Hi Sara,
I'm sorry to hear that you're back in an MC flare. The odds are very high that you are indeed correct in thinking that the PPI is the cause of the return of your MC symptoms.
As Leah pointed out, an antihistamine can help in some cases, especially if nausea is part of the problem. And Jean is right on target that a low carb diet will help to prevent reflux problems.
Have you checked your vitamin D level lately? Not only GERD, but MC and all other AI issues (yes the evidence suggests that GERD is an AI issue, according to recent medical research) are associated with a vitamin D deficiency. But more than that, research also shows that vitamin D is also very effective at treating GERD and associated reflux problems (even when a vitamin D deficiency is not present). Several members here have found that the treatment does indeed work, and it works very well. Note that this requires a serious amount of vitamin D, not the anemic RDA recommended by "health experts". Most members find that using 8,000–10,000 IU per day for a couple of weeks or so will provide relief much faster than using 5,000 IU or less.
But weaning off a PPI is not easy, because PPIs actually cause the very problem that they are prescribed to prevent. They actually weaken the lower esophageal sphincter (LES), which makes it more likely that acid contents of the stomach will backflow into the esophagus. But the patient doesn't feel any acid burn, because the PPI neutralizes stomach acid by preventing the stomach from producing it. And it takes time for the LES to regain it's strength, after weaning off a PPI, which means that many unfortunate patients find themselves stuck in a vicious cycle, having to use PPIs because they are unable to wean off them without a strong rebound effect that can be worse than the original symptoms.
As we get older, we tend to lose the ability to produce adequate amounts of stomach acid, and this can cause poor digestion, resulting in indigestion, heartburn, nausea, and acid reflux. The reason why it causes acid reflux is because the clenching strength of the LES is determined by the pH of the stomach contents on the back side of the LES. The lower the pH (IOW, the greater the acidity), the tighter the LES clinches. If the acidity is weak, the LES doesn't have much incentive to remain tightly clenched. That's why PPIs weaken the LES, because like any muscle, if we don't use it, it becomes weaker over time.
When a patient complains of reflux or stomach pain, doctors virtually never bother to test stomach acidity — instead they prescribe a PPI or an antacid, which may be just the opposite of what the patient actually needs. The truth is, very, very few patients actually have too much stomach acid, but that doesn't keep doctors from prescribing acid reducers right and left, because drug reps promote PPIs and H2 antihistamines — they never promote stomach acid enhancers (such as Betaine HCL), because they're cheap.
As far as treating/controlling GERD is concerned, that question comes up very often here, and there are many discussions about it in the archives. To save time and effort, I'll just point to another thread that you may find to be helpful, especially my first post on the second page of that thread, where I list ways to prevent GERD. Here's a quote of the part of that post that addresses GERD, but you may find that reading the rest of the thread is also helpful, because as you will see there, vitamin D level is extremely important for preventing/treating GERD, and antihistamines can help.
Tex wrote:You're probably aware that avoiding eating for several hours before bedtime is very helpful, especially for retraining our lower esophageal sphinctor. And avoiding foods known to cause reflux problems at all times is usually necessary for treating a GERD problem. Examples of such foods include chocolate, alcohol, coffee, tomatoes, peppermint, etc. Definitely avoid them for several hours before bedtime, because they can almost guarantee reflux problems.
One very important trick to help prevent GERD/reflux issues is to never lie on your right side, because that position places much of the stomach higher than the lower esophageal sphinctor (LES), which will allow acidic stomach contents to backflow into the esophagus if the LES fails to clench tightly enough at all times. This is very important, because taking any antacid or H2 blocker (or PPI) will lower your stomach acidity, and research shows that the weaker the stomach acidity on the backside of the LES, the less tightly it will clench. IOW, the stronger the stomach acid, the more tightly the LES will clench to hold back the acid. The reason why I advise against PPIs, is because they are known to weaken the clenching strength of the LES, and it can take months to rebuild the strength of the LES after a PPI is discontinued. That makes it very difficult to wean off a PPI, because weaning off them will actually cause the very problem that they are prescribed to treat.
The only time that I ever had a serious reflux problem in my life is when I was recovering from surgery, and the doctor in charge insisted that I take a PPI each day, while in the hospital. As best I can recall, I only took a PPI for 3 days, but it took me many months to get rid of the reflux problem after that. That's when I learned to never sleep on my right side.
Some people find that elevating the head of their bed a few inches by placing those legs on blocks, can help to prevent GERD/reflux problems, also.
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=621
If you have serious problems trying to wean off the PPI, you should be able to bridge the gap by using an H2 blocker for a while, but please be aware that it takes months to overcome the damage caused by PPIs. IMO, PPIs should be illegal, except in very exceptional situations.
And yes, if you are only avoiding gluten in your diet, it is very possible that you may have other food sensitivities that have developed over the past year. You may have been sensitive to other foods initially, but your immune system wasn't producing enough antibodies to them to cause any problems. Over time, antibody levels are cumulative, and so they can eventually reach a point at which they surpass the threshold at which a reaction is triggered.
I hope that this is helpful.
Tex
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