Apparently, If You Take A PPI, You Are Officially An Addict

Post by **tex** » Fri Sep 04, 2009 3:58 pm

Hi All,

This is bad news, since these drugs are so popular:

July 2, 2009 -- Proton pump inhibitors are highly effective treatments for acid reflux symptoms, but taking prescription-strength dosages of the drugs for just a few months can lead to dependency, new research suggests.

Healthy adults in the study with no history of acid reflux symptoms -- such as chronic heartburn, indigestion, or acid regurgitation -- developed such symptoms when they stopped taking the drugs after eight weeks of treatment.

http://www.webmd.com/heartburn-gerd/new ... x-symptoms

Why aren't the manufacturers required to do this sort of research before the drugs receive FDA approval?

Tex

JLH · Post by **JLH** » Fri Sep 04, 2009 4:11 pm

I can think of million$ of reasons.

starfire · Post by **starfire** » Fri Sep 04, 2009 4:52 pm

Yeah, and I'm hooked.

Love, Shirley

Post by **Rosie** » Fri Sep 04, 2009 5:47 pm

Doctors are just too cavalier about prescribing drugs. My doctor wanted me to try a PPI when I had no symptoms of acid reflux to test if it would help my asthma problems with hoarseness and coughing. I tried it for about a week but didn't like how it made me feel and quit. I'm sure glad I didn't take it any longer than that, according to the article. It didn't help at all. It turns out that the hoarseness is a common side effect of inhaled corticosteroids and partially went away when I quit taking the corticosteroids. The rest of the hoarseness and weak voice disappeared when I went gluten-free about 6 weeks ago, an unexpected benefit!

Rosie

ant · Post by **ant** » Sun Sep 06, 2009 4:10 am

Is Gaviscon is a PPI? I had been taking it for years (on and off) for what I was told was a hiatus hernia. I now think the symptoms of the "hiatus hernia" (heartburn and some reflux) where probably caused by gluten. And, of course, all that Gavison may have contributed to my eventual MC.

Best Ant

Post by **tex** » Sun Sep 06, 2009 11:09 am

Hi ant,

No, Gaviscon is not a PPI. I'm confused about the ingredients, though. What are the ingredients shown on the package? On the net, I see two different formulations listed:

1. A combination of alginic acid, aluminum hydroxide, and magnesium trisilicate.

2. A combination of sodium alginate, sodium bicarbonate and calcium carbonate.

Which one is correct?

Sodium alginate is the sodium salt of alginic acid, (also known as algin or alginate), which is an extract of seaweed, (it's a viscous gum found in the cell walls of brown algae). It's used, (among other things), as a gelling agent, and it's often used to thicken liquids.

Aluminum hydroxide helps to reduce stomach acid, as does magnesium trisilicate, (magnesium trisilicate is a food additive often used as a kind of absorbent to filter unwanted residue fat from used frying oil, for example).

Theoretically, at least, Gaviscon shouldn't predispose one to MC. Occasional use shouldn't cause any problems. However, regular, long-term use of antacids that contain aluminum, could possibly cause problems, since such use of aluminum-containing antacids can sometimes lead to subtle poisoning, mental changes and weak bones. Because the brain lesions found in Alzheimer's disease contain aluminium, there is concern that consumption of excess aluminium compounds may cause or contribute to the development of Alzheimer's, and other neurodegenerative diseases. Of course, none of that has been researched sufficiently to allow any iron-clad conclusions.

I have no idea why two different versions are listed on the net. Either someone made a bad mistake, or the manufacturer has drastically changed the ingredients, at one time or another.

The second version is available without a prescription. I'm not sure about the other version - possibly it's a prescription-only version, and if so, that would explain the reason for two versions.

Tex

Gayle · Post by **Gayle** » Mon Sep 07, 2009 10:29 am

HI All,

I had been taking the OTC Prilosec for nearly 2 years -- due to the suggestion/insistence of multiple Physician's -- because of some "chronic" coughing (I had whooping cough) and some reflux symptoms.

The drug didn't bother me in any way, but this past spring I began to wonder about the desirability of now eliminating any thing that was aimed at altering any part of the GI track -- due to my CC diagnosis.

So I weaned myself down by going to 1 every other day for a month, then 1 every 3rd day for another month. Then I stopped. I was prepared for possibly encountering for some ‘issues’ by having on hand a small package of Pepcid AC. (Pepid is a different type of acid reducer.)

End result: I had NO PROBLEM getting off the Prilocec. And never had occasion to take the Pepcid. Happy ever-after.

Cheers,

Gayle

ant · Post by **ant** » Mon Sep 07, 2009 11:34 am

Thank Tex

All I remember is that they have a liquid version and a chewable pill version. I will check the packet on the chewable version I was using when I get back to Hong Kong in a few weeks (I think I still have one at the back of the cupboard). But maybe it did change over the years. I never had to get a prescription for it.

All best, ant

Post by **tex** » Mon Sep 07, 2009 12:20 pm

Gayle,

Good for you. That sounds like the correct way to approach the problem of terminating the use of one of those products. You're way ahead of the researchers, (as if that should be surprising. LOL).

Ant,

I'll bet that's the key - they probably have a different formulation for the liquid version, than they use for the tablets.

