Anyone taking Nexium for GERD?

[Torsten]

I've had reflux problems since I was 15 and nothing much has helped other than diet changes. Then a few weeks ago I came across Nexium, a relatively new PPI. It works like magic. In fact, it works so good that the first day I took a whole pill I still felt full 6 hours after a light meal as my tummy didn't seem to be digesting anything. I felt a little bit nauseous, but otherwise fine.

I reduced my dose to half a 20mg pill every 3 days as this was plenty to keep the GERD under control. Pretty amazing really. I just took the next half pill whenever I started getting reflux. Sadly over the course of three week the side effects have become worse and worse. if I take it on a full tummy then I feel nauseous for 5 hours, if I take it on empty tummy then I get a bad headache for hours. Sometimes I puke, mostly not. This might sound weird, but given the almost constant reflux discomfort [and the damage this can cause] I am quite happy to take a few hours of nausea every few days in my stride if that stops the reflux. I can't stand the headaches though.

Then last night just before bed I decided to take my half pill after eating just a light snack, hoping that the reduced food amount would decrease the nausea. I woke up 2 hours later feeling rather ill. This degenerated within minutes into a migraine like state with the full spectrum of migraine symptoms except the visual part [a clear indicator to me that it wasn't a migraine]. I violently puked for 20 minutes, passed out a few times and had hot and cold sweats for a couple of hours. My brain was so affected that I could not form a sentence, I could not see properly, and mostly writhed on the floor wimpering and puking. I could not even comprehend simple yes or no questions. Clearly a very toxic reaction.

This was from a mere 10mg, but as I said, the side effects seem to be getting stronger with each dose, so I am now scared to even take 5mg. Silly thing is that I probably only need 1 or 2mg/day to fix my reflux.

The reason why this is so important to me is because I noticed something very important in those two weeks while the nexium was working well. I had cut my food intake by nearly 50%!! Firstly I simply could not eat my normal size portions anymore, and secondly [which is more important I think], I did not need constant snacks throughout the day to calm my tummy down.

As I already eat very healthy foods [low GI, lots of vege and cereal, etc], I have long felt that the only way I could lose weight is by excercise and lower food intake. I don't mind an active lifestyle, but I hate excercise itself, so lower food intake has been my goal for a long time, but has been hindered by reflux. I lost 3 kilos in 2 weeks while on nexium, and I wasn't even paying attention to my weight or food intake.

So, my mission now is to get the reflux under control. Nexium works, but does not agree with me and I am hoping that maybe others have had experience with nexium and have found ways of managing the side effects. Ive' tried other PPIs and they have not helped, so I really need to try and make this one work.

Any advice appreciated.

[Amulte]

ive suffered reflux since a teenager myself and ive tried plenty, they work but never fix the problem and the idea of taking a pill every day shits me. tried various things prescription and non to fix it, at the point now its a suspected Helicobacter Pylori Infection as thats the last option.

http://www.cancer.gov/cancertopics/pdq/pre...ent/page2/print

[foolsbreath]

I've been up all night 3 times this week due to reflux, last night included

I'm going to the docs and getting a script, I'll let you know how I go with it, I usually take 300mg zantac, with some results, but not sustained, and when I stop the reflux seems much worse than before taking the zantac..

[reshroomED]

I took Nexium (40mg) for approx six months for GI problems.

Administering doc suggested to take as needed.

Chemist warned not to stop taking them suddenly.

Oncologist stated that my gastro problems were caused by not taking them constantly (at this stage taking at least one every three days as opposed to rec dosage of one per day). The story went that, as a proton-pump inhibitor, non-regular dosage would cause non-regular production of stomach acids and my stomach was 'chasing it's tale pH-wise' so to speak.

Personal experience was excessive gas build-up in stomach. Possible slight alleviation of reflux-type problems , but hard to tell with the constant bloated feeling.

Stopped taking them (against doc's recommendation and about twelve months ago) and found it uncomfortable for a few days but soon noticed little difference bar the lack of excess wind.

ed

[Evil Genius]

Hi Torsten,

i´ve had some Reflux Problems earlier in my life. The only medicamentations i took were Basica and omeprazol in order to reduce the acid. I´m not sure how they are getting called in Australia. I´ve stopped taking them as i wasn´t sure if i my problem was due to the acid and because i didn´t wanted to reduce it permanently. After taking some antibiotics, the reflux stopped. It probably was due to helicobacter. I can still remember that the Doctors told me not to eat after 18.oo as well as having a diet with low protein and low fat. They told me to sleep in a upright position. It takes some time and practice to find sleep but you can get used to it :-) It´s like sleeping in a boot camp.

You shouldn´t take antazida for a long time as the stomach produces more acid in this case. If you suffer from a very bad GERD, a surgery would be another option. I´ve heard that these type of surgeries aren´t very problematic. bye Eg

Edited March 9, 2007 by Evil Genius

[oxydiser]

As soon as you compromise the enteric coating of nexium (by splitting the tablet) you reduce the bioavailability of the dose ingested by 50% due to the acid lability of the compound. That said, the PPIs are a very well tolerated group of drugs but nausea/vomiting/headache are common side effects.... nonetheless the severity of your side effects is puzzling.

I would go back to the doctor to eliminate other conditions... ever had an barium meal/endoscopy? Could be pyloric stenosis/hernia or as amulte pointed out a H.pylori infection/induced ulcer.

Out of curiosