PPI 101

Okay, maybe this isn't PPI 101, but I have done some research about this class of drugs. I'm a natural girl and don't like taking pharmaceuticals. I was distressed when my doctor prescribed a PPI for me when I left the hospital. There were many reasons for this, which I haven't seen posted on this forum...and I searched former postings. Here is the thing...first I'm 20 years post menopausal and already have osteoporosis. PPI's interfere with the dissolving of calcium, thereby weakening bones over long term use. It increases risk of hip fracture. Second, having extra calcium in the blood puts stress on the kidneys and can lead to renal complications. Last, It is very hard to withdraw from PPI's, once started. Gastrin hormone triggers the stomach to produce acid. A PPI suppresses the gastrin and it builds up in the blood. When a person stops taking the PPI, this over abundant gastrin has to be depleted before acid production returns to normal. It can take 4 weeks to 3 months for the gastrin to be depleted. Here is a web address for research concerning acid rebound.  

http://www.webmd.com/heartburn-gerd/news/20090702/stopping-ppis-causes-acid-reflux-symptoms

Anyway, I presented all of the double blind tested and published research proving my concerns to my doctor and begged him to take me off the PPI and give me liquid Zantac, which is a histamine blocker and often referred to as H2. H2 uses a different pathway to suppress acid production and doesn't pose the same health risks. He still wanted me on the PPI for the first 6 weeks and promised I could stop them after that time period. Well, I begged again at four weeks out and he relented. He let me have the liquid Zantac. The problem is I am already acid rebounding. I'm so mad. At least the H2 doesn't have the same side effects as the PPI and I can use the Zantac to ease me through PPI withdrawal.

Thanks for listening...I just had to say.....

 

Hi

Thanks for the info, had no idea about that. Great information to know!

Smiles,
Lisa

My surgeon does NOT routinely prescribe a PPI to sleeve patients. He does, however, ask them to take a generic pepcid for the first several months. As I had acid issues I added generic Zantac to the mix and then I was finally put on a PPI.

I very much appreciated my doc's path though. He started with the easiest and safest method to treat post op acid and we progressed to stronger meds as was indicated by my symptoms.

For me it was the right thing and I am happy to be on the PPI. I will eventually have to wean off the PPI, but for now it sure does the trick!

Ok Dr. Mapie..lmao  I dunno how far out you are. 

If your doc perscribed a PPI post op I highly suggest ya take it to help control symptoms of acid reflux from SURGICAL inflammation up at the esogastric area.  No doubt long term usage of PPIs is HORRIBLE what they do to a persons BODY, especially an altered stomachs body, but for the limited time less than 6 months ONLY..a post surgical pt is on em...will NOT cause long term problems  like wrist/hip fractures. And ya never COLD TURKEY off PPIs without gettin the very same outcome you describe...ya go H2 blockers...like tagament zantac pepcid titrate DOWN for a few weeks then OFF em...w/ PPIs so long as your supplementing CALCIUM, MAGNESIUM, Vit D3  AND  Vit B12...calcium will not absorb without mag n D3 right.  PPIs interfere with not only calcium and magnesium absorption but Vit B12 which we need to supplement post op cuz of less intrinsic factor. 

We produce way less HCL post VSG..gastrin hormone is made by parietal cells. Parietal cells are mainly located in RUGGAE the stretchy inside folds/ tissue of fundus and stomach body (antrum)...pretty much is ALL removed with VSG.  HCL: helps digest /breakdown animal proteins but especially is our bodies defense...against so many bad bugs gettin in us (animal meats/produce,water,air,touch).  So ya see why achlorhydria/hypochlorhydria  is so common.  especially as we age too right! less and less HCL. is produced as we age. Lots of seniors with lots of bad bug/digestion complaints... Peeps got it backwards tho...digestive enzymes ADDING betaine is much better... docs want ya hooked on PPIs...bandaid remedies that do NOT cure ya of GERD only MASK $ymptoms...compare it to lapband...a temporary solution with harmful side effects...lol. 

n yeah I know everyone here is into PPIs as an appetite supppressant...because "acid mimics hunger"  ...even tho  THIRST mimics hunger...stress -fear anger, boredom mimics hunger and true hunger mimics hunger lmao ...but lets POP A PILL easy way out transfer addiction I think so...That's why I don't get too nuts when I see someone wanting to use Alli, speed, diet pills, phentermine whatever....to get rid of hunger post VSG...the use abuse of drugs (PPIs) without  diagnosis of GERD advocated here...to me ain't no different. just as many side effects...using that other **** as PPIs imo.

maybe YOU might wanna check into NATURAL remedies to help 'break thru acid'  like acv in water, cayenne pepper in water, curry/cumin /ginger teas,  alkalinize your water a 4 oz dose before a meal, papaya enzymes..throw in a great multi-strain probiotic give yer immune system a boost...naturally ,-) .,,natural help WITHOUT drugs right!

