tcab006@yahoo.com (t

I have been using Protonix for 2 years now. I recently started using
Prilosec OTC and found the results very good. I am sleeping much
better with Prilosec taken before dinner than with Protonix. However,
I do the 14 days worth then stop only to find that my reflux hits me
hard right away after a day or two. Is anyone taking Prilosec OTC
everyday and having/not having any problems?

thanks

me6

Ive been taking it pretty much daily now for abt 6 weeks.... until
they diagnosed what is going on with me. I had a gastric scope exam
last week and will go to doctor this week to see what he says abt
results.

Anyway..... Ive been taking Prilosec daily for abt 6 weeks now with no
bad side effects.

And hopefully it has effected a cure for whatever condition i have
had. I do feel better

howard mccollister

If the problem is GERD, then be aware that PPIs such as Prilosec don't
"cure" anything - they only suppress the symptoms by changing the nature of
the reflux from acid to alkaline. The resultant alkaline reflux also damages
the esophagus, but it doesn't cause the same degree of pain when it does
reflux.

If EGD shows that there is no damage to the esophagus (erosion, stricture,
Barrett's esophagus) then symptomatic relief may be appropriate, as long as
an ongoing surveillance plan by EGD is worked out, usually every couple of
years, to make sure the esophagus isn't sustaining ongoing damage.

HMc

me6

Now wait a minute. I was under impression that Nexium and Prilosec
actually ALLOW the healing of erosions caused by GERD. Not true?


I will speak to the doctor who did the EGD on me this Thursday. I
will then know what exactly is going on. They did the actual EGD abt
a week ago.... but couldn't get in to see the doctor til this week for
results.

They DID tell me after the procedure that they found a small papilloma
<sp?) But I was still kinda groggy and that is all I remember

howard mccollister

It's the acid that causes the erosions, so supressing the acid allows the
erosions to heal. Ulceration and erosion is possible from alkaline reflux,
but far less common. OTOH, there is chronic, ongoing damage from the
alkaline reflux that results from acid suppression. This can manifest itself
as pain, bad breath, foul taste, regurgitation, stricture formation, and
Barrett's esophagus.

Medication won't cure GERD, only suppress the symptoms.

HMc

me6

OK

So what actually cures GERD then?

Lifestyle changes such as elevated bed.... diet changes....etc?

howard mccollister

The cause of GERD is malfunction of the lower esophageal sphincter. The only
way to cure GERD is to correct that malfunction. Lifestyle changes such as
weight loss and diet manipulation with strict avoidance of certain foods
(foods that cause transient inappropriate LES relaxation) may address the
LES problem satisfactorily, but symptom management with medication, diet,
and bed elevation won't address it all. It would be like saying that a
diabetic keeping his/her blood sugars normalized with insulin "cures"
diabetes.

The definitive "cure" for GERD is surgical...eg. fundoplication, Stretta,
maybe Enteryx.

Again, symptom management may be appropriate if the symptoms are managed to
the patient's satisfaction and there is no evidence of ongoing esophageal
damage from reflux, but one shouldn't fool one's self into believing that
these things are actually curing GERD, or that they would ever have the
potential to do so. Doctors see patients all the time with advanced
Barrett's esophagus or stricture that report that they "used to have
terrible heartburn, but it went away as I got older". They've just finally
burned out their lower esophagus. It's likewise not uncommon to see patients
that report difficulty swallowing and are found to have a significant
stricture as the cause. They also often report severe reflux symptoms in the
past, which finally went away, yet the damage was ongoing.

HMc

me6

OK Howard thanks!

Ive learned a lot abt this from you .... and others.

I will see the doctor who did my gastric scope two weeks ago.....will
see him tomorrow Thursday. Then I will know for sure what is/was
going on.

I must say that Im feeling better the last week or so.

me6

Just had a thought....

If in fact I find out I have GERD..... is it wise to be "scoped" on a
regular basis? Say once a year....every two years?

howard mccollister

Yes, if you have GERD as diagnosed either by ambulatory pH testing or by
signs of GERD damage at EGD, you should follow an EGD surveillance protocol.
This might imply scopes every 1-5 years, depending on the findings at EGD.
Barrett's esophagus with dysplasia means EGD yearly. GERD with no visible
damage or changes might mean EGD in 5 years.

HMc