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Message Icon Event: Medication Effectiveness - Event Date: 10áJaná2019 Post Reply Post New Topic
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andyrwhite
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Quote andyrwhite Replybullet Calendar Event: Medication Effectiveness
    Posted: 10áJaná2019 at 3:34pm
Lanzaprozole and Omeprazole stopped working for me, so now on 20 mg twice daily Esomeprazole . Definite improvement but I am not symptom free ie mild nausea, salty taste in mouth on waking ( bile? ) and ocassional belching. Some of this I know may be due to what I eat or drink. I wonder if bile salts do just as much damage as stomach acid and if so do PPI's reduce the effect? My segment has increased from a mere 0.5 cm to 3 cm and my next endoscopy is due on 19/1. Apparently size of segment doesn't correlate to any increased risk. I am currently Non Dysplaysia.
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chrisrob
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Quote chrisrob Replybullet Posted: 10áJaná2019 at 3:58pm
Hi Andy and welcome to the forum.

Acid reflux is a combination of acid and reflux. It's not so much you produce too much acid than the acid is not remaining where it's "safe" - ie the stomach that's protected to hold it.

PPIs (lansoprazole etc) were originally designed to reduce acid in the stomach to permit the healing of stomach ulcers. However, it was found they were immensely beneficial to anyone with acid reflux because they make what's refluxing less erosive. But PPIs do not stop the reflux iteslf. That has to be managed by lifestyle modification or surgery.

Because it's the only tool in a GP's armoury, if PPI's don't appear to be working, they'll change them to a different one, even though all PPIs are as effective as each other when taken in equivalent dose, and increase the dosage.

I personally was on 80mg omeprazole daily which was totally ineffective for my reflux, prior to my fundoplication.

The symptoms you describe do seem concommitant with reflux rather than acid so if you don't already:
  • eat small meals - little and often
  • leave at least 3 hours between last meal and going to bed
  • Do not do any exercise after food that involves tilting, squeezing or shaking the stomach until it has emptied a bit (about an hour or so)
  • avoid tight clothing
  • raise the head of the bed 8 inches / 10 cm on blocks


Bile is a bit like washing up liquid. By itself it won't damage your oesophagus but in combination with the acid can attempt to destroy the structure of the oesophagus.

You may find this free encyclopaedia helpful.
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andyrwhite
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Quote andyrwhite Replybullet Posted: 10áJaná2019 at 4:28pm
Many Thanks Chris. Useful advice.
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