Esomeprazole for Acid Reflux

I take it, doesn't help.much.

SilverBrook

This paper:

pmc.ncbi.nlm.nih.gov/articles/PMC10248387/

Various observational studies, clinical trials, and meta-analyses have established the adverse effects associated with the long-term use of proton pump inhibitors including renal disorders (acute interstitial nephritis, acute kidney injury, chronic kidney disease, and end-stage renal disease), cardiovascular risks (major adverse cardiovascular events, myocardial infarction, stent thrombosis, and stroke), fractures, infections (Clostridium difficile infection, community-acquired pneumonia, and Coronavirus disease 2019), micronutrient deficiencies (hypomagnesemia, anemia, vitamin B12 deficiency, hypocalcemia, hypokalemia), hypergastrinemia, cancers (gastric cancer, pancreatic cancer, colorectal cancer, hepatic cancer), hepatic encephalopathy, and dementia.

…

… patients with Barrett’s esophagus, severe esophagitis, and history of bleeding gastrointestinal ulcers and the users of long-term non-steroidal anti-inflammatory drugs (NSAIDs) may need long-term therapy of PPIs. Consequently, such patients should be monitored for adverse effects associated with the use of long-term PPI therapy.

Clinicians including prescribers and pharmacists should be aware of the adverse effects of taking proton pump inhibitors for an extended period of time.

As PPIs are prescribed so frequently, one has to wonder if, when a patient is diagnosed with one of the conditions mentioned in that list, whether any connection is made between it and long-term PPI use.

But it’s certainly been a nice little earner for the drug companies 😡

I have been taking Esomeprazole for several years and now rarely suffer from indigestion caused by a hiatus hernia. If it occasionally happens I take a Gaviscon tablet,

I had been taking Omeprazole for about 16 years, but have now been switched to Esomeprazole following my last gastroscopy when I was diagnosed with a sliding hiatus hernia. I hate taking PPI's, but they do work and stop the misery of acid reflux. I have tried a bed wedge and various other things, but nothing worked. I have also been prescribed Gaviscon Advance, which has enabled me to cut the PPI's down to 2-3 per week.

Thanks everyone. I’m really hoping they’ll work for me, for the shortest time. It’s amazing how many people take PPIs when you mention them!

Thank you. It’s reassuring to hear they worked for you!

CalRuth

Proton pump inhibitors (PPI's) first hit the market in 1987, so not quite thirty years ago.

This means we are only just seeing some of the consequences of long term use. The ones that females in particular need to worry about are the absorption ones (anaemia, B12 deficiency, low calcium and low potassium), as we already have a higher risk of osteoporosis.

But short term use to get on top of symptoms is fine. They can also be taken on an 'as needed' basis which once on top of things might suit you better, and extend the period in which you feel comfortable taking them.

Hope they work for you!

This paper:

pmc.ncbi.nlm.nih.gov/articles/PMC10248387/

Various observational studies, clinical trials, and meta-analyses have established the adverse effects associated with the long-term use of proton pump inhibitors including renal disorders (acute interstitial nephritis, acute kidney injury, chronic kidney disease, and end-stage renal disease), cardiovascular risks (major adverse cardiovascular events, myocardial infarction, stent thrombosis, and stroke), fractures, infections (Clostridium difficile infection, community-acquired pneumonia, and Coronavirus disease 2019), micronutrient deficiencies (hypomagnesemia, anemia, vitamin B12 deficiency, hypocalcemia, hypokalemia), hypergastrinemia, cancers (gastric cancer, pancreatic cancer, colorectal cancer, hepatic cancer), hepatic encephalopathy, and dementia.

…

… patients with Barrett’s esophagus, severe esophagitis, and history of bleeding gastrointestinal ulcers and the users of long-term non-steroidal anti-inflammatory drugs (NSAIDs) may need long-term therapy of PPIs. Consequently, such patients should be monitored for adverse effects associated with the use of long-term PPI therapy.

Clinicians including prescribers and pharmacists should be aware of the adverse effects of taking proton pump inhibitors for an extended period of time.

As PPIs are prescribed so frequently, one has to wonder if, when a patient is diagnosed with one of the conditions mentioned in that list, whether any connection is made between it and long-term PPI use.

