The People's Perspective on Medicine

Can You Get Off a PPI Without Suffering Heartburn?

One reader found a way to get off a PPI without withdrawal symptoms: Eat just one low-carb meal a day to reduce discomfort.
PPI esomeprazole heartburn

Have you ever tried to get off a PPI like esomeprazole (Nexium) or lansoprazole (Prevacid)? If so, you might have experienced rebound heartburn. People who encounter this problem–and many do–may find it difficult to stop taking their acid-suppressing medication.

A Different Way to Get Off a PPI:

Q. I’ve accidentally found an amazing way to get off of acid-suppressing drugs without having rebound reflux. I’ve been taking heartburn medicines for decades, ever since cimetidine first came out. Later, I started taking omeprazole or esomeprazole. Whenever I tried stopping these drugs, I got horrible heartburn.

This time, I discovered by accident how to get off them. I’ve been trying to lose weight, so I’ve gone low carb. I eat just one meal a day, because I’ve heard that intermittent fasting is helpful.

A week ago, I decided to try once again not to take daily medication to control my incessant heartburn. I stocked up on Tums and other antacids because I knew I would be in trouble once I stopped. Then I took my last Nexium and waited for the flames of hell to appear in my chest.

About 15 hours passed and I started to feel a little heartburn coming. I took a Tums and waited for the next round. I’m still waiting. A week later, I’ve not had any heartburn. I should be in agony, but I’m completely heartburn-free. I feel like singing!

Hopefully, this information will help others who were addicted to PPIs as I was. The solution is: Eat one meal a day and fast for 23 hours before you eat again. Stick to low carbs and water. Good luck!

Low-Carb Diet Can Help:

A. Research supports your accidental discovery. A very low-carbohydrate diet has been shown to help control symptoms of acid reflux (Alimentary Pharmacology and Therapeutics, Nov. 2016; Digestive Diseases and Sciences, Aug. 2006).

We were not able to find research demonstrating that intermittent fasting is helpful for heartburn. However, people who follow a schedule of eating within a twelve-hour daily window or less seem to sleep better, gain less weight and have healthier hearts (Journal of Physiology, June 15, 2017). We offer several other non-drug approaches to get off a PPI in our Guide to Digestive Disorders. 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Digestive Disorders
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Download this guide to getting off heartburn medicine. Preventing ulcers. Effective treatments for constipation and diarrhea. Foods and drugs that cause gas.

Digestive Disorders
Citations
  • Pointer SD et al, "Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women." Alimentary Pharmacology and Therapeutics, Nov. 2016. DOI: 10.1111/apt.13784
  • Austin GL et al, "A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms." Digestive Diseases and Sciences, Aug. 2006. DOI: 10.1007/s10620-005-9027-7
  • Melkani GC & Panda S, " Time-restricted feeding for prevention and treatment of cardiometabolic disorders." Journal of Physiology, June 15, 2017. DOI: 10.1113/JP273094
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I did it first by cooking all food I ate, even fruits during the healing process; also by eliminating foods and drink that caused acute atypical GERD (in my throat instead of lower down). Using powdered slippery elm bark from the natural food section of a good grocery store (they can order it): 1 T. in a cup of water or juice before or after meals or whenever in acid distress. Just slug it down because it’s not tasty. I also still use DGL tablets from the same good grocery store when I feel acid after something that bothered me. I was on PPI’s two months full time, tapered down slowly (important!). It worked. Stress was a contributing cause, so dealing with that adds to the cure. It can be done.

I weaned myself off of my aciphex that I had taken for 18 yrs. Weaning is the way to go and I totally agree with the low carb diet. I totally stopped eating carbs, sugars, processed food for the 6 weeks I weaned myself down and had absolutely no problems. I had previously tried to stop cold turkey with no diet change and it was a week of a constantly severe heartburn. I also take a sip of raw apple cider vinegar and water before I eat. It appears to neutralize the stomach acid enough to make me heartburn free. Also, I don’t overeat or bend over after eating; that can lead to reflux.

I had to use quite high doses of ibuprofen immediately after a knee replacement, and for another few weeks at a normal dose, because I was allergic to the usual prescription drugs. Since it was OTC it didn’t say to take it WITH a little food; so I ruined my stomach. I then was told to take omeprazole, but not for how long and was on it for MANY months. I tried stopping it but the heartburn was terrible. So I tried taking one pill every other day for a week. Then one every third day for another week. I only took one the 4th week and found I no longer needed it. Just taper off gradually. It worked! My Doctor told me to ALWAYS take my meds WITH a little food, except for synthroid which has always to be taken on an empty stomach.

I came off years of Prevacid by cutting back very, very, very slowly. I was on two a day. For one week I took two alternating with one. For the next week, 1-1/2 and one. Then one alternating with a half. Then a half alternating with none. I never skipped a meal or altered my diet. And never had any reflux rebound. However, I had already addressed the original problem by having hernia surgery with a wrap. Amazingly, I still experienced rebound afterwards when I stopped the drug, but nobody knew about the rebound effect then. I took the damn drug for another year until I read here about rebound and tried the very sloooow tapering off, which worked!

