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PPIs and weight changes

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URL: http://www.barrettscampaign.org.uk/forum//forum_posts.asp?TID=505
Printed Date: 20 Jul 2019 at 7:12am


Topic: PPIs and weight changes
Posted By: chrisrob
Subject: PPIs and weight changes
Date Posted: 29 Oct 2010 at 4:02pm
Amongst side effects reported for Proton Pump Inhibitors (Omeprazole, Lansoprazole, Pantoprazole etc.) are weight gain and weight loss.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761557/ - This recent study has looked at weight gain, for example and one of our forum members recently indicated he/she had gained weight from PPI usage.

I was wondering how common this is. Has your weight been affected by the use of these drugs?

I know this isn't a very scientific study, but the results may be interesting?

Chris



Replies:
Posted By: mrstella
Date Posted: 29 Oct 2010 at 5:47pm

I have gained weight since taking PPI's but i would guess that is down to being able to eat easier and no doubt to the choccy addiction i have now developed.



Posted By: jcombs99
Date Posted: 29 Oct 2010 at 6:36pm
Folks
   It's not the ppi's your takeing it's the stress of dealing with your new found barretts I gained 20 lbs. THEN lost 40 lbs ..That's why you ablate it........

HGD JEFF


Posted By: BooBoo
Date Posted: 30 Oct 2010 at 10:47am
Hi, I have put on about 20lbs  since being on Omeprazole and then get told it won't help my barrett's being over weight. Another losing battle to try and fight


Posted By: RichardT
Date Posted: 30 Oct 2010 at 2:51pm
Weight gain could be because
your diet has changed
the medication is making you retain water
your digestion has changed because of the reduced acid - though I think in theory any change there would make you loose weigh.

I know from personal experience that I have a threshold weight over which my body gets stressed - and reflux does indeed get worse.

Having a digestive problem does mean that one needs to re-adjust ones diet and perhaps re-train ones food habits. I'm lucky in that I have always liked vegetables and salads, so cutting down on meat and other fattening food has not been difficult.

But there are foods which are much less fattening than their calorie count would indicate. Coconut and peanuts are two. Other tree nuts also are probably a lot more healthy than we have been taught. I can give more info if anyone is interested.

-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: shaddy
Date Posted: 02 Nov 2010 at 5:07pm
hi chrisrob, did u get my reply shaddy.


Posted By: chrisrob
Date Posted: 02 Nov 2010 at 8:24pm
Hi Shaddy,

I've been out all afternoon but have just responded to your PM.

Chris


Posted By: bouncethruit
Date Posted: 07 Nov 2010 at 12:13pm
Dear Richard
 
You have just hit the nail on the head, since taking PPI's I have noticed I am always drinking tea or coffee and I thought it was my imagination...
 
I think that you do retain water most definately and "bloat" out
 
I am only happy when I'm swallowing cubes of jelly because they are easier to swallow, but I'm fighting to keep weight on, I guess its all down to the individual and their particular lifestyle.  
 
Happy Days!Embarrassed


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GfromWalesUK


Posted By: RichardT
Date Posted: 09 Nov 2010 at 8:15am
> I think that you do retain water most definately and "bloat" out. 

Curious. Makes me wonder why.

A complete guess:
PPIs are metabolised by the liver, not by the kidneys. Water is excreted via the kidneys of course. So the PPI must somehow be affecting kidney function. Maybe the kidneys don't like the high PPI level in the blood so are retaining water to avoind increasing the concentration.

What is your blood pressure like? If you retain water - that could be high. BP monitors are cheap. Get one.

I suppose you might be able to increase kidney function by eating, for instance, more salt. Salt is removed by the kidneys and doing so removes water in the process.

We are told salt raises blood pressure: the best I can find on this is that it does - but only in some people who have a certain gene (so it's an ethnic thing). If you drink enough water, salt is not a problem to most people.

As I said - a complete guess. I would not want to counter one chemical by using another. It's too much like a doctor prescribing pills to offset the side effects of other pills! Athough salt is hardly dangerous.


-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: Terrapin54
Date Posted: 11 Dec 2010 at 12:07pm
Originally posted by bouncethruit

Dear Richard
 
 
I am only happy when I'm swallowing cubes of jelly because they are easier to swallow, but I'm fighting to keep weight on, I guess its all down to the individual and their particular lifestyle.  
 
