Acid rebound or unresolved underlying problem

Digestive health
1

I was diagnosed with reflux esophagitis last year when I underwent endoscopy and for some reason, the heartburn started again so I took 20mg AcipHex once a day for 2 weeks. It's been a week since I've stopped the PPI and I've been having trouble eating normal amount of food I used to eat before and suffering from constant bloating,  mild sensation of something stuck in my chest/throat, indigestion like symptoms and what I suspect constipation.

I'm not sure if what I'm experiencing is acid rebound (is it possible to experience acid rebound on 2 week long use of PPI) or my underlying problems hasn't been resolved with the 2 weeks of PPI treatment.

2

II would say the problem as not settled down yet usually takes longer then That for PPI meds to work and you would have to be on them much longer to get rebound I would of thought

3

Hi Coca,

PPI's do not resolve the problem besides killing all the acid which is not good for any of us, you suppose to have an acidic stomach. They only good for some symptoms and not all of us feel better with it. The long prolonged use of PPI's creates new symptoms and real problems. So your best option is to eat better.  Do a google search on acid reflux diet.

4

Unfortunately, the problem with PPIs is that they treat symptoms, and not the problem. A lot of people go on PPIs, and then go right back to eating like they normally do. It sounds like you had a problem one year ago, and took PPIs to fix the problem. You stopped PPI treatment, and went back to your old diet?

Now that the heartburn is back, the PPI treatment is no longer effective?

After experiencing bad silent reflux, and now having it under control somewhat with a new diet, I will never go back to what I used to eat. I never want to go through that again.

I think the majority of heartburn is caused by hietal hernias, or improper bacteria balance in the digestive system, or a combination of both. Stress was also a huge contributor to my reflux. A weak sphincture can be exposed with too much gas producing bacteria, or SIBO.

I have since gone on a low FODMAPS diet, and avoiding sugars, gluten, and alcohol. I do have a glass of wine or very low sugar cider once in awhile, and it seems to be fine. But, I'm convinced that my binge drinking one weekend was the cause of my reflux, so I'll never have more than 2-3 drinks in an entire week.

Reflux is absolutely miserable, so if you do find something that keeps it in check, never go back to your old diet or habits.

5

I have been experiencing the same thing for 8 months. A couple months ago my doctor prescribed me sucralfate. I still continue to take it but only half as much. I still get reflux but nothing like it was.

6

Hi,

I had mild reflux last year and got worst after stress and worriying.  This year again I got it back.  Doc told me it was due to indigestion and I never eat any fremented food.  You are right stress and wrong food caused reflux.  I having a lump feeling in my throat for many years, warm feeling in my abdomen and now I feel my toungue has needle pricking.  No idea what to do except to eat right and worry less.  I have given up hope on Medicine they do nothing. If you have healed it please share your tips with me.  I had this issue after working with my a new boss and caring for bed bound dad.

 

7

I wouldn't say I have completely healed, but it has gotten A LOT better.  It has taken months to get to the point of it being comfortable.  It went fro bad to really bad over a course of 5-6 months.  Over that span, I made small changes in my diet.  I did all the things doctors recommended; removed acidic foods, no coffee, no soda, etc.  I was growing impatient, and very stressed out over my condition.  Things continued to get worse, no matter what I tried.

I then did everything I could to reduce stress, and my faith and prayer was the biggest thing to help me cope.  I do believe God played a role in guiding me towards healing for me, since the doctors didn't do anything at all.

I think what helps us heal will be different for everyone, but the number one thing everyone with GERD needs to do is reduce and eliminate as much stress as possible.

I then started reading about inflamatory foods, and as it turned out, most of these inflamatory foods are also removed from most GERD reducing diets (FODMAPS, PALEO, SIBO diets, etc).  The number one is Gluten.  I removed Gluten, dairy, removed sugars (except for honey), eliminated sodas, eliminated alcohol, especially beer, limited myself to 1 serving of fruit per day.  I began to eat very lean protein (chicken, fish, eggs, etc.), veggies, .  It took a fairly long time for my diet to really begin to show a difference.  I began to eat a clove of garlic each day, and this seemed to really improve my condition much faster than anything else.  If you can't eat raw garlic, I recommend baking a bunch in tin foil, and keeping it in the fridge each week.  Don't measure success in days, but instead weeks.

I still believe I had some sort of imbalance in my gut flora (bacteria in the digestive tract).  I still struggle to get that balance optimal, but it seems to be slowly getting better.

Good luck.

8

It's been 10 days since I've stopped my PPI and few days after I post this discussion.