Tex

angy · Post by **angy** » Sun Sep 13, 2009 1:56 pm

Interesting posts made me think....I reallly only started taking stuff like gaviscon..tums..cimitedine and mebeverine when i got this dam cc...hardly ver took anything like that beforehand. Maybe with the ocassional spicy food that gave me heartburn..

starfire · Post by **starfire** » Sun Sep 13, 2009 5:10 pm

Gayle,

Congratulations on kicking the Prilosec.

I was on Prilosec for several years, then when Doc moved me on to Nexium.

I kicked it once for a couple of years but ended up with Barrett's Esophagus so I'm back on it now.

I hope you have better luck.

Love, Shirley

Gayle · Post by **Gayle** » Sun Sep 13, 2009 6:21 pm

Hi Shirley,

Barretts is nothing to sneeze at!!

I would be back on a PPI quicker than Jack Sprat with that diagnosis!!

Actually when looking back, the main reason that PPI's were being prescribed in my case was my terrible continuous coughing, --- and the reasoning that sometimes that kind of coughing can be caused by small amounts of gastric secretion retro-grading back up into the phaynx, sometimes so subtlely as to not be noticed as such.

Turned out eventually that everyone believed that what I had was probably whooping cough. That had been around in our area in AZ, and was diagnosed in some of the folks there. I of course had gone home to MN with this, so not easily suspected here until it subsided (5 month later).

Try to imagine having the frequency and urgency of CC (which was not diagnosed at that time) with the continual harsh coughing of whooping cough!! Some days it didn't seem life was worth living.

For some time the pertussis component had been eliminated fom the DPT shots. I hadn't had that component of immunization for many years. Now, public health concerns have lead to the Pertussis component being included again, as infected adults such as myself were leading to an increased number of whooping cough cases in children. If you have ever seen the terror of a small child, with their small airways, with whooping cough, you know how serious that disease can be. It can be deadly in the small child.

I bet Polly can add much to this line of thinking, as I bet she's seen this.

Cheers,
Gayle

Post by **tex** » Sun Sep 13, 2009 8:37 pm

Gayle wrote:Try to imagine having the frequency and urgency of CC (which was not diagnosed at that time) with the continual harsh coughing of whooping cough!!

That was always one of my greatest fears, when I was trying to work, while having active D - having to cough, (or sneeze), at an inopportune time.

It was virtually a guaranteed "accident".

Tex

starfire · Post by **starfire** » Mon Sep 14, 2009 6:50 am

WOW!!! Just the thought of the combination of MC & WC is enough to give me chills!! My Mom says I had WC but I don't remember it. OK with me. The description is enough. Sorry you had to go through it.

The second endoscopy I had last fall indicated that the Barrett's was improved........ at least that's the way I took it. I don't dwell on having it but don't want to take chances with it either.

Hope you are feeling better soon.

Shirley

Gayle · Post by **Gayle** » Mon Sep 14, 2009 10:33 am

LOL! LOL! One can plainly see that I am no longer in touch with nursery rhyme characters. Jack Sprat did have some dietary restrictions however. To me, that fable is about compatability -- as both Jack and wife got along well by getting exactly what they each could/should eat.
Who was the quick one? Maybe that was Jack-be-Nimble? LOL!

Anyway, Thanks for the good thoughts Shirley. Actually, I am doing well at this point.

That WAS a very bad time – and it all began with a case of Plantar Fascitis, for which I was prescribed high dose NSAIDS for that pain. My PCP here took pity on me with all my problems and prescribed an NSAID called Feldene, which is a potent NSAID only available by prescription. Directions were to take one immediately after largest meal of the day. Directions were followed to a T, but after about 3 weeks I was also beginning to feel stomach discomfort. So I thought to myself “I can’t take this drug” and although I do know better, I flushed the remainder down the john

. I decided for myself that I could only take Tylenol for a while.

Lo and behold, by about 10 weeks later, the symptoms of CC began to resolve and I went into a spontaneous remission.

I did NOT connect the dots then and there however.

A few months later I began using some NSAIDS again

and wa-la eventually developed all the nasty lower GI problems all over again. To make a long story short, that is when the CC was finally firmly diagnosed and Entocort prescribed. AND it was then that I learned about the correlation between CC and NSAIDS.

Then, looking back over that history, things fell into place!! It is not really probable that some of the food intolerance’s experienced by many here are my particular problem, as I was in a full remission with no dietary restrictions what so ever for many months, but relapsed when resuming ingestion of NSAIDS.

I would add here that my GI practice here in MN did NOT inform me about the potential connection to NSAIDS. I found that information on one of the Mayo sites on the Internet. AND, the GI I see at MAYO AZ, has been most emphatic about this possible connection during our conversations. (But then, -- He just happens to have been one of the original co-authors on that original study publication.)

I would also add that the Mayo model uses an extensive group of folks to serve their patients. You see the DR in Clinic, but are also encouraged to call with concerns or questions. It has been my GREAT fortune that the Physician that I see there has a

RN that works with him taking the phone calls and working with the patients. SHE is THEE most comprehensively knowledgeable person regarding this condition I’ve ever met -- and takes the time to discuss things. She listens, understands, explains, and when I have gotten to feeling depressed, she jockeys me back out of it.

Once I asked here how she learned so much about this condition? Her answer “By talking to our patients. You people have taught me pretty much everything I know about this very frustrating condition!”

For all this, I truly appreciate her -- and have informed the Dr of this appreciation too.

Best,
Gayle