Happy Days!Embarrassed
Looks like your in good company. Allegedly, George Osborne's favourite snack are orange jelly cubes!LOL


Posted By: Terrapin54
Date Posted: 12 Feb 2011 at 6:58pm
Hi Richard,
I've just voted about putting on weight, which makes me happy. Two months ago I was down to 59 kilos (from my 'normal' 72 k) but since I've been on PPI's I have regained my appetite and am now at 63.6 Kgs (hospital scales). I can only put down to PPI's, as before that I had no appetite and ate very sparsely.
RichardBig%20smile


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Whereof of one cannot speak, one must remain silent.


Posted By: Carolyn
Date Posted: 22 Mar 2011 at 9:20pm
Since I was diagnosed I have lost about 10kg - gone from 73kg to 63kg.   Not sure if it is the PPI (Lanzoprazole) or the fact I stopped drinking rum and coke most evenings and instead have a glass of wine - usually red. I have had heartburn for more years than I can remember (am now 69) and the PPI certainly work for me with no side effects tho I could not take Dr. Reddys Omeprazole. My appetite is good, I exercise regularly and feel good. Just have to forget the Barretts as my next scope is not until next February (2012)I do worry sometimes.


Posted By: johnd
Date Posted: 22 Mar 2011 at 11:20pm
Well after being diagnosed and put on Omeprazole I have to confess that at this stage I could eat anything in any quantity, I think I had better renew the gym membership or else all hell will break loose. It's a strange feeling, on the one hand you have been just told you have something scary, and on the other you have the cure to what I now realise was years of discomfort. You had a problem with Dr Reddy's?

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55yo, diagnosed 2011 at 5cm Barrett's, 3cm as at 2013 (?), so far non-D


Posted By: RichardT
Date Posted: 23 Mar 2011 at 8:19am
> I was diagnosed I have lost about 10kg - gone from 73kg to 63kg. Not sure
> if it is the PPI (Lanzoprazole) or the fact I stopped drinking rum and
> coke most evenings and instead have a glass of wine - usually red.

Acid production is part of an immensely complicated hormonal system. Food ingestion triggers the process and various steps are controlled by acid levels is duodenum and other places. Some of the hormones control bile an pancreatic secretions. Some of the hormones affect the brain causing a feeling of fullness.

Interfering with acid production interferes with the whole system with unpredictable results and it's incredible that more side-effects are not reported. In your case it's quite possible that one side effect is that your appetite is altered. Standard Coke however is full of calories so, unless you were drinking low-calorie Coke, that is probably the answer. But loosing weight is no bad thing surely!



-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: Carolyn
Date Posted: 23 Mar 2011 at 9:18am
Hi Johnd:   I was diagnosed about 15 months ago and given Dr. Reddys omeprazole = made me feel really nauseous. The same applied to Dr. Reddys thyroxine. (a cheap version made in India I think). I changed to Lanzoprazole and have had no problems apart from the weight loss. I am 69 and have a 5cm Barretts with LG Dysplasia.
I had scopes every 3 months but now don't need another for a year. They just keep an eye on it here and won't do anything unless it becomes High Grade. I feel well, go to the gym, play a bit of golf and lawn bowls and just have to forget about my problem unless other symptoms show. I was told to eat anything I like in moderation, so life goes on. Have had heartburn for at least 40 years but didn't realise it was doing any damage so just chewed gaviscon if needed.


Posted By: chrisrob
Date Posted: 23 Mar 2011 at 11:33am
Peculiarly, when I was first on omeprazole, although usually the pharmacist dispensed a generic version, he occasionally (presumably because of his stock levels?) dispensed the branded "Losec". I found, although according to the patient information sheets they were identical, the Losec was much more effective.
I discussed this with my doctor who said it could be something to do with the size of the granules or the thickness of the enteric capsule but was happy to specify "Losec" on future prescriptions. When I then moved, my new doctor said it was rubbish and only prescribed generic omeprazole which, when it was less effective, she increased the dosage of.

Sorry to have gone off topic a bit.

Carolyn, weight loss (or, indeed, weight gain) are often noticed when diagnosed. But keep an eye on it. If it continues too much or too quickly, speak to your doctor about it. It's one thing to lose weight if you need to but you need to ensure it's under your control.

