Long Term Effects For Prevacid, etc. ?

Question:

Hello: I realize this has been touched on, somewhat, in previous posts, but would like tostart a new thread devoted to this single question, please. What is the latest research regarding the taking of Prevacid (or Nexium, etc.) indefinitely ? I guess I’m bothered by all their ads that say to take only for a maximum of approx. 8 days or so, and that it is not for long term use. My general MD (and also a Gastroenteroligist I’ve seen) wants me to take it indefinitely. Their belief is that the the research on really long term effects hasn’t been done yet, or is inconclusive, and that damage to the esophogus, etc. is by far the greater danger. Any thoughts on long term effects would be most appreciated. Thanks, Bob

Response:

– Hide quoted text — Show quoted text -> Hello: > I realize this has been touched on, somewhat, in previous posts, but > would like tostart a new thread devoted to this single question, please. > What is the latest research regarding the taking of Prevacid (or Nexium, > etc.) > indefinitely ? > I guess I’m bothered by all their ads that say to take only for a maximum of > approx. > 8 days or so, and that it is not for long term use. > My general MD (and also a Gastroenteroligist I’ve seen) wants me to take it > indefinitely. > Their belief is that the the research on really long term effects hasn’t > been done yet, or is inconclusive, and that damage to the esophogus, etc. > is by far the greater danger. > Any thoughts on long term effects would be most appreciated.

There is no study that indicates that long term use of PPIs prevent esophageal cancer. In fact, just the opposite; the alkaline reflux that results from acid suppression may be more carcinogenic that the acid reflux. HMc

Response:

Switched from Nexium to Protonix

Question:

Hi, I switched from Nexium to Protonix because my health plan had Protonix as a formulary (read cheaper) drug. Now my heartburn is severe. I’ve been taking the Protonix for a week. Both dosages are 40mg. I rarely had heartburn while on the Nexium. Should I give it more time or bite the bullet and go back to Nexium? Thanks. The Wobulator *Please REMOVE the obvious for my correct email address*

Response:

Yes, I’d think so. You might consider Aciphex/rabeprazole as it maybe the most effective of class. WARNING: I am not a physician.

– Hide quoted text — Show quoted text -> Hi, > I switched from Nexium to Protonix because my health plan had Protonix > as a formulary (read cheaper) drug. Now my heartburn is severe. I’ve > been taking the Protonix for a week. Both dosages are 40mg. I rarely > had heartburn while on the Nexium. Should I give it more time or bite > the bullet and go back to Nexium? Thanks. > The Wobulator > *Please REMOVE the obvious for my correct email address*

Response:

>Yes, I’d think so. You might consider Aciphex/rabeprazole as it >maybe the most effective of class. >WARNING: I am not a physician.

I got some samples of Aciphex from the doctor but also got a prescription for Nexium. Thanks. > Hi, > I switched from Nexium to Protonix because my health plan had Protonix > as a formulary (read cheaper) drug. Now my heartburn is severe. I’ve > been taking the Protonix for a week. Both dosages are 40mg. I rarely > had heartburn while on the Nexium. Should I give it more time or bite > the bullet and go back to Nexium? Thanks. > The Wobulator > *Please REMOVE the obvious for my correct email address*

The Wobulator *Please REMOVE the obvious for my correct email address*

Response:

Should I be taking Nexium with my fullness symptoms?

Question:

Hello, I recently visited my family physician with complaints about always having a feeling of fullness in my stomach. I’ve had no feeling of acid indigestion but have had severe bloating. Because of recurring headaches, I’ve been taking Excedrin almost daily for months. (I now find that just drinking caffeinated coffee takes care of my headaches). My doctor prescribed Nexium and I’m wondering if I’m taking the correct medication since I don’t seem to have any acid reflux symptoms. Anyone advice appreciated.

Response:

> Hello, > I recently visited my family physician with complaints about always having a > feeling of fullness in my stomach. I’ve had no feeling of acid indigestion > but have had severe bloating. Because of recurring headaches, I’ve been > taking Excedrin almost daily for months. (I now find that just drinking > caffeinated coffee takes care of my headaches). My doctor prescribed Nexium > and I’m wondering if I’m taking the correct medication since I don’t seem to > have any acid reflux symptoms. > Anyone advice appreciated.

Might the fullness really be gas?  Look at your diet and see if it happens more after certain kinds of foods.  Sugars and even artificial sweeteners frequently produce gas. Also, are you constipated?  This too can lead to a full feeling. To answer your question about nexium – does it help? Louise

Response:

– Hide quoted text — Show quoted text -> Hello, > I recently visited my family physician with complaints about always having a > feeling of fullness in my stomach. I’ve had no feeling of acid indigestion > but have had severe bloating. Because of recurring headaches, I’ve been > taking Excedrin almost daily for months. (I now find that just drinking > caffeinated coffee takes care of my headaches). My doctor prescribed Nexium > and I’m wondering if I’m taking the correct medication since I don’t seem to > have any acid reflux symptoms. > Anyone advice appreciated. > Might the fullness really be gas?  Look at your diet and see if it > happens more after certain kinds of foods.  Sugars and even artificial > sweeteners frequently produce gas. > Also, are you constipated?  This too can lead to a full feeling. > To answer your question about nexium – does it help?

But they don’t produce gas in the stomach…that is from swallowed air. The most common reason for air swallowing is reflux. Only about 40% of people with GERD have symptoms of heartburn or "acid indigestion". Having said that, I think it’s reasonable to continue the PPI if it helps your symptoms of bloating. If it doesn’t, I wouldn’t pay for another such pill until the diagnosis had been confirmed. HMc

Response:

If you do have gas in your stomach, you could try one of the preparations which contains simethicone (sp?), eg Myalanta.  The simethicone will help you burp and get rid of the gas. AB

– Hide quoted text — Show quoted text -> > Hello, > > I recently visited my family physician with complaints about always > having a > > feeling of fullness in my stomach. I’ve had no feeling of acid > indigestion > > but have had severe bloating. Because of recurring headaches, I’ve been > > taking Excedrin almost daily for months. (I now find that just drinking > > caffeinated coffee takes care of my headaches). My doctor prescribed > Nexium > > and I’m wondering if I’m taking the correct medication since I don’t > seem to > > have any acid reflux symptoms. > > Anyone advice appreciated. > Might the fullness really be gas?  Look at your diet and see if it > happens more after certain kinds of foods.  Sugars and even artificial > sweeteners frequently produce gas. > Also, are you constipated?  This too can lead to a full feeling. > To answer your question about nexium – does it help? > But they don’t produce gas in the stomach…that is from swallowed air. The > most common reason for air swallowing is reflux. > Only about 40% of people with GERD have symptoms of heartburn or "acid > indigestion". > Having said that, I think it’s reasonable to continue the PPI if it helps > your symptoms of bloating. If it doesn’t, I wouldn’t pay for another such > pill until the diagnosis had been confirmed. > HMc

— Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com).

Response:

Alkaline reflux?

