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Medication Effectiveness

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Support Forum
Forum Discription: News and Events
Printed Date: 12 Jul 2020 at 7:51am

Topic: Medication Effectiveness
Posted By: andyrwhite
Subject: Medication Effectiveness
Date Posted: 10 Jan 2019 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.

Posted By: chrisrob
Date Posted: 10 Jan 2019 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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Posted By: andyrwhite
Date Posted: 10 Jan 2019 at 4:28pm
Many Thanks Chris. Useful advice.

Posted By: Merl@2018
Date Posted: 19 Feb 2019 at 7:34pm
Hi Andy, I read on ur prev msge re: salty taste in ur mouth after esomeprazole? I have had the salty,minty taste for 4 mos and have been om esomeprazole 20mg which GP increased to 40mg/day.However, with increased dose,the salty taste is still there everyday. Is it not a side effect of the esomeprazole?

Posted By: andyrwhite
Date Posted: 26 Feb 2019 at 10:07am
I have always thought it was bile salts but Chris will probably be able to tell us

Posted By: chrisrob
Date Posted: 26 Feb 2019 at 5:36pm
Do remember, PPIs (eg esomeprazole) are good at reducing acid but the reflux continues. It can be anything from your stomach.

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