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20mg vs 40mg or 80mg

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Barrett's Oesophagus
Forum Discription: Your Questions about Barrett's Oesophagus
Printed Date: 03 Jun 2020 at 8:03am

Topic: 20mg vs 40mg or 80mg
Posted By: nasdaq
Subject: 20mg vs 40mg or 80mg
Date Posted: 22 Feb 2019 at 11:10am

as we all know that PPI can have side effects. My doc told me clearly that if I gonna eat healthy I will not have some deficiency syndrome.

Independent of that -> e.g.
Is the Vitamin B12 absorption better on 20mg than on 40mg?

If I´m taking ever two days 20mg PPI - Is this also better than taking everyday 20mg (In fact that PPI have a half-life of 5 days as I know)

Logically 20mg must be better - but I want to ask the experts.

Thank you

Posted By: chrisrob
Date Posted: 23 Feb 2019 at 10:56am
Side effects of PPIs are usually minimal and their prevalence is often exaggerated.

Absorption of soem essential minerals may be compromised when PPIs are used in high dose over a long period due to - induced hypochorhydria . Although appropriated in the duodenum, minerals may require the action of hydrochloric acid to convert them to chlorides which are more easily assimilated.

The best advice is to remain on the lowest dose of PPI that works. If you are worried about deficiencies, ask for a blood test. If found to be deficient, supplementation may be prescribed.

Prior to my fundoplication, I took omeprazole for years at 40mg daily. It was only after they were increased to 80mg for the last two or three years that I became anaemic and needed supplemental iron. I do still use 20mg omeprazole daily but have no indication of any deficiency (in fact my iron levels remain at a healthy high level).

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Posted By: nasdaq
Date Posted: 24 Feb 2019 at 11:33am
Thank you Chris!

I asked this because when I diagnosed my only symptom was coughing. I never had heartburn but I had regurgitation very often when I ate late and drinked too much beer (that started 20 years ago).

After my diagnosis I do my best - Raise my head when I sleep, eat the last meal   before 6 p.m. - ( more and more dinner canceling - last meal 4 pm and try not to eat fatty meals - I eat no instant dishes. Lot of fruits, rolled oats, vegetables and sometime beef or chicken. No Alcohol and 1 coffee a day.
(By the way when I would eat a big roast pork with fatty sauce - I still fell nothing)

My next check is in August.

I feel no pain, no regurgitation - no reflux and the cough disappeared to 99%. I have to burp after a meal (only air ) but I can control it. I sleep very well and in the morning I´m absolute fit - Thats my time for gym or running.

I also have to say that on my first diagnosis My esophagus was completely clear - no strictures and of course - no signs of acid damaged segments - only a visible <3cm Barrett ( Histological - Barrett Mucosa no dysplasia)

So I think about to stop the PPIs (20mg Pantoproazol). Of course I will discuss this with my GI - but first want to discuss this here - finding some people with the same situation.

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