Caution to those of us who have Barrett’s esophagus. My gastroenterologist does not recommend stopping PPIs when this condition is present.

Dr Graedon thanks again for what you do. I had tried to get off PPI’s after taking them for a year
after an MI. The combo of Plavix, baby aspirin, and a beta blocker was killing my stomach. Every time I tried to quit the rebound reflux had me back on pantoprozole. I felt I had to get off the PPI after reading about the kidney problems in The Peoples Pharmacy.

I also was on a very low carb diet and suddenly realized I wasn’t getting rebound. Never had a clue why but its probably getting off the carbs and sugar.

That particular med seems to have rebound issues–at least for me. It’s just addictive. I have had better luck with sustained release prilosec (omeprazole). But all these drugs have bad side effects/issues/increased risk for cardio and osteopathic issues. Perhaps taking extra calcium and B-12 helps can counteract those issues. But I’m just a case study (N=1)

Since heartburns are caused by the stomach’s acid going upstream to the esophagus, and since baking soda neutralizes acids, I take a half teaspoon of it whenever heartburn starts. An instant burp proves the neutralization has been done. Please note that this intake of sodium counts in the salt balance.

Had good success with mastic gum.

A major reason for acid re-flux and indigestion is overeating: Other reasons are dairy, eggs, and the combination of sugar and dairy: Consumption of meat and dairy without accompanying fiber. Meat and dairy have zero fiber which leads to chronic constipation.

What exactly is your low carb diet? Does this mean you eat a high protein diet? Please give us more information.

After consultation with a Naturopath, I slowly weaned off my PPI while adding digestive enzymes, DGL, and Aloe juice. It worked! After a year on the PPI meds, I have been doing fine without them now for 2 months.
It feels great to be off them!!

Regarding Prilosec / Nexium – my husband and I have taken it for years and thendecided we wanted to get off the daily dose. Read on this website about Zantac 150 being a good replacement. My grocery store had same strength generic tablets for Zantac 150 – in fact, 200 tablets of maximum strength RANITIDINE tablets, 150 mg. cost far less than half the cost of one pkg. of Prilosec. We take one tablet after evening meal – have not had a problem since we started using the product. The Ranitidine works “similar” to prilosec, but not the same. You can find the comparison on-line and the full explanation of how each works. SO HAPPY to be off prilosec / nexium.

I had been taking PPIs for 5 years when I developed brain fog. I used sucralfate to help with the heartburn during the withdrawal from PPIs. I discovered that, as we age, the acid production in our stomachs decreases. Our stomachs NEED acid to digest our food, and heartburn results when it struggles to produce more. Since then I have taken a tablespoon of vinegar before every meal, and my heartburn has disappeared. It only comes back if I have forgotten to take the vinegar for several days. Happily, vinegar has controlled heartburn for me for several years now.

I found out that you just can’t go cold-turkey off these drugs. After being on Nexium for far too long this is what I did. For about 2 weeks one Nexium every other day; then, again, for about 2 weeks, one every two days; then one every 3 days, etc. until none. All the while doing this I took a pro-biotic every day. This took a good deal of time to find one that worked. I might add that there were several other products, such as deglycyrrhizinated licorice, that I tried.

I found I still had to chew one antacid tablet before bed. This was until someone told me about aloe juice. Very bitter tasting but you don’t take much, 2 tbsp. And, there is a product, George’s Aloe, that has taken all the “nasty” from it but left all the beneficial in. It’s a bit pricey, so i’m going to go with the straight stuff. There is a product from Lily of the Desert. It’s aloe herbal Stomach Formula and claims to balance stomach acidity naturally with added natural ingredients such as peppermint leaf and several others. Also changed to a different pro-biotic.

I think each individual has to do their own experimenting to find what product works best for them. I have finally settled on the following routine: One good quality probiotic; 2 tbsp. Aloe juice in the a.m. and 2 tbsp. of the Lily of the Desert before my evening meal. This is all working very well.

I read that a person taking a teaspoon of raw honey morning & night got off the heartburn/med cycle. It has worked for me after years on omeprezol & prevacid. I only do it in the morning—had stocked up on DZL licorice & almonds & ginger chews, but didn’t need them. Did not affect my blood sugar adversely.

PPIs rob the body of essential nutrients. They counteract stomach acid which is intended to breakdown food and send it on it’s way to the large intestine. I have learned that the best way to encourage digestion to properly function is to not drink liquids an hour before, an hour after, and during the meal, as it dilutes stomach acids. The feeling of heartburn is said to be lack of acid and poorly digested food.

Seems like just a little common sense to me.

That’s all very well but what about the reason the patient was originally put on the PPI?
OK, we want to come off it but how are we going to control the dire symptoms that were the reason that we started taking the PPI? Note, no one is taking a PPI for fun! I understand there are risks in taking PPI, and I have tried 3 times to come off. My quality of life was nil. Gastric pain overtook my life, and the only way I could function was taking vast quantiities of Gaviscon both liquid and tablet. I lasted 2 weeks without PPI.

I may try the low-carb/1 meal a day regimen but it sounds a challenge to anyone with a busy life, and I suffered so much the last time that I am loath to try.

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