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 (Prilosec) for a long time.
A recent 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, online March 2, 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 that it may 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.