Your LGD obviously has shown no signs of worsening which is why the consultant feels annual surveillance will be frequent enough for you.
Although NICE guidelines recommend HALO for HGD, it can be used for LGD if the consultant makes a case for it, so if it does worry you, you could ask about going down that route.

All the best

Chris


Posted By: jcombs99
Date Posted: 23 Mar 2011 at 12:08pm
C
    Remember if it turns to HGD (like I HAD)you'll get two options CUT it out or ablate it .Why not beat it like right now and see if you can get in that LGD clinic trial (halo) and be done with it ..How many second opinions did you have?? The doctors say every 6 months scope (EGD) for LGD..
HGD JEFF

" It's better to ablate then wait "


Posted By: RichardT
Date Posted: 23 Mar 2011 at 12:13pm
> the Losec was much more effective.
> I discussed this with my doctor who said it could be something to do with
> the size of the granules or the thickness of the enteric capsule

I've been wondering about the effect of these... The intended action is that the capsule dissolves in the stomach releasing the granules which then take a time to absorb water and burst open. By that time they should be in the gut out of an acid area. However if you try dissolving the capsule, it takes quite a while - it first goes to a sticky mess.

Since I split the 10mG doses in half, I have gotten out of the habit of eating the capsule - all those colourings and other unknown rubbish have never appealed! The granules on their own are likely to pass much quicker through the stomach - especially is it is empty - straight into the intestine, so the whole process is shortened and probably more predictable

There are minor chemical differences between some of the various brands and this could affect the generic effect. However, the half-lives of all the types seen to be short, so the standard dosage is wrong and the effective overdose levels could be causing the differences betwen various brands.

-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: Carolyn
Date Posted: 25 Mar 2011 at 1:29am
Hi to all in the UK and USA.   I live in New Zealand, so Jeff, thanks for the advice, but we don't appear to have any Halo trials going here, and my specialist told me that despite what I have read, ablation IS a big deal and I cannot get it done in New Zealand until it goes HGrade. So I must just continue with my 30mg Lanzoprazole mornings and 300mg ranitidine at night. A retired pathologist I have contact with says I am being treated aggressively and he has seen LGD just dry up and disappear, so I am hoping that is what will happen with mine. My only other problem is sometimes food sticks (like raw apple or carrot) in my throat but the specialist checked me out and says all is OK there. So I just have to put it behind me, but I do read about everyone elses problems on this forum and find it a great way to keep up to date with goings on and reassuring. Thanks everyone.


Posted By: johnd
Date Posted: 25 Mar 2011 at 8:24am
Carolyn

HALO: although this seems like a magic bullet, the gastro's in the UK seem to be not quite sure about it unless its HGD. It would be great if Barrets did just 'go away', it would be a weight off my mind.

I'm on 20 to 30 Omeprazole a day, I take 20 in the evening and sometimes 10 in the morning. I don't know why but I think a smaller dose twice daily is better than once.

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55yo, diagnosed 2011 at 5cm Barrett's, 3cm as at 2013 (?), so far non-D


Posted By: RichardT
Date Posted: 25 Mar 2011 at 9:51am
> It would be great if Barrets did just 'go away', it would be a weight off my
> mind.

My own feeling is that plain Barrett's is of itself a plain adaptation to acid/bile reflux. I think it is modern bad diet and lifestyle that leads separately to Barrett's then to cancer. Change your diet and lifestyle, I think it's probable you will live with barrett's indefinitely. Though it can regress - mine is now showing islands of normal cells.

All too little is known about the causes!


> I'm on 20 to 30 Omeprazole a day, I take 20 in the evening and sometimes 10
> in the morning. I don't know why but I think a smaller dose daily is better
> than once.

Omeprazole has a very short half-life. My own experience is around 2 hours. 20mG lasts about 18 hours. 10mG about 15. That means little and often is certainly the best way to go. It's all written up on my www site.

