Should you be taking PPI’s for Gastritis?
Proton pump inhibitors (PPIs) are one of the most prescribed drugs in the world. Its estimated by the FDA that up to one in every 14 Americans have been prescribed a PPI at some point.
Although they are a safe drug and are used by millions of people every day with no issues. There is a concern by some experts that long term use may be linked to dementia, heart problems and bone fractures.
One study published by JAMA Neurology in 2016 showed a link between PPIs and a higher risk of Dementia. The study took place over 8 years on more than 70,000 adults over 75 years old. The results showed that after 18 months patients had a 44% higher chance of being diagnosed with dementia, the chance was slightly higher in men at 52%.
My experience with PPI’s
I have taken PPIs over the years and feel like I have had a love/hate relationship with them. They definitely have helped me at times when my stomach has been really bad, but I am also aware that they are not something I want to be taking long term.
When I first had Gastritis symptoms many years ago, before I really knew what it was. I would generally go and see my doctor with symptoms such as nausea, feeling full, discomfort in my upper abdomen and explain that I generally just felt awful.
My GP would usually straight away click on his computer without too much discussion and then hand me over a prescription for PPI’s, telling me to take them every day for 3 months, and that these would solve all my issues.
They would also generally set it up as a repeat prescription (without me even asking), so if after the 3 months I was still having problems then I was encouraged to just keep taking them for longer.
I did this for quite some time, and in the beginning, they actually worked really well, and usually, after the three months I would stop taking them and I would be fine for a while.
But I would always get the same problems back again after a month or two and so I would go straight back on the PPI’s. It seemed like I was in a vicious circle like this for several years.
I felt like my stomach was just sensitive all the time and the smallest thing would set off a flare-up.
I started to look into PPI’s a little more and this was when I saw the studies (mentioned above) and realised that I needed to find a way to heal naturally without becoming more dependent on PPI’s.
Some people need to be on PPIs long term and so coming off them needs to be considered carefully and discussed with your GP.
What are Proton pump inhibitors?
PPIs work by limiting the amount of acid produced in the stomach. They are powerful drugs that target the proton pumps in the stomach, stopping some stomach cells from “pumping” acid into the stomach.
They are designed to be taken for weeks or months but I know lots of people who are told to take them for much longer, sometimes indefinitely.
Types of PPI’s
lansoprazole – These have been the best PPI for me, it worked very quickly and I had few side effects, but everyone is different and I know people who didn’t tolerate it as well. These are prescribed in 30mg or 15mg capsules.
Omeprazole – I did have these once before but they gave me a terrible headache and it didn’t go until I stopped taking them. These seem to be one of the main ones prescribed by GP’s in the UK and many people seem to tolerate them well. (these can also now be bought over the counter)
Esomeprazole (Nexium) – These can be bought over the counter in a low dose. I have bought them before and they worked very well at calming things down. I only took them for a few weeks but I had no issues. These can be bought on Amazon – Nexium
Weaning off PPI’s
One of the reasons many people end up staying on these drugs long term is that when they stop they get unpleasant side effects, often similar to the symptoms they had when they first started taking them. This is referred to as rebound.
One way to help stop this happening is to wean off the tablets very slowly. I was at one time taking Lansaprazole 30mg, I had been feeling better and was following a plain diet that was really helping. I told my GP I wanted to come off of the tablets and she gave me some 15mg dose capsules.
I started by taking my 30mg dose one day, followed by 15mg the day after, then 30mg again the next day.
I did this for a week and then the following week I just started taking the 15mg every day, which I did for 2 weeks. On week 4 I just took a 15mg tablet every other day.
Then I stopped taking any tablets, but I did buy a bottle of Gaviscon advance Gaviscon Heartburn and Indigestion Liquid, Double Action, Mint Flavour, 600 ml which lots of people said was fantastic at this stage of weaning off. If had any acid symptoms I would have a couple of spoonfuls of this and it really did help.
Luckily this worked well for me, although I did carry on with a strict diet for a month or so afterwards, especially avoiding spicy foods, alcohol and no NSAIDS (Asprin, ibuprofen etc)
The amount of time it takes to wean off will depend on how long you have been on the PPi’s in the first place. Generally the longer you have been taking them the longer you should take weaning off.
Sometimes people will transfer on to a H2 blocker when weaning off PPI’s. Your GP is the best person to ask about this.
Now when I have a flare-up I try and avoid going onto PPI’s if I can, as it does take a while to come off them. I have found lots of ways of soothing and healing my stomach naturally. Find out about them here:- PPIs – What’s the alternative?