Question:

– Hide quoted text — Show quoted text -> I was diagnosed with LPR a few weeks ago. I know I’ve had it off and > on for years. Also have irritable bowel and hiatal hernia. But all has > been under control, through a lot of natural means, until the past few > months. So ENT put scope down my nose to throat and confirmed that it > was LPR (no heartburn, just pain, chronic throat clearing and > coughing). > He wanted me on Zantac. But my internist said no and I should use a > PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they > don’t help. In fact, tonight, after taking an Aciphex this morning and > last night, I have that drawing hungry gnawing in my gut. > I even tried DGL licorice for about three days, and no help as well. > Even though I’ve read that H2 blockers are not as good, I’m trying > that. > It’s so bizarre that the meds seem to increase the acidity instead of > decrease it. Same thing happens when I take natural enzymes. > Now, I have been reading and see there is an alkaline reflux. I’m > wondering if that’s what I have, so that’s why digestive enzymes and > PPIs make things worse. Anyone have any experience with this and can > suggest what someone with this can do to heal it?

The next step is a complete diagnostic workup. Technically, the ENT can’t diagnose LPR since reflux, its character and extent, hasn’t been diagnosed yet. There are other things that can cause such laryngitis/pharyngitis. I agree that given your symptoms, it’s a reasonable presumption, but you need to have your upper GI tract evaluated. You need to have EGD, ambulatory pH testing, esophageal manometry. Your internist should be quite willing to get a consultation from a surgeon or gastroenterologist. Acid reflux, if that is indeed what you have, that does not respond to PPIs will usually require anti-reflux surgery. The only other thing you might try is a prokinetic agent, metaclopromide (Reglan) in hopes that it will aid in esophageal clearing and gastric emptying enough to control your symptoms. In the meantime, diet, weight loss, eating habits etc as detailed by many previous poster here on this newsgroup. HMc

Response:

I was diagnosed with LPR a few weeks ago. I know I’ve had it off and on for years. Also have irritable bowel and hiatal hernia. But all has been under control, through a lot of natural means, until the past few months. So ENT put scope down my nose to throat and confirmed that it was LPR (no heartburn, just pain, chronic throat clearing and coughing). He wanted me on Zantac. But my internist said no and I should use a PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they don’t help. In fact, tonight, after taking an Aciphex this morning and last night, I have that drawing hungry gnawing in my gut. I even tried DGL licorice for about three days, and no help as well. Even though I’ve read that H2 blockers are not as good, I’m trying that. It’s so bizarre that the meds seem to increase the acidity instead of decrease it. Same thing happens when I take natural enzymes. Now, I have been reading and see there is an alkaline reflux. I’m wondering if that’s what I have, so that’s why digestive enzymes and PPIs make things worse. Anyone have any experience with this and can suggest what someone with this can do to heal it? Thanks, Susan

Response:

Alkaline reflux?

Aciphex is a medication used to treat gestational acid reflux disease (GERD) and ulcers. buy aciphex and feel better today!

Question:

– Hide quoted text — Show quoted text -> I was diagnosed with LPR a few weeks ago. I know I’ve had it off and > on for years. Also have irritable bowel and hiatal hernia. But all has > been under control, through a lot of natural means, until the past few > months. So ENT put scope down my nose to throat and confirmed that it > was LPR (no heartburn, just pain, chronic throat clearing and > coughing). > He wanted me on Zantac. But my internist said no and I should use a > PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they > don’t help. In fact, tonight, after taking an Aciphex this morning and > last night, I have that drawing hungry gnawing in my gut. > I even tried DGL licorice for about three days, and no help as well. > Even though I’ve read that H2 blockers are not as good, I’m trying > that. > It’s so bizarre that the meds seem to increase the acidity instead of > decrease it. Same thing happens when I take natural enzymes. > Now, I have been reading and see there is an alkaline reflux. I’m > wondering if that’s what I have, so that’s why digestive enzymes and > PPIs make things worse. Anyone have any experience with this and can > suggest what someone with this can do to heal it?

The next step is a complete diagnostic workup. Technically, the ENT can’t diagnose LPR since reflux, its character and extent, hasn’t been diagnosed yet. There are other things that can cause such laryngitis/pharyngitis. I agree that given your symptoms, it’s a reasonable presumption, but you need to have your upper GI tract evaluated. You need to have EGD, ambulatory pH testing, esophageal manometry. Your internist should be quite willing to get a consultation from a surgeon or gastroenterologist. Acid reflux, if that is indeed what you have, that does not respond to PPIs will usually require anti-reflux surgery. The only other thing you might try is a prokinetic agent, metaclopromide (Reglan) in hopes that it will aid in esophageal clearing and gastric emptying enough to control your symptoms. In the meantime, diet, weight loss, eating habits etc as detailed by many previous poster here on this newsgroup. HMc

Response:

I was diagnosed with LPR a few weeks ago. I know I’ve had it off and on for years. Also have irritable bowel and hiatal hernia. But all has been under control, through a lot of natural means, until the past few months. So ENT put scope down my nose to throat and confirmed that it was LPR (no heartburn, just pain, chronic throat clearing and coughing). He wanted me on Zantac. But my internist said no and I should use a PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they don’t help. In fact, tonight, after taking an Aciphex this morning and last night, I have that drawing hungry gnawing in my gut. I even tried DGL licorice for about three days, and no help as well. Even though I’ve read that H2 blockers are not as good, I’m trying that. It’s so bizarre that the meds seem to increase the acidity instead of decrease it. Same thing happens when I take natural enzymes. Now, I have been reading and see there is an alkaline reflux. I’m wondering if that’s what I have, so that’s why digestive enzymes and PPIs make things worse. Anyone have any experience with this and can suggest what someone with this can do to heal it? Thanks, Susan

Response:

Moderate Hiatal Hernia

Question:

Howard…. could you please explain what is meant by moderate? It’s been a month since my EGD and I’m not feeling much relief from the Nexium. How long should I wait for a return visit with my doctor? Any help would be greatly appreciated.

Response:

> Howard…. could you please explain what is meant by moderate? It’s been a > month since my EGD and I’m not feeling much relief from the Nexium. How long > should I wait for a return visit with my doctor? Any help would be greatly > appreciated.