-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: chrisrob
Date Posted: 25 Mar 2011 at 12:02pm
Hi Carolyn,

The bodies overseeing treatment in different countries have to be cautious - they are too worried of the consequences if they get it wrong.
I don't know who that body is in NZ but in UK it's NICE and their guidelines are available on this site http://www.barrettscampaign.org.uk/nice-guidelines.html - here.
So it's really only recommended here for HGD presently though LGD "trials" are being undertaken. Until there's more data available on the outcomes for LGD patients, it's unlikely the recommendations will change.

You do seem to be on a very high medication level for both your lansoprazole and your ranitidine but assuming they'r keeping your symptoms under control, perhaps you shouldn't worry too much.

Although it has been know for Barrett's to go away by itself it is not that common. However, by keeping acid reflux under control, hopefully the Barrett's won't spread or get any worse.

We do not know all the causes of Barrett's. The most common assumption is that much may well be due to diet and lifestyle though there are also genetic factors and other factors that are the subject of much research presently. (Google: NF-kB, PEA3, T4 if you dare.)

But remember, only a small proportion of people with Barrett's will go on to develop cancer - and they won't be the ones being regularly screened!

All the ebst

Chris


Posted By: RichardT
Date Posted: 25 Mar 2011 at 2:32pm
> We do not know all the causes of Barrett's.

Is there any doubt that Barrett's is caused by acid (or, maybe, bile) reflux?

If the oesophagus is badly attacked by reflux - what choice do the cels have? Get eroded? Ulcerate? Or change into intestinal type cells , i.e. Barrett's. Surely metamorphosong is the safest.

> The most common assumption is that much may well be due to diet
> and lifestyle though there are also genetic factors and other
> factors that are the subject of much research presently.

Genetics and life style most certainly play their parts in the cause of reflux. Hiatal hernias are certainly often genetic in origin. Obesity is certaunly lifestyle.

One should not confuse the causes of the disease (reflux) with the body's response to that problem!

-------------
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org



Posted By: jcombs99
Date Posted: 25 Mar 2011 at 2:43pm
C
   In New Zealand maybe Halo is a big deal (new) but in the USA with the right doctor it isn't.. My doctor treats ALL types of barretts..NO ONE has ever died of HALO WOW!!!. Not bad maybe these barrx people know what their doing .My doctor has done over 3000 halos as of last yr..No one by him as ever died of cancer after it was haloed (HGD) if thats all they had when they came in(50% have cancer with HGD)..
   I'm sure in 3 to 5 yrs everyone will be ablating just barretts till then you have to pay or wait.
   Work with your doctors on the drugs I went from 60mg a day to 30mg, but thats the lowest I will go..

Good luck with your treatments and tests more is better in this case..

HGD JEFF


Posted By: Yaya
Date Posted: 08 Jun 2019 at 11:38pm
Hi Jeff,
Im the mother of a 19 years old who has a 1 cm of Barrett no dysplasic and an hernia hiatal around 3 cm. Living in USA
I will be interested to know the name of your surgeon who did 1000 halos!
Thank you so much and have nice weekend

Yaya


Posted By: Cinders
Date Posted: 08 Jul 2019 at 4:20pm
How common IS it FOR long term users to have to increase the daily dosage of omneprazole to 60mg? I've been on omneprazole for 20years


Posted By: chrisrob
Date Posted: 09 Jul 2019 at 7:41am
Usually most people manage on 20mg omeprazole as a low maintenance dose. The guidelines say to use the lowest dose that works for you.
Why are you having to increase your dose? If you think your omeprazole is no longer working, have you tried a different one like lansoprazole? Your GP should be able to write a different script. (30mg lansoprazole is equivalent to 20mg omeprazole.)
If you are still getting acid refluxing, it may be right to increase the dose, if that helps. However, is it the acid, burning, that's causing the problem (ie oesophagitis) or reflux (with symptoms such as cough)?

Reflux which should be managed by https://sites.google.com/site/downwithacid2/home/reflux/reflux-remedies - lifestyle modification or, if necessary, https://sites.google.com/site/downwithacid2/home/reflux/reflux-reduction/fundoplication - surgery .

http://https://www.academia.edu/33849157/Prevalence_of_Extra-Oesophageal_Reflux_symptoms_amongst_acid_refluxers_and_perceived_efficacy_of_regular_medication_and_reflux_reduction_intervention - PPIs reduce acid not reflux : they just make it less erosive.

I was on 80mg omeprazole for a few years until I had a fundoplication.

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk



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