Proton Pump Inhibitors Dammed if you do dammed if you dont!

[Jimbo1968]

As I've already stated I feel my bouts of diarrhea are down the commencement of taking Lansoprazole - Prevacid, I'd kind of levelled of at a couple of days D a week, I decided therefore to stop taking the tablets and see what happens. Well I took my last one on Saturday 3rd October and I've spent most of my Tuesday 6th in toilet with one of my worst bouts of diarrhea since my first Day. My intestines are gurgling really loudly and i'm lucky to spend 30 minutes out of toilet. I don't Know what to eat or take for the better, this is ridiculous and my heart goes out to the people for which this is a daily occurrence. any tips please

[tex]

Jim,

You shouldn't stop a PPI cold turkey if it has been used for years (the drug will cause a rebound effect that can be worse than the original symptoms), because PPIs slowly cause semi-permanent to permanent changes to the histology of the stomach. It can take months for enough healing to occur to allow the mucosal lining of the stomach to return to near-normal histology. In the interim you may be able to control the problem by taking an H2 blocker, such as cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), or famotidine (Pepcid).

Here's how digestion begins:

When the mucosal tissues of the mouth sense that food is being ingested, it sends a signal to the enteric nervous system that results in the production of histamine. The histamine attaches to H2 receptors in the parietal cells in the stomach, activating the production of stomach acid, in order to prepare for the food that's on the way. But PPIs interrupt this process, and greatly attenuate the ability of the parietal cells to produce stomach acid. As time goes on, this tends to cause long-term changes in the histology of the mocosal lining of the stomach. For most patients, if the PPI is discontinued, the histology of the mucosal lining of the stomach slowly returns to normal. In some cases however, this damage may be permanent.

The reason for taking an H2 blocker is to reduce the stomach acidity (just as the PPI was doing) with a much lower risk of triggering an MC reaction. The stomach acidity is associated with a high histamine level. The intestines are loaded with mast cells, and many of us find that our MC can be triggered by the mast cell reactions that result in the release of histamine. IOW, for some of us an H2 blocker can stop the D because it reduces histamine levels in the gut. If/when the parietal cells of the stomach eventually return to normal, the H2 blocker can probably be discontinued.

I hope that some of this is helpful,
Tex

[Jimbo1968]

Tex that the as an excellent explanation , I appreciate the time you given me , thank you so much. Jim

[tex]

You're most welcome. I hope that you're able to get everything under control soon.

Tex

[Gabes-Apg]

It can take months for enough healing to occur to allow the mucosal lining of the stomach to return to near-normal histology. In the interim you may be able to control the problem by taking an H2 blocker, such as cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), or famotidine (Pepcid).

in line with this, many have reduced GERD symptoms by increasing Vit D intake, and correcting other deficiencies
(magnesium and potassium)

are you taking Vit D3?
Have you had your levels tested in the past 6 months?

in line with the timeline mentioned by Tex, if you are Vit D3 deficient, it can take a couple of months to correct these deficiencies.

based on what we have learnt here, have a 8-12 week plan on transitioning off the PPI's...
- take the right supplements to correct deficiencies
- adjust your eating plan to suit MC and healthy digestion
- lifestyle adjustments, ie minimise stress, raise the bed head of your bed, sleep on your right side, dont have large meals before going to bed, Dont eat before doing tasks that involve bending etc etc
- then taper of the meds etc