A hiatus hernia is where the upper part of the stomach can slip or has slipped up into the chest. The part that slips includes the gastroesophageal junction and the lower esophageal sphincter. A "moderate" hiatus hernia is one where the gastroesophageal junction is displaced about 2-3 centimeters upward into the chest. It is a common misconception, even among doctors, that a hiatus hernia and acid reflux are the same thing. "Doctor, I have terrible heartburn"…."Yes, you must have a hiatus hernia."    Baloney. Many people with hiatus hernia have no acid reflux, and many people with acid reflux have no hiatus hernia. The causative factor in GERD is dysfunction of the lower esophageal sphincter. In about 40% of cases, the main reason for LES dysfunction is low resting pressure. In SOME of those cases, hiatus hernia contributes to that low resting pressure, therefore, hiatus hernia might contribute to GERD in some cases. The erroneous belief in the relationship of hiatus hernia severity to GERD severity is a holdover from the old days when doctors thought, erroneously, that low LES pressure was the cause of GERD. However, in over 60% of cases of acid reflux, the main cause is transient lower esophageal sphincter relaxation. The cause of these TLESR’s are primarily such things as nicotine, alcohol, caffiene, full stomach, and some foods such as tomatoes and other spices. It’s amazing to me how few doctors understand this concept. I guess it’s just easier to tell the patient "Oh, it’s just your hiatus hernia acting up…take these pills" So, whether or not someone has a hiatus hernia is pretty much irrelevant to GERD. The problem is the function of the LES, which is the root cause of GERD. If you have acid reflux, the place to start is lifestyle modification (diet, weight loss, smaller meals etc etc….these will help control your LES dysfunction. You can also take anti-secretory medication. These meds will not fix your LES dysfunction, nor will they do anything for your hiatus hernia, but they will decrease the amount of acid in the stuff that you reflux thereby moderating your symptoms. Maybe…unless the LES dysfunction is too severe. If these things don’t work, then the function of your Lower Esophageal Sphincter needs to be addressed surgically. Bottom line….don’t worry about your hiatus hernia, worry about controlling your acid reflux. Just because you have one doesn’t imply anything about the severity of your GERD. A high DeMeester score (>14.7) or refluxing more than about 3% of the time on 48 hour pH testing, that means something. A LES resting pressure less than 10 mmHg on manometry, that means something. An EGD that shows erosive esophagitis, stricture, or Barrett’s esophagus, that means something. All of these things allow us to draw real conclusions about your reflux disease. The presence or absence of a hiatus hernia tells us virtually nothing. If you haven’t had 48 hour ambulatory pH testing or esophageal manometry, and if all the doctor saw at EGD was a "moderate" hiatus hernia, then we still have virtually no objective information about whether or not you have GERD. HMc

Response:

Aetna wants me to try protonix?

Question:

I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a new plan wants me to try a cheaper alternetive-protonix. Does anyone have experience with this?How similar/disimilar are they? Aetne wants to spend less, but will step me up only if protonix doesnt do a good job….thanks in advance…ED

Response:

> I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > new plan wants me to try a cheaper alternetive-protonix. Does anyone > have experience with this?How similar/disimilar are they? > Aetne wants to spend less, but will step me up only if protonix doesnt > do a good job….thanks in advance…ED

It’s a common insurance company maneuver. All insurance companies negotiate deals with drug companies, and it sounds like Aetna just negotiated a better deal with Wyeth Pharmaceuticals than they had with Astra Zeneca. Protonix is fine. Different people respond to different medications differently. For some people, Nexium doesn’t work worth a damn and Protonix is their salvation. And the opposite is true too. Give the Protonix a try, see if it works ok for you. If not, your doctor will write a strongly worded letter to Aetna certifying that Protonix doesn’t work for you and you’ll get Nexium.   Probably. HMc

Response:

> I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > new plan wants me to try a cheaper alternetive-protonix. Does anyone > have experience with this?How similar/disimilar are they?

Ahh, welcome to modern prescription coverage.  Due to changing carriers I had to move from prevacid->prilosec->protonix->nexium. For the most part, they’re the same, although the latter three seemed to work a bit better than prevacid for me, but everyone is different. Chances are, Protonix will treat you similarly to Nexium, but if it doesn’t work out, like Howard says you can usually get your doctor to talk to the insurance company and okay Nexium (but be prepared for a larger copay). Note that it’s worth checking out the OTC availability, since sometimes the OTC stuff can be cheaper than the prescription copay, although this widely varies (for a while I was taking Zantac, and OTC generic Zantac (ranitidine) from Walmart was *way* cheaper than my $15 copay at the time), since at least one proton pump inhibitor is on the market now (Prilosec OTC).  But check with your doctor before doing any drastic changes… — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

– Hide quoted text — Show quoted text -> I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > new plan wants me to try a cheaper alternetive-protonix. Does anyone > have experience with this?How similar/disimilar are they? > Aetne wants to spend less, but will step me up only if protonix doesnt > do a good job….thanks in advance…ED > It’s a common insurance company maneuver. All insurance companies negotiate > deals with drug companies, and it sounds like Aetna just negotiated a better > deal with Wyeth Pharmaceuticals than they had with Astra Zeneca. > Protonix is fine. Different people respond to different medications > differently. For some people, Nexium doesn’t work worth a damn and Protonix > is their salvation. And the opposite is true too. > Give the Protonix a try, see if it works ok for you. If not, your doctor > will write a strongly worded letter to Aetna certifying that Protonix > doesn’t work for you and you’ll get Nexium.   Probably. > HMc

Howard, I know that nexium and protonix are needed for alot of people. Isnt it some potent stuff though?

Response:

My prilosec seems to work fine for my acid but I still have stomach pain. Can’t wait for the endeoscopy. OH JOY!

– Hide quoted text — Show quoted text -> I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > new plan wants me to try a cheaper alternetive-protonix. Does anyone > have experience with this?How similar/disimilar are they? > Ahh, welcome to modern prescription coverage.  Due to changing > carriers I had to move from prevacid->prilosec->protonix->nexium. > For the most part, they’re the same, although the latter three seemed > to work a bit better than prevacid for me, but everyone is different. > Chances are, Protonix will treat you similarly to Nexium, but if it > doesn’t work out, like Howard says you can usually get your doctor to > talk to the insurance company and okay Nexium (but be prepared for a > larger copay). > Note that it’s worth checking out the OTC availability, since > sometimes the OTC stuff can be cheaper than the prescription copay, > although this widely varies (for a while I was taking Zantac, and OTC > generic Zantac (ranitidine) from Walmart was *way* cheaper than my $15 > copay at the time), since at least one proton pump inhibitor is on the > market now (Prilosec OTC).  But check with your doctor before doing > any drastic changes… > — > Richard W Kaszeta > http://www.kaszeta.org/rich

Response:

– Hide quoted text — Show quoted text -> > I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > > new plan wants me to try a cheaper alternetive-protonix. Does anyone > > have experience with this?How similar/disimilar are they? > > Aetne wants to spend less, but will step me up only if protonix doesnt > > do a good job….thanks in advance…ED > It’s a common insurance company maneuver. All insurance companies > negotiate > deals with drug companies, and it sounds like Aetna just negotiated a > better > deal with Wyeth Pharmaceuticals than they had with Astra Zeneca. > Protonix is fine. Different people respond to different medications > differently. For some people, Nexium doesn’t work worth a damn and > Protonix > is their salvation. And the opposite is true too. > Give the Protonix a try, see if it works ok for you. If not, your doctor > will write a strongly worded letter to Aetna certifying that Protonix > doesn’t work for you and you’ll get Nexium.   Probably. > HMc > Howard, I know that nexium and protonix are needed for alot of people. Isnt > it some potent stuff though?