My daughter has a hiatus hernia and has been recommended Gaviscon Advance (not the regular one, ask for Advance) and it's really sorted her reflux out. Taking Omeprazole etc for a long time is apparently not a good idea. (Can't remember why but Dr. Google will know)

I started with 20mg Omeprazole, worked fine, now reduced to 10 mg - no problems

Google l glutamine for gut health. Might suit you. I was miserable/in pain and told it was caused by a rolling hiatus hernia. One teaspoon of powder in a little water each morning - no more bother. Powder is the least expensive and easiest to digest (Nature's Best). Of course do all the other sensible things too - (posture is the one I forget).

petra I’m not discounting what you say, but in my case the camera clearly showed a hiatus hernia, hence medication.

I take Esomeprazole 20 mg/day taken early morning, been on it for close on 15 years, works like a charm brilliant, try it hope it works for you,

Lifestyle changes did it for me, especially the drinking.

I had an endoscopy just after Covid and that was enough to makle me think I never wanted to go back there again!

Now I have lost weight but especially cut out the alcohol. Funny how the only time it comes back is when I'm start drinking again!

Not saying we're all the same but I can't remember the last time I took an antacid!

It would help a lot of sufferers if doctors were to test for low stomach acid production
The symptoms of which can mirror too much acid.
Instead they just accept what we tell them and then prescribe meds that stops what little acid we are producing.
Viscous circle.

zoe.com/learn/low-stomach-acid-symptoms#

I take Famotidine, 10mg twice a day, generally it works, I’m not allowed a proper dose from the prazole family of drugs, but can take a low dose very occasionally if needed. Famotidine means minor constipation for me.
Being contradictory, a glass or two of white wine now and then calms my reflux.
The head of our bed is raised with a block and yes, Gaviscon Advance at bedtime.

I have managed to get myself off Lansoprazole by a mix of measures,, I have a large glass of Kefir for breakfast, I eat a proper meal at lunchtime and if I'm going to have chocolate or fruit I have it then.. especially if it is citrus fruit. then I have something light before 6pm..

I have a glass of milk to sip throughout the night. and finally I take a large spoonful of Aniseed Advance Gaviscon at about 9-10 before I go to sleep.. and sleep with 3 pillows initially, usually losing one during the night if no reflux..

When I first stopped the Lansoprazol I had really bad heartburn and reflux, and was often vomiting during the night.. but it has now my stomach has settled with this new regime and I rarely have any discomfort now. If I feel any discomfort during the day I suck an antacid tablet but that is rare.. I feel so much better having discarded the prescribed medication..

Thanks SilverBrook. Endoscopy didn’t show any inflammation fortunately. The hospital prescribed Lansoprazole but because it didn’t agree with me I was unable to take it for the full 8 weeks. I’m hoping Esomeprazole will suit me better. I’m not overweight and am trying the lifestyle changes you mention. I could perhaps do better regarding sugar though so will bear that in mind. I believe Esomeprazole is more expensive than Lansoprazole which seems to be the NHS go-to for acid reflux!

In studies, Esomeprazole has been found better than Lansoprazole in treating erosive esophagitis - which is what can happen with uncontrolled reflux.

You said you'd had a normal endoscopy. So the results didn't mention any inflammation in the esophagus or any erosion?

All of the PPIs can have the same side effects: headaches, feeling sick, being sick, diarrhoea, constipation, stomach pain, flatulence. PPis change the way the digestive system works normally so there are bound to be side effects.

Thing is, once you start taking PPIs it can be hard to stop. As soon as the stomach goes back to producing the normal amount of acid it needs, you get more pain. You may already be in that situation.

What lifestyle changes have you tried? Diet and weight are the two main drivers in this. Too much belly fat pushes the acid up through the lower esophageal sphincter - which tends to weaken as we age - which is why so many older people suffer reflux.

Do you drink alcohol? That is one of the worst causes of reflux, especially for people who have a glass of wine in the evening. Sugar will have same effect. Wine is fermented sugar.

I remember watching an episode of the Food Doctor (years ago) where a singer was losing the upper register of her voice to acid reflux. She was gigging and then having a couple of glasses of wine to wind down. The acid reflux was burning her vocal chords. She stopped drinking, healed and got her full register back.