Also consider GERD behaviors...which I think is most important for post op symptoms like.

Not laying down 1 hour after eating or drinking anything...

No animal fatty cheesy greasy 3 hours before bed. Animal fats take ~5 hours to digest/absorb...so avoid em prior to bed.

Recliner or recliner position while resting/sleeping  head n shoulders elevated , big pillows or linen under your side of the mattress....sleep/lay on your back or LEFT side only

stuff like that!  

Don't be mad..making better choices..isn't that the name of this tune? ...like yer doin be proud of yourself Dr. Mapie lol...your checkin things out, thinking outside the box, findin what works for YOU.....ain't gonna be spoonfed nothin by noone....inc your doc..lmao!! 

Years ago a doc told me...I could tell ALL my patients I need to cut their heads off...and 99% of them will say...OKAY...you my dear are that 1%.  I like that about me....I like that about YOU too Dr. Mapie! lol 

yer an awesome VSGr  yer gonna do excellante!  

Progress not perfection! 

Thanks Carmelita. You have vast knowledge. I've read some of your other posts. I like you too. Much of what you said, I knew...but you caught me on a few things I didn't know. I love knowledge! Here is one I didn't hear you mention...vitamin K2. I use all of the supplements you mention, plus K2. I like K2, because it helps carry calcium into the bones. It does have one complication, which is blood clotting. So individuals with blood clotting issues shouldn't supplement with it. On the magnesium...I found a new solution. I use a magnesium lotion, which carries magnesium into the body through a trans-dermal pathway. 

I'm glad you brought up natural solutions. I love using natural solutions....and I use a great probiotic. In fact, my goal it to include something probiotic with every meal; fermented cabbage juice, kombucha, yogurt, fermented pickles (juice right now), kefir. I make my own ferments, which produce probiotic microbiota.I think I'm going to pick up the papaya enzymes. Also fresh green vegetable juice is great at neutralizing acid...especially celery juice. The burn just disappears. 

 

You aren't rebounding, not in the least.  You have to realize that you would have THIS much acid even if you never took a PPI.  The stomach continues making enough acid for a whole stomach for a few weeks to a few months.

Sounds like you quit your PPI cold turkey, in all that research did you actually think about 'how' to stop taking it?  You taper off of it.

Calcium- true, IF you take massive doses.  If you are on a PPI for six months or longer you should double your calcium (vs. taking massive doses you would need to cause the problems you worry about), for less than six months it is not necessary.  Your bones aren't going to turn to dust tomorrow.

To be honest I would stop hyper focusing on PPIs.  You don't like pharmaceuticals but I can assure you, you got a slew of them during surgery.  That's okay but preventing esophaeal problems is not okay???  I am not sure you would have enjoyed natural surgery. ;o)  We all avoid taking things we don't need but sometimes the risk outweighs the benefit.

You make some good points. I didn't know about the stomach making enough acid for a normal sized stomach post surgery...and maybe I have been hyper-focused on the PPI's. I haven't gone completely cold turkey off of them, but I probably should have titrated off them for a longer period of time...and I am taking prescription strength liquid Zantac. I understand pharmaceuticals are unavoidable sometimes, I just always try to get off of them as soon as I can. Besides wanting to protect my bones, I think some of my antagonism toward pharmaceuticals stems from when I was on chemotherapy, and my liver couldn't metabolize the chemo. I was one sick puppy. I learned, at that time, about how our liver is responsible for detoxing all medications. It took 1 1/2 years for my liver to recover. I worked with my oncologist and learned they really don't know, exactly, the size of the initial dose. They make their best guess. I also asked him to cut my chemo short and he did, because my liver was becoming compromised. Anyway, I've become very protective of my liver when it comes to medications, food, and supplements...and I really like to heal myself with food if I can (but that's another subject).  Last, you are right; I don't want esophageal problems. Thanks for the feedback. It really helps when I have an understanding of the whole picture.

 

It is really hard to google issues sometimes.  It is so hard to determine what is realistic and what is exaggeration.  It is hard to know good sources vs. not good sources and top that off with WLS folks have a whole different set of issues and needs, it's very difficult.