The entire class of drugs, proton pump inhibitors, is VERY effective at controlling stomach acid output. HMc

Response:

– Hide quoted text — Show quoted text -> > > I’ve been on nexium .40 mg for 1 1/2 yrs now and its amazing.but now a > > > new plan wants me to try a cheaper alternetive-protonix. Does anyone > > > have experience with this?How similar/disimilar are they? > > > Aetne wants to spend less, but will step me up only if protonix doesnt > > > do a good job….thanks in advance…ED > > It’s a common insurance company maneuver. All insurance companies > negotiate > > deals with drug companies, and it sounds like Aetna just negotiated a > better > > deal with Wyeth Pharmaceuticals than they had with Astra Zeneca. > > Protonix is fine. Different people respond to different medications > > differently. For some people, Nexium doesn’t work worth a damn and > Protonix > > is their salvation. And the opposite is true too. > > Give the Protonix a try, see if it works ok for you. If not, your doctor > > will write a strongly worded letter to Aetna certifying that Protonix > > doesn’t work for you and you’ll get Nexium.   Probably. > > HMc > Howard, I know that nexium and protonix are needed for alot of people. > Isnt > it some potent stuff though? > The entire class of drugs, proton pump inhibitors, is VERY effective at > controlling stomach acid output. > HMc

I bet but can it be good for long term use? Can it damage the system ever if used to long?

Response:

> The entire class of drugs, proton pump inhibitors, is VERY effective at > controlling stomach acid output. > HMc > I bet but can it be good for long term use? Can it damage the system ever if > used to long?

When the class first came out (Losec — now Prilosec), it was only FDA approved for short term use as there was speculation (and no long term data) that it would increase the risk of stomach cancer. It has long been known that no stomach acid would result in higher levels of circulating gastrin because it’s acid that determines gastrin output via negative feedback. In other words, gastrin stimulates acid output and acid controls gastrin levels. So, if there is too much acid, there is no gastrin, and if there is too little acid, there is lots of gastrin. If you take these anti-acid drugs, you will have high circulating levels of gastrin. Gastrin is a trophic hormone — it stimulates the stomach lining and the speculation was that that constant stimulation would increase the risk of stomach cancer. This has not  been shown to be the case, and the FDA has approved PPIs for long term use. I have seen multiple polyps in the stomach many times in patients who have been on long term proton pump inhibitors, but biopsies always show little or no malignant potential, as far as we know. It IS speculated that the use of anti acid medications such as H2 receptor antagonists and PPIs increases the risk of esophageal cancer. The use of these medications alkalinizes the stomach, changing  the pH and allowing bile salts to come out of solution. These bile salts are highly irritating to the lining of the lower esphagus, but don’t cause the severe symptoms that acid causes. So even though a person’s heartburn symptoms go away, their risk of esophageal cancer actually increases. The point is that these medications don’t do anything to stop the reflux, they only change the character of the refluxate, and although there are fewer symptoms, the esophageal changes of Barrett’s esophagus (and it’s attendant cancer risk) actually progress more rapidly. The incidence of esophageal cancer has been increasing rapidly over the last 35 years, and the graphs coincide exactly with the discovery and increasing use of anti-secretory medications. The use of these medications only stops the SYMPTOMS of GERD, but doesn’t actually stop the reflux. Managing the symptoms might be appropriate if there is no evidence of Barrett’s esophagus on EGD, but ongoing surveillance is important because of the increased risk of esophageal cancer. HMc

Response:

Two questions. 1 Are polyps caused by propton pump inhibitors lessening the acid content of the stomach? 2 "Stomach Pain" is listed as one of the side effects of proton pump inhibitors, how does a patient know if his pain is caused by the drug instead of his ulcer or other problem? Derek.

– Hide quoted text — Show quoted text -> > The entire class of drugs, proton pump inhibitors, is VERY effective at > > controlling stomach acid output. > > HMc > I bet but can it be good for long term use? Can it damage the system ever > if > used to long? > When the class first came out (Losec — now Prilosec), it was only FDA > approved for short term use as there was speculation (and no long term data) > that it would increase the risk of stomach cancer. It has long been known > that no stomach acid would result in higher levels of circulating gastrin > because it’s acid that determines gastrin output via negative feedback. In > other words, gastrin stimulates acid output and acid controls gastrin > levels. So, if there is too much acid, there is no gastrin, and if there is > too little acid, there is lots of gastrin. If you take these anti-acid > drugs, you will have high circulating levels of gastrin. > Gastrin is a trophic hormone — it stimulates the stomach lining and the > speculation was that that constant stimulation would increase the risk of > stomach cancer. This has not  been shown to be the case, and the FDA has > approved PPIs for long term use. I have seen multiple polyps in the stomach > many times in patients who have been on long term proton pump inhibitors, > but biopsies always show little or no malignant potential, as far as we > know. > It IS speculated that the use of anti acid medications such as H2 receptor > antagonists and PPIs increases the risk of esophageal cancer. The use of > these medications alkalinizes the stomach, changing  the pH and allowing > bile salts to come out of solution. These bile salts are highly irritating > to the lining of the lower esphagus, but don’t cause the severe symptoms > that acid causes. So even though a person’s heartburn symptoms go away, > their risk of esophageal cancer actually increases. The point is that these > medications don’t do anything to stop the reflux, they only change the > character of the refluxate, and although there are fewer symptoms, the > esophageal changes of Barrett’s esophagus (and it’s attendant cancer risk) > actually progress more rapidly. The incidence of esophageal cancer has been > increasing rapidly over the last 35 years, and the graphs coincide exactly > with the discovery and increasing use of anti-secretory medications. > The use of these medications only stops the SYMPTOMS of GERD, but doesn’t > actually stop the reflux. Managing the symptoms might be appropriate if > there is no evidence of Barrett’s esophagus on EGD, but ongoing surveillance > is important because of the increased risk of esophageal cancer. > HMc

Response:

> Two questions. > 1 Are polyps caused by propton pump inhibitors lessening the acid content of > the stomach? > 2 "Stomach Pain" is listed as one of the side effects of proton pump > inhibitors, how does a patient know if his pain is caused by the drug > instead of his ulcer or other problem? > Derek.

1.  Yes. The decreased stomach acid results in higher circulating gastrin, which stimulates the polyp growth in stomach lining. 2.  It’s not classified as "stomach" pain, but as "abdominal" pain. Usually it is cramping in the small intestine or in the colon. One would sort it out by the nature of the pain, or ultimately by EGD if it could not be diagnosed clinically. HMc

Response:

> Two questions. > 1 Are polyps caused by propton pump inhibitors lessening the acid content > of > the stomach? > 2 "Stomach Pain" is listed as one of the side effects of proton pump > inhibitors, how does a patient know if his pain is caused by the drug > instead of his ulcer or other problem? > Derek. > 1.  Yes. The decreased stomach acid results in higher circulating gastrin, > which stimulates the polyp growth in stomach lining.

What is polyp growth? – Hide quoted text — Show quoted text -> 2.  It’s not classified as "stomach" pain, but as "abdominal" pain. Usually > it is cramping in the small intestine or in the colon. One would sort it out > by the nature of the pain, or ultimately by EGD if it could not be diagnosed > clinically. > HMc

Response:

– Hide quoted text — Show quoted text -> > Two questions. > > 1 Are polyps caused by propton pump inhibitors lessening the acid > content > of > > the stomach? > > 2 "Stomach Pain" is listed as one of the side effects of proton pump > > inhibitors, how does a patient know if his pain is caused by the drug > > instead of his ulcer or other problem? > > Derek. > 1.  Yes. The decreased stomach acid results in higher circulating gastrin, > which stimulates the polyp growth in stomach lining. > What is polyp growth?

Something that grows in dark, moist places and looks like a mushroom. Derek

Response:

> What is polyp growth?

