By now you’ve probably heard about the dangerous side effects of proton pump inhibitors, more commonly referred to as as PPIs. These acid-suppressing drugs were once hailed for their effectiveness at decreasing the frequency of acid reflux caused by GERD and for their lack of harmful side effects. Today, the data is there, and it tells a different story.
PPIs were never meant to be used as a long-term solution for acid reflux and GERD. While the medication suppresses acid reflux and the other symptoms of GERD, it also leads to calcium malabsorption and osteoporosis, B12 deficiency and anemia, and SIBO (Small Intestine Bacterial Overgrowth) which causes bacteria to accumulate in the small intestine instead of in the large intestine, where it belongs. In addition to this, PPIs do nothing to treat the actual source of your reflux issues: an anatomical issue with the lower esophageal sphincter that prevents it from closing properly and allows acid to splash back up into the esophagus.
Patients are seeing all the recent data about the dangers of PPIs, and as they become more aware of safer alternative treatment methods for their GERD they’re making the choice to get off their medications. Unfortunately for many patients, quitting PPIs is easier said than done. It’s not something that can be done overnight, and patients feel the effects when they try to go cold turkey. Instead, we recommend slowly weaning yourself off your PPIs with the help of a reflux doctor. At Tampa Bay Reflux Center, we encourage all of our patients to take steps to wean themselves from PPIs and seek alternative treatment options like anti-reflux surgery, the only thing proven to effectively treat GERD long-term by correcting the LES and alleviating the symptoms of GERD.
Here are some steps you can take when weaning yourself off a PPI, as well as what to expect from the process.
As bad as PPIs are for you, quitting cold turkey can be even worse. PPIs work by blocking the production of acid in your stomach, but when you quit, it all hits you at once. Rebound hyperacidity often leads to people going back to their PPI.
In order to avoid this, we recommend a step by step system. But, before trying these steps, be sure to consult with your reflux doctor to make sure they apply to you.
Step 1: Begin alternating between 1 PPI/day and 2 PPIs/day. On days with 1 PPI, take the PPI with your largest meal. If needed, supplement with over the counter H2 blockers or antacid.
Step 2: After 2 weeks of alternating, reduce intake to approximately 1 PPI/day. Take the PPI with your largest meal. If needed, supplement with over the counter H2 blockers or antacid.
Step 3: After about 2 more weeks, you can try to transition off completely.
Always remember that diet and exercise play a part in your acid reflux and symptoms of GERD. When weaning, be sure to implement both diet and lifestyle changes. If your BMI is 25 or greater, consider a weight loss program before the weaning process to help reduce your acid reflux.
You can expect to experience more acid reflux while weaning yourself off PPIs than you did while you were on your PPIs. This is normal, as “acid surges” are a common side effect of the weaning process and may be treated with over the counter H2 blockers or antacid. These medications aren’t meant for long-term use either, but they can help you quit your PPI for good! Be sure to have a safe treatment plan that you can transition to once you quit your PPI. If you have any questions on alternative treatments options for acid reflux and GERD, be sure to contact our office or book an appointment!