestion is caused by too much acid or too little.
    In my case, a nice side effect of cutting out the acid-inhibiting medication and adding the betaine is that my osteopenia reversed itself.

  13. Greg Pharmacy Student

    JM and others,
    G.E.R.D. stands for GastroEsophageal Reflux Disease. This means that the pain, “heart burn”, is due to gastric contents (stomach acid and digested food) irritating the esophagus (throat) which causes pain. After continual irritation cancer may develop, this is called Barrett’s Esophagus.
    Of course, GERD is usually a symptom of eating something your body doesn’t like (large meals, spicy food, etc.). The stomach keeps food in it with a muscle on the top and one on the bottom, some foods and drugs relax this muscle which allows REFLUX or the gastric contents to go up and out of the stomach. If you have GERD, AVOID: alcohol, nicotine and other foods and drugs that relax this muscle.

  14. lls

    I have the same problem, the doctors keep changing prescriptions on me and none really worked. Then one day I remembered that you could use a 1/2 to 1 teaspoon of baking soda mixed in a tall glass of water. It works for me and I dont have a problem sleeping at night.

  15. Nancy A.

    A few months ago I was started on Prilosec, 2 a day and had severe stomach pains so asked my doctor for something else and was prescribed Aciphex. During this time I was being worked up for several GI problems, including gallbladder which was removed a couple of months later. While on the Aciphex the problems became worse, gradual over time, until I had severe chest pain even at rest in the night and stomach pains.
    I was not able to eat much at all and lost about 15 pounds. Because of the severe chest pain and upcoming surgery I was referred to a cardiologist who did further studies and discovered an LAD blockage (I’m 65). I was glad to have this uncovered so it can be watched but in dealing with the chest pain and trying to figure out why it started suddenly, I decided to stop the Aciphex. The chest pain subsided gradually and totally within a few days. I am concerned about the effects of these medications and what damage they may be doing.

  16. JM

    I work in health care and hear a lot of patients complain of GERD. Now ads on tv call it acid reflux disease. I didn’t know it had become one. I wonder if acid reflux isn’t a symptom of eating something your body doesn’t like or eating something that produces some kind of allergic reaction.
    I found that stopping gluten stopped my GERD. It might work for others as well and is relatively simple to experiment with.
    I think it’s better to try the process of elimination with diet, even though it’s tedious, rather than to take a medication that may produce other adverse symptoms.

  17. GWC

    My MD has had to “stretch my throat” twice in the last 18 months, blaming the problem on GERD. He then put me on Prilosec (generic) until my next visit – 1 year later. I would appreciate your strategy for getting off this drug, as well as similar ones.

  18. RS

    Vinegar. Small diluted doses. It’s not about stopping stomach acid… it’s the opposite. You need to get the acid to “work”. I have read about this in many medical articles. Even spoke to a pharmacist. I had a friend who had taken medication for GERD and heartburn for years and tried my suggestion. She no longer takes medication.

    • Marcia Jones

      How much vinegar do you take. Do you use organic vinegar?

  19. Greg Pharmacy Student

    It is not uncommon to have “rebound” acid reflux when trying quit Nexium or other proton pump inhibitors: Prevacid, Aciphex, and Prilosec. I’ve heard that to quit you should slowly decrease the dose by extending the time between the doses you take.
    Some people might be able to quit medication if their GERD is due to H. pylori, a type of bacteria that infects the stomach and may cause GERD. Your doctor can test for H. pylori by testing your breath or stool.

  20. BW

    For GERD I take 1-2 tablespoons of organic, preservative free aloe vera juice before eating anything. And I avoid all foods that cause GERD for me: chocolate, alcohol, citrus, tomatoes, pepper, fried food. I don’t eat for four hours before bedtime, sleep on a wedge to elevate my head, and if the GERD appears at bedtime, I sleep on my left side.
    Chewing gum helps too, or anything that increases saliva, but most gum has artificial sugar that can upset the stomach too.
    I am sure your booklet has even more helpful information.
    I don’t know why nearly everyone I know has GERD. It seems to be a recent condition?

  21. J Farrell

    Was unable to eat a whole meal, lost 10 lbs. Awful taste in mouth, liver enzymes shot up over 1000. All scans, blood tests OK (except for liver enzymes). Am now on methylprednisolone, Prilosec & Pepcid. Numbers almost normal, bad taste coming back– What are good foods to help my situation?

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