Google. Or, look at http://www.endoskopischer-atlas.de/m18e.htm and at  http://tinyurl.com/rgcx . In fact, look at this guy’s whole site, it’s pretty good http://tinyurl.com/rgd1 HMc

Response:

- Hide quoted text — Show quoted text -> > The entire class of drugs, proton pump inhibitors, is VERY effective at > > controlling stomach acid output. > > HMc > I bet but can it be good for long term use? Can it damage the system ever >  if > used to long? > When the class first came out (Losec — now Prilosec), it was only FDA > approved for short term use as there was speculation (and no long term data) > that it would increase the risk of stomach cancer. It has long been known > that no stomach acid would result in higher levels of circulating gastrin > because it’s acid that determines gastrin output via negative feedback. In > other words, gastrin stimulates acid output and acid controls gastrin > levels. So, if there is too much acid, there is no gastrin, and if there is > too little acid, there is lots of gastrin. If you take these anti-acid > drugs, you will have high circulating levels of gastrin. > Gastrin is a trophic hormone — it stimulates the stomach lining and the > speculation was that that constant stimulation would increase the risk of > stomach cancer. This has not  been shown to be the case, and the FDA has > approved PPIs for long term use. I have seen multiple polyps in the stomach > many times in patients who have been on long term proton pump inhibitors, > but biopsies always show little or no malignant potential, as far as we > know. > It IS speculated that the use of anti acid medications such as H2 receptor > antagonists and PPIs increases the risk of esophageal cancer. The use of > these medications alkalinizes the stomach, changing  the pH and allowing > bile salts to come out of solution. These bile salts are highly irritating > to the lining of the lower esphagus, but don’t cause the severe symptoms > that acid causes. So even though a person’s heartburn symptoms go away, > their risk of esophageal cancer actually increases. The point is that these > medications don’t do anything to stop the reflux, they only change the > character of the refluxate, and although there are fewer symptoms, the > esophageal changes of Barrett’s esophagus (and it’s attendant cancer risk) > actually progress more rapidly. The incidence of esophageal cancer has been > increasing rapidly over the last 35 years, and the graphs coincide exactly > with the discovery and increasing use of anti-secretory medications. > The use of these medications only stops the SYMPTOMS of GERD, but doesn’t > actually stop the reflux. Managing the symptoms might be appropriate if > there is no evidence of Barrett’s esophagus on EGD, but ongoing surveillance > is important because of the increased risk of esophageal cancer. > HMc

OH MY! OH MY!  WHAT TO DO!  I am so confused.  I am taking Protonix so I don’t have acid reflux so I don’t get esophegeal cancer and long term use will likely CAUSE the cancer.  What do you suggest people with this chronic problem do exactly?  This is really perplexing.  I’d rather take no meds if given a choice.  Please tell me what to do here as I have been on Protonix for several years and am only 47.  I love my life and want to keep on livin it!  ( :  Is there anything that will actually stop the reflux…diet, etc.?

Response:

– Hide quoted text — Show quoted text -> What is polyp growth? > Google. > Or, look at http://www.endoskopischer-atlas.de/m18e.htm > and at >  http://tinyurl.com/rgcx . In fact, look at this guy’s whole site, it’s > pretty good http://tinyurl.com/rgd1 > HMc

Yuck!

Response:

– Hide quoted text — Show quoted text -> > > The entire class of drugs, proton pump inhibitors, is VERY effective at > > > controlling stomach acid output. > > > HMc > > I bet but can it be good for long term use? Can it damage the system ever >  if > > used to long? > When the class first came out (Losec — now Prilosec), it was only FDA > approved for short term use as there was speculation (and no long term data) > that it would increase the risk of stomach cancer. It has long been known > that no stomach acid would result in higher levels of circulating gastrin > because it’s acid that determines gastrin output via negative feedback. In > other words, gastrin stimulates acid output and acid controls gastrin > levels. So, if there is too much acid, there is no gastrin, and if there is > too little acid, there is lots of gastrin. If you take these anti-acid > drugs, you will have high circulating levels of gastrin. > Gastrin is a trophic hormone — it stimulates the stomach lining and the > speculation was that that constant stimulation would increase the risk of > stomach cancer. This has not  been shown to be the case, and the FDA has > approved PPIs for long term use. I have seen multiple polyps in the stomach > many times in patients who have been on long term proton pump inhibitors, > but biopsies always show little or no malignant potential, as far as we > know. > It IS speculated that the use of anti acid medications such as H2 receptor > antagonists and PPIs increases the risk of esophageal cancer. The use of > these medications alkalinizes the stomach, changing  the pH and allowing > bile salts to come out of solution. These bile salts are highly irritating > to the lining of the lower esphagus, but don’t cause the severe symptoms > that acid causes. So even though a person’s heartburn symptoms go away, > their risk of esophageal cancer actually increases. The point is that these > medications don’t do anything to stop the reflux, they only change the > character of the refluxate, and although there are fewer symptoms, the > esophageal changes of Barrett’s esophagus (and it’s attendant cancer risk) > actually progress more rapidly. The incidence of esophageal cancer has been > increasing rapidly over the last 35 years, and the graphs coincide exactly > with the discovery and increasing use of anti-secretory medications. > The use of these medications only stops the SYMPTOMS of GERD, but doesn’t > actually stop the reflux. Managing the symptoms might be appropriate if > there is no evidence of Barrett’s esophagus on EGD, but ongoing surveillance > is important because of the increased risk of esophageal cancer. > HMc > OH MY! OH MY!  WHAT TO DO!  I am so confused.  I am taking Protonix so > I don’t have acid reflux so I don’t get esophegeal cancer and long > term use will likely CAUSE the cancer.  What do you suggest people > with this chronic problem do exactly?  This is really perplexing.  I’d > rather take no meds if given a choice.  Please tell me what to do here > as I have been on Protonix for several years and am only 47.  I love > my life and want to keep on livin it!  ( :  Is there anything that > will actually stop the reflux…diet, etc.?

I confess that the relationship of long term anti-secretory medication to esophageal cancer is a little controversial in the medical world, but the mounting evidence is compelling. The situation is not dissimilar to the relationship of smoking to lung cancer. Many physicians fought the concept that those two things might be related for many years. The base reasons are the same — chronic irritation of the bronchial tree and chronic irritation of the lower esophagus. Personally, I think the evidence supporting the relationship of anti-secretory medication to Barrett’s esophagus and esophageal cancer is compelling as do the majority of physicians that deal with these issues on a daily basis. You may remember an advertising campaign by RJ Reynolds Tobacco in the 50s that featured TV and print ads focused on doctors smoking cigarrettes while relaxing. You are unlikely to see those ads again anytime soon. If your symptoms are under good control ie. medication, lifestyle changes, and watching your diet are controlling your reflux symptoms to your satisfaction, then nothing needs to be done UNLESS your EGD shows evidence of esophageal damage from the reflux. If you have an EGD which shows inflammation, stricture, or Barrett’s esophagus, then it is time to consider surgical intervention. Chronic relux sufferers need to have periodic EGD to evaluate the lower esophagus. Every 2-4 years depending on findings. If you haven’t had one, you need one. Medication and lifestyle changes only control the SYMPTOMS of reflux. Those things do nothing to address the CAUSE of the relux, that being dysfunction of the lower esophageal sphincter. The only way reflux can be stopped is with surgery. State-of-the-art in that regard is either a Nissen laparoscopic gastric fundoplication (look at http://tinyurl.com/rkvi ) or the Stretta procedure (look at http://tinyurl.com/rkvn ). Both are, or can be, effective anti-reflux treatments that can CURE acid reflux, not just manage the symptoms. HMc

