PPI meds may lead to esophageal cancer

 Lapbander here, thought I'd share something with you guys, since I know that many people with VSG have problems with acid reflux at least for a while after surgery.  I'm trying to go off of a PPI medication (Dexilant), and dealing with the rebound, so I've been researching about alternative treatments for acid reflux.  I found this article very interesting:

www.reporternews.com/news/2011/aug/08/heartburn-drugs-may-ra ise-risk-of-esophageal/

It basically says that although PPI meds reduce the amount of acid being produced by the body, there are still stomach contents that may be washing over the esophagus which can lead to cancer.  I don't think this is a concern for short-term use, but for those who take the meds over a longer period of time.  

I raised a question about acid reflux rebound and getting off of PPI meds on the band forum, and didn't get much response, so I thought I'd check here.  Anyone have any tips on what was effective for you in reducing acid and going off of PPI meds?

Thanks!

Tami

That is very interesting, but my husband's uncle died from Barrett's Esophagus and it was from the long term effects of the stomach acid eroding his at the base of his esophagus had he been treated for GERD he may not have developed the cancer.  My husband is on Dexilant as well because Prevacid (prescription strength) wasn't helping any longer and he gets endoscopies every for month 2 times a year to make sure his esophagus hasn't developed barrett's and so far the medicine has been helping medicine is weird - one day one thing is the right thing to do and the next is something different.  Thank you for the info.

 Oh, trust me, I *know* what you're talking about in regards to contradictory information.  I could give you a dozen examples of directly contradictory advice regarding acid reflux, all with data to support their position.  

I think the point of this article, though, is that even though PPI meds may "mask" the symptoms, that doesn't mean that the damage is not being done.  If someone remains on PPIs long-term, they need to get an endoscopy regularly, even if they are not having symptoms of acid reflux.

I'm glad your husband is doing well on the Dexilant, and getting regular endoscopies.  I was recently upgraded 25% for health insurance premiums for a new plan because of taking it, and my current insurance doesn't cover it, and it's expensive!  Which is why I've been looking at the possibility of going off.  

Tami

My husband had to fight our insurance and appeal thier decision they didn't want to pay for dexilant either... he fought and won.
thank goodness... Good luck and thank you again for the info

Thanks for the article!



~Lori

When I quit taking the PPI I begin to lose my voice and sound hoarse.  I was on dexilant and it worked well but my ins didn't cover it so my Dr prescribed Protonics and I take it twice a day.  I have for several years.  I have gerds but not heartburn.  I used to have heartburn when I was young but no longer.  I have endoscopies regularly and I feel comfortable with my Drs decisions regarding my medications and my health care.  I would not leave my medication because I read something about it causing cancer until I discussed it with my Dr to get the full scoop on it.  If I did that then I would also have to stop eating bacon, sausage, ham, some cheeses, artificial sweetener, coffee, tea, all commercial meat and poultry, sea food, and just about any prepared mixes or foods.  I am not willing to do that. 

gosh, what doesnt lead to cancer these days.
Thanks for your post.... 

I started taking a PPI shortly after my VSG. I took it faithfully for a good 6-7 months. I was on Omeprazole 40 mg 1x in the morning.  I wanted to stop taking it because I heard somewhere that PPI's mess with calcium absorbtion (and I think a couple other vites). So i just stopped taking it.  I tried so hard to just deal the with rebound acid for a few days hoping it would stop but it got worse. I googled "getting off omeprazole" and came across an article that explained in detail how to get off of it. You take your normal dose for 3 days and then take half the dose for the 4th day. on the 5th day you go back to normal dose and 6th day is half again. You do that for 3 weeks and then take a normal dose every other day. Do that for 3 weeks and then do a normal dose every 2 days. I was able to completely stop taking them after about 5 weeks. I still take 20 mg omeprazoles if I need them. I have taken maybe 5 in the past 3 months. It is directly related to spicy, fried foods, alcohol or anything with tomatoe sause/paste. If I know i'm going out to drink then I take a pill to prevent anything from happening. My PCP also told me if I quit smoking, I would never need another PPI again. Apperantly, my LES (lower esophogal spinchter, sp?) is weakened from smoking which allows what little acid I do have to come back up. I also notice when I go out and drink (and chain smoke), I have horrible reflux for a couple days after. I'll try to find that exact article for you.

 Thanks for the info!  I've read that it's important to taper off, but I appreciate the specific steps to do that!  

One thing that I thought I'd mention to you about Omeprazole (or any PPI) is that from what I've read, they are only effective if taken for several days, so taking one now and then for occasional acid reflux isn't really the best approach.  Better to take an H2 blocker like Pepcid or Zantac before eating something that might cause a problem, or Gaviscon when you have unexpected symptoms of acid reflux.  

Thanks for the info, and keep your fingers crossed for me!  You've given me hope that it's possible!

ETA:  I quit smoking cigarettes with the help of the Greensmoke electronic cigarette.  Unfortunately, I don't feel compelled to go off of those, since they eliminate most of the reasons why I wanted to quit cigarettes (I get the nicotine, but none of the carcinogins, plus no smells, second-hand smoke, ash, fire hazard, yellow teeth, etc).  I'd love to know whether it's the nicotine or some other element in tobacco smoking that impacts acid reflux.  

Tami

If you need only an occasional acid reliever- use Pepcid 75, it will work much better than intermittant PPI dosing.