It turned out I had delayed gastric emptying induced by PPI! The doctor at first thought that it might have been unresolved underlying problem due to the short use but after few more probing, time, and changing doctors, my new doctor said that she believes I might have temporary delayed gastric emptying.

The symptoms are: bloating, fullness, excessive burping, indigestion-like symptoms, constipation, as well as acid reflux. She explained that due to PPI inhibiting up to 90% of my acid secretion, the solid food weren't as digesting as fast as normal people would and was just sitting in my stomach because I only had about 10% of acid to break it down! Which is why I was suffering from acid reflux because the undigested food was coming back up my throat. She said that not many doctors are aware of this information because 1) it is largely unexplored 2) it's only recent that research has been looking on to this issues.

She told me to give a few weeks until my stomach acid returns to normal level and to come back if my symptoms doesn't seemed to improve. Yesterday, I managed to eat probably around 2000 calories. I'm feeling much better now, no acid reflux (unless I push it and try to return to my normal eating habit too quickly or overeat in one sitting), no more excessive burping, constpiaton hungry more often and bloating has gone down considerably

I've googled PPI induced delayed gastric emptying and it seems its more common than I've thought as. My new doctor also warned me that she don't really like to prescribe PPI to her patients because sometimes PPI can lower the level of stomach acid permanently.

9

Hi gomer, I'm really sorry to hear this. It's horrible condition I wouldn't wish to anyone. My new doctor has diagnosed it as 'PPI induced delayed gastric emptying.'

It's basically due to PPI inhibiting your stomach acid secretion that your stomach doesn't have enough acid to break your food down which resulted in your food sitting in your stomach and causing reflux as your undigested food comes up to your throat as well as constipation. The symptoms of delayed gastric emptying is bloating, excessive burping, constipation/diarrhoea, constant fullness, acid reflux/GERD, abdominal distension, cramp.

Thankfully my new doctor told me that because its medication induced condition, it's temporary and it will go away albeit slowly when PPI is stopped. Not alot of doctors knows about this because the effect of PPI on gastric emptying hasn't been studied until recently and quite difficult to distinguish between GERD vs GERD symptoms due to delayed gastric emptying. 

It was quite difficult for me to trust my new doctor because my previous one was saying she wanted me to try different PPI etc, but my new doctor told me to stop the medication and give it a couple of weeks for my acid level to become normal. She said that the longer a person been on PPI the longer the delayed gastric emptying will last even after the discontinuation of medication. Since I was only on it for 2 weeks, its been 10 days since I've stopped it and I managed to eat around 2000 calories yesterday and am feeling much better than yesterday today. So although I'm not a medical professional and I don't know your medical history, I suggest that you try and google PPI induced delayed gastric emptying and its symptoms to see if it matches yours. The only person who knows more aboout your body other than your doctor is YOU. I, semiconsciously, knew that taking PPI would worsen them, I also felt as if the food was just sitting in my stomach and not going down. It was a lot like indigestion symptoms.

I hope you get better,

10

Hello, I have gotten better!

It turned out to be 'PPI reduced delayed gastric emptying'. My doctor told me if the symptoms doesn't better few weeks even after stopping my medication to come back so she could arrange for endoscopy. Have you tried endoscopy to see what is going on? I live in UK so I could get them done for free but I also had endoscopy in other country that are privatised and need health insurance quite cheaply. My home country is Korea and if you have insurance (which I do), its quite cheap. I think it only costed me about 100 dollars for endoscopy much cheaper than if you have gone private in UK which is around 1000-5000 pound. 

My PPI induced delayed gastric emptying symptoms was basically indgestion like symptoms. acid reflux, bloating, excessive burping, feeling food sitting in my stomach for abnormally long time, constipation etc. 

I also tried to lessen the amount of stress which is quite difficult, but stress is the biggest factor in GERD.

It might be that your physical sensation is psychosomatic (I'm a psychology major and have experienced this when I was in lot of high stress and anxiety).

It's basically when your stress (which is psychologically) manifest itself in physical symptoms. It usually happens when an individual is under a lot of stress/anxiety (more than what they can handle mentally) and this shows physically but doctors can't really find physical evidence of what is causing these physical symptoms. So if medication hasn't worked, it might be that stress is the trigger. I had a really severe GERD symptoms last year when I was going through exam and financial stress and my doctor who performed endoscopy couldn't find any inflammation, weak stomach opening etc. He was really puzzled as to what was causing heartburn. So he suggested that it might be psychological and true to his words, when my exams was over and my financial situation gotten a bit better and stable, it went away (although slowly). So I suggest that you find an outlet for the stressy you're going through. For me, I like to weightlift as an outlet for my stress. I really hope you get better.