Response:

howard!  you are such a wealth of knowledge and so wonderful to give of your time so freely here.  i would love your take on this situation.  by the way i am waiting for my appointment with a gastro….can’t get in until nov. 25th.  i know it’s a long wait but my internist and i agree that there is no crisis here and he is the one i want to see.  i have been on protonix off and on for a couple of years and have never treated my reflux very seriously until recently. it seems that when my diet gets crazy i start thinking the protonix isn’t working and have twice tried other drugs.  i had the same result with nexium and prilosec.  after a couple days i was elated.  it seemed that i could have my margaritas and mexican food and get by with no acid reflux.  i felt like a criminal getting by with the crime.  well, within about 7-10 days i would feel like there was a big lump in my diaphram and that i couldn’t belch to save my life.  it was like there was no digestion going on whatsoever.  the feeling was worse to me than the actual acid reflux and pain/pressure i had experienced in the past.  once i would stop the new drug, that problem would resolve within a couple of days and i would get back on the protonix.  i am now diligently keeping a food diary and being very good about my diet.  i am losing weight because i am eating smaller portions.  i have also elevated my bed.  things are soooo much better now.  i am just curious if you have heard of others having that experience with those meds?  thanks again for sharing your time and knowledge with all of us here….guess we are all a mess!

Response:

– Hide quoted text — Show quoted text -> > > > The entire class of drugs, proton pump inhibitors, is VERY effective > at > > > > controlling stomach acid output. > > > > HMc > > > I bet but can it be good for long term use? Can it damage the system > ever > >  if > > > used to long? > > When the class first came out (Losec — now Prilosec), it was only FDA > > approved for short term use as there was speculation (and no long term > data) > > that it would increase the risk of stomach cancer. It has long been > known > > that no stomach acid would result in higher levels of circulating > gastrin > > because it’s acid that determines gastrin output via negative feedback. > In > > other words, gastrin stimulates acid output and acid controls gastrin > > levels. So, if there is too much acid, there is no gastrin, and if there > is > > too little acid, there is lots of gastrin. If you take these anti-acid > > drugs, you will have high circulating levels of gastrin. > > Gastrin is a trophic hormone — it stimulates the stomach lining and the > > speculation was that that constant stimulation would increase the risk > of > > stomach cancer. This has not  been shown to be the case, and the FDA has > > approved PPIs for long term use. I have seen multiple polyps in the > stomach > > many times in patients who have been on long term proton pump > inhibitors, > > but biopsies always show little or no malignant potential, as far as we > > know. > > It IS speculated that the use of anti acid medications such as H2 > receptor > > antagonists and PPIs increases the risk of esophageal cancer. The use of > > these medications alkalinizes the stomach, changing  the pH and allowing > > bile salts to come out of solution. These bile salts are highly > irritating > > to the lining of the lower esphagus, but don’t cause the severe symptoms > > that acid causes. So even though a person’s heartburn symptoms go away, > > their risk of esophageal cancer actually increases. The point is that > these > > medications don’t do anything to stop the reflux, they only change the > > character of the refluxate, and although there are fewer symptoms, the > > esophageal changes of Barrett’s esophagus (and it’s attendant cancer > risk) > > actually progress more rapidly. The incidence of esophageal cancer has > been > > increasing rapidly over the last 35 years, and the graphs coincide > exactly > > with the discovery and increasing use of anti-secretory medications. > > The use of these medications only stops the SYMPTOMS of GERD, but > doesn’t > > actually stop the reflux. Managing the symptoms might be appropriate if > > there is no evidence of Barrett’s esophagus on EGD, but ongoing > surveillance > > is important because of the increased risk of esophageal cancer. > > HMc > OH MY! OH MY!  WHAT TO DO!  I am so confused.  I am taking Protonix so > I don’t have acid reflux so I don’t get esophegeal cancer and long > term use will likely CAUSE the cancer.  What do you suggest people > with this chronic problem do exactly?  This is really perplexing.  I’d > rather take no meds if given a choice.  Please tell me what to do here > as I have been on Protonix for several years and am only 47.  I love > my life and want to keep on livin it!  ( :  Is there anything that > will actually stop the reflux…diet, etc.? > I confess that the relationship of long term anti-secretory medication to > esophageal cancer is a little controversial in the medical world, but the > mounting evidence is compelling. The situation is not dissimilar to the > relationship of smoking to lung cancer. Many physicians fought the concept > that those two things might be related for many years. The base reasons are > the same — chronic irritation of the bronchial tree and chronic irritation > of the lower esophagus. Personally, I think the evidence supporting the > relationship of anti-secretory medication to Barrett’s esophagus and > esophageal cancer is compelling as do the majority of physicians that deal > with these issues on a daily basis. You may remember an advertising campaign > by RJ Reynolds Tobacco in the 50s that featured TV and print ads focused on > doctors smoking cigarrettes while relaxing. You are unlikely to see those > ads again anytime soon. > If your symptoms are under good control ie. medication, lifestyle changes, > and watching your diet are controlling your reflux symptoms to your > satisfaction, then nothing needs to be done UNLESS your EGD shows evidence > of esophageal damage from the reflux. If you have an EGD which shows > inflammation, stricture, or Barrett’s esophagus, then it is time to consider > surgical intervention. > Chronic relux sufferers need to have periodic EGD to evaluate the lower > esophagus. Every 2-4 years depending on findings. If you haven’t had one, > you need one. > Medication and lifestyle changes only control the SYMPTOMS of reflux. Those > things do nothing to address the CAUSE of the relux, that being dysfunction > of the lower esophageal sphincter. The only way reflux can be stopped is > with surgery. State-of-the-art in that regard is either a Nissen > laparoscopic gastric fundoplication (look at http://tinyurl.com/rkvi ) or > the Stretta procedure (look at http://tinyurl.com/rkvn ). Both are, or can > be, effective anti-reflux treatments that can CURE acid reflux, not just > manage the symptoms. > HMc

I would like to add to this Howard with your aproval. A healthy diet itself can decrease chances of cancer with the right amount of antioxidents and greens as well correct?

Response:

– Hide quoted text — Show quoted text -> howard!  you are such a wealth of knowledge and so wonderful to give > of your time so freely here.  i would love your take on this > situation.  by the way i am waiting for my appointment with a > gastro….can’t get in until nov. 25th.  i know it’s a long wait but > my internist and i agree that there is no crisis here and he is the > one i want to see.  i have been on protonix off and on for a couple of > years and have never treated my reflux very seriously until recently. > it seems that when my diet gets crazy i start thinking the protonix > isn’t working and have twice tried other drugs.  i had the same result > with nexium and prilosec.  after a couple days i was elated.  it > seemed that i could have my margaritas and mexican food and get by > with no acid reflux.  i felt like a criminal getting by with the > crime.  well, within about 7-10 days i would feel like there was a big > lump in my diaphram and that i couldn’t belch to save my life.  it was > like there was no digestion going on whatsoever.  the feeling was > worse to me than the actual acid reflux and pain/pressure i had > experienced in the past.  once i would stop the new drug, that problem > would resolve within a couple of days and i would get back on the > protonix.  i am now diligently keeping a food diary and being very > good about my diet.  i am losing weight because i am eating smaller > portions.  i have also elevated my bed.  things are soooo much better > now.  i am just curious if you have heard of others having that > experience with those meds?  thanks again for sharing your time and > knowledge with all of us here….guess we are all a mess!

I have seen people respond and not respond to virtually all of the anti-secretory medications on the market. Some of those medications work great for some people and not for others. Some people who have had such meds work well for years stop responding. The reasons for this are variable and speculative. They appear to relate to changing function of the lower esophageal sphincter. As I said previously, anti-secretory medication doesn’t affect the LES, only the amount of acid available for reflux. And this can vary during the course of a day. Prilosec blood levels can change during the day and if you take it once in the morning as typically recommended, the blood levels may be low in the evening. Nexium is basically the same drug as Prilosec, but with different absorption and release so it supposedly maintains higher blood levels over a 24 hour period. I have seen this to be *generally* true, but certainly not *universally* for example. The key point is that medication and lifestyle changes are the way to go as long as they are controlling your symptoms to your satisfaction AND as long as their is no progression of damage to the lower esophagus (esophagitis, stricture, Barrett’s). If lifestyle changes and medications AREN’T controlling your symptoms to the point where you can live with it, or if there IS evidence on EGD of esophagitis, stricture, Barrett’s, then it’s time to consider surgery. Surgery for GERD is remarkably effective, but like all surgery should only be done if there is no other way to address the issue safely and effectively. I cannot emphasize enough that long term GERD patients need a screening EGD to evaluate for reflux damage because of the very well-defined relationship of esophageal cancer to reflux. Barrett’s esophagus is readily discernable on EGD. HMc

Response:

> I would like to add to this Howard with your aproval. A healthy diet itself > can decrease chances of cancer with the right amount of antioxidents and > greens as well correct?

Doug, there is no question that a healthy diet is an important aspect of long term health, but there are huge variations within that "healthy diet" label. The theory of anti-oxidants and free-radical scavenging relative to cancer and heart disease is very interesting and is borne of some interesting lab work. However, it has never been shown in practice in randomized double-blind studies to be significant. One problem is the bioavaliability of the various anti-oxidants. These things are not closely monitored by the FDA as prescription drugs and there is a huge variability in quality, ranging from good bioavailability to outright scam. I believe that the key to many human ailments lays in free-radical scavenging, but we aren’t there yet. So far, there has been nothing in the anti-oxidant arena that has been shown to be effective, even though the science behind the theory is interesting, and may hold some promise. Just my opinion…. HMc

Response:

Acid Reflux – Coffee, Beer and Wine

Question:

I’ve been on Nexium for a couple months now after being diagnosed with Acid Reflux.  I really miss my 2 cups of coffee on the morning & an occasional beer or glass of wine.  I’ve heard Kona or Sumatra Coffee might be less aggravating to reflux symptoms & plan to try them.  I haven’t even attempted to drink Wine or Beer since starting the Nexium.  Anyone with Acid Reflux find any wine or beer that doesn’t cause aggravation?

Response:

> I’ve been on Nexium for a couple months now after being diagnosed with > Acid Reflux.  I really miss my 2 cups of coffee on the morning & an > occasional beer or glass of wine.  I’ve heard Kona or Sumatra Coffee > might be less aggravating to reflux symptoms & plan to try them.  I > haven’t even attempted to drink Wine or Beer since starting the > Nexium.  Anyone with Acid Reflux find any wine or beer that doesn’t > cause aggravation?

Although I find that *any* beer or wine aggravate my GERD, smooth dark beers seem to aggravate it the least.  For example, Guinness draught. — Richard W Kaszeta http://www.kaszeta.org/rich

Response:

i'm new too

Question:

http://gerdonline.itgo.com/surgery.html hey i did it!!!!!! well kinda—–i couldn’t get it highlighted. hope it works for you dawn. stella

Response:

>well kinda—–i couldn’t get it highlighted.

duh !!!!! i am an idiot!!!!! stella

Response:

>I take one prevacid at nite… but hating taking a med all the time… >thinking >of trying some ginger.

Ginger works well. I didn’t get rid of my severe reflux until I cut out all dairy products (now I eat only kosher) and drink fresh ginger juice daily. CW http://www.volare.net/gerd

Response:

if i dont take my prevacid 30 mg or a nexium 40mg once a day it dont matter what i eat or  drink water, cokes or dont eat anything i get heartburn badly so i have to take prevacid or nexium at least once a day but after that i can eat or drink ANYTHING for 24 hours

– Hide quoted text — Show quoted text ->I take one prevacid at nite… but hating taking a med all the time… >thinking >of trying some ginger. > Ginger works well. I didn’t get rid of my severe reflux until I cut out all > dairy products (now I eat only kosher) and drink fresh ginger juice daily. > CW > http://www.volare.net/gerd

Response:

Yes, esophagitis can trigger reflux. Ginger helps heal esophagitis as well, as I said. The problem I had before was that it kept coming back until I quit dairy (this includes crackers, breads, cheese, and anything else with even an atom of milk in it — even eating a piece of bread containing milk will give me heartburn) and other irritating foods (such as vinegar, lemons, or tomatoes). Now I have no problem drinking water and I really don’t have any acid reflux after meals. Granted, I’m not "normal" yet, but I was just about there before I became sick with the flu and vomited my way back into esophagitis hell last week. CW http://www.volare.net/gerd – Hide quoted text — Show quoted text ->if i dont take my prevacid 30 mg or a nexium 40mg once a day it dont matter >what i eat or  drink water, cokes or dont eat anything i get heartburn badly >so i have to take prevacid or nexium at least once a day but after that i >can eat or drink ANYTHING for 24 hours > >I take one prevacid at nite… but hating taking a med all the time… > >thinking > >of trying some ginger. > Ginger works well. I didn’t get rid of my severe reflux until I cut out >all > dairy products (now I eat only kosher) and drink fresh ginger juice daily.

Response:

Stella: You can send the link to my email. But if you know how to "copy" and "paste" you can highlight the address / the url and right click mouse-and hit copy and then paste it into your post here on the ng. I was diagnosed about a year ago. I had this choking feeling in my throat.. thought it was my thyroid. Also thought I had sinus drainage- which I found out is a common symptom.  The Prevacid has mostly taken away the choking/lump feeling in my throat… If I could do something about feeling like I will choke if I do not CONSTANTLY have water by my side. And this clearing my throat/sniffing thing I do (I sound like a dog!) tks- dawn

>Good to talk w/ others that understand. > oh how true!!!! >What is Nissen? >Is is meds or surgery? cool > link to it that tells everything  about it. but since i’m

computer-illiterate i – Hide quoted text — Show quoted text -> haven’t the faintest idea of how to post a link to a newsgroup. with your > permission i’d send it to you directly. >I take one prevacid at nite… but hating taking a med all the time… get > frustrating after a while. how long ago were you dx’d? were you on other meds > before the prevacid? took prevacid for about 2 yrs but once i was up to 5 a day > (30mg?) my dr switched me to aciphex. that was in june of ‘99. > be well, > stella

Response:

Yes, will I be 60 and have about 30 pills to take each day? I am wondering about ginger? I read something on it. I may try it…. but keep taking prevacid for a bit too. I have a huge deductible for my insurance, as I am buying ins. as an individual….so I have to pay for too… thankfully I have a doc that will give me samples, when he has them. Some nites I dont take my prevacid. Some times I take one every-other nite.

– Hide quoted text — Show quoted text -> howdy back at ya >  the one prevacid  seems to take care of me but  at 3.50$ a pill is killing > me since my insurance wont  help me at all in that area  alos my doc put me > on nexium  i can take either one  at a time  they both work great for me > but am concerned about the future do we have to live with this all our > lives?? > hi dawn, CaSey, and psychic sandwich……i’ve been wanting to post here > also > but never see much going on. maybe we can change that! anyway i was dx’d > with > GERD in 1989 and just went through all those nasty  tests to see if ‘m a > candidate for the nissen…….no test results back yet though. > the "clearing the throat" thing is something i’ve dealt with for a long > time. > my dr says it’s part of the deal. annoying, isn’t it?? oh well, after all > these > years of being on every med available ,i’m accepting this as part of > everyday > life. hello to everyone and hope you are all having pain-free days.

Response:

>Good to talk w/ others that understand.

oh how true!!!! >What is Nissen? >Is is meds or surgery?

link to it that tells everything  about it. but since i’m computer-illiterate i haven’t the faintest idea of how to post a link to a newsgroup. with your permission i’d send it to you directly. >I take one prevacid at nite… but hating taking a med all the time…

frustrating after a while. how long ago were you dx’d? were you on other meds before the prevacid? took prevacid for about 2 yrs but once i was up to 5 a day (30mg?) my dr switched me to aciphex. that was in june of ‘99. be well, stella

Response:

howdy back at ya  the one prevacid  seems to take care of me but  at 3.50$ a pill is killing me since my insurance wont  help me at all in that area  alos my doc put me on nexium  i can take either one  at a time  they both work great for me but am concerned about the future do we have to live with this all our lives??

– Hide quoted text — Show quoted text -> hi dawn, CaSey, and psychic sandwich……i’ve been wanting to post here also > but never see much going on. maybe we can change that! anyway i was dx’d with > GERD in 1989 and just went through all those nasty  tests to see if ‘m a > candidate for the nissen…….no test results back yet though. > the "clearing the throat" thing is something i’ve dealt with for a long time. > my dr says it’s part of the deal. annoying, isn’t it?? oh well, after all these > years of being on every med available ,i’m accepting this as part of everyday > life. hello to everyone and hope you are all having pain-free days.

Response:

hi dawn, CaSey, and psychic sandwich……i’ve been wanting to post here also but never see much going on. maybe we can change that! anyway i was dx’d with GERD in 1989 and just went through all those nasty  tests to see if ‘m a candidate for the nissen…….no test results back yet though. the "clearing the throat" thing is something i’ve dealt with for a long time. my dr says it’s part of the deal. annoying, isn’t it?? oh well, after all these years of being on every med available ,i’m accepting this as part of everyday life. hello to everyone and hope you are all having pain-free days.

Response:

Hi ! Good to talk w/ others that understand. I  do the throat clearing thing and also a kind of breathing/sniffing thing (Lord, I sound like a real dork! haha!) But I dont even realize i am doing it!! And then I catch myself and think WHAT IN THE WORLD IS WRONG WITH ME??!!! I can get into a rhythm doing it… like I’m playing a song ! haha! What is Nissen? Is is meds or surgery? I take one prevacid at nite… but hating taking a med all the time… thinking of trying some ginger. dawn

– Hide quoted text — Show quoted text -> hi dawn, CaSey, and psychic sandwich……i’ve been wanting to post here also > but never see much going on. maybe we can change that! anyway i was dx’d with > GERD in 1989 and just went through all those nasty  tests to see if ‘m a > candidate for the nissen…….no test results back yet though. > the "clearing the throat" thing is something i’ve dealt with for a long time. > my dr says it’s part of the deal. annoying, isn’t it?? oh well, after all these > years of being on every med available ,i’m accepting this as part of everyday > life. hello to everyone and hope you are all having pain-free days.

Response:

i was just diagnosed as manic depressive (the kind where you haven’t had a major manic phase, just hypomanic ones) in the beginning of january, and just discovered this newsgroup, which makes me really happy b/c i’ve been feeling very alone with this disease.  i know a ton of people who have been diagnosed as depressive and been on various meds for it, but i don’t know anyone else who is manic.   but anyway, i have been on 4 anti-depressants in the past year and a half (prozac, zoloft, paxil, and pamelor) and all of them made me hypomanic.  right now i’m on 900 mg of lithium per day and i just had some questions which my pdoc hasn’t been able to answer really well, since she hasn’t gone through this herself.  i’ve noticed that with the lithium i have felt very clumsy and sort of "slow" — i can’t seem to formulate a thought as well, find the right words as easily, i’m always tripping over things (in fact last week, i fell and gave myself a concussion).  is this normal?  i mean, do other people feel this or is it just me? i’m just feeling kind of scared b/c i don’t want to lose that quick, bright, funny side of myself that the MD brings on.  i have just been feeling so stupid and slow lately. will this get better with time or am i going to feel like this as long as i am on the lithium? thanks, chris

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<snip> > since she hasn’t gone through this herself.  i’ve noticed that with the > lithium i have felt very clumsy and sort of "slow" — i can’t seem to > formulate a thought as well, find the right words as easily, i’m always > tripping over things (in fact last week, i fell and gave myself a > concussion).  is this normal?  i mean, do other people feel this or is > it just me? i’m just feeling kind of scared b/c i don’t want to lose > that quick, bright, funny side of myself that the MD brings on.  i have > just been feeling so stupid and slow lately. will this get better with > time or am i going to feel like this as long as i am on the lithium? > thanks, chris

Hi Chris, For me, it gets better and then it may get worse for awhile too.  I think it’s related to my mood, or what my mood would have been without the lithium. As your typical m-d, I have some theories about everything, including this stupidity: the lithium interrupts my spiraling into mania or depression; it short-circuits the obsession to euphoria, rage, or unhappiness.  A lot of my "intelligence" was derived from my ability to obsess about something until I got it right.  On lithium, I have to find another way to be smart, and it’s hard work sometimes . . . I remember the first paper I wrote when I went back to graduate school after 2 years on lithium.  I thought I was a 2nd grader. But, I think I have found some ways to be smart with the derailment of my thought which lithium provides.  It reminds me of how a functioning alcoholic can accomplish many tasks while drunk, but has no idea how to do them when sober.  The part of our mind that learned how to be smart without the lithium isn’t activated anymore, but we can learn how to be smart with another part of our minds, I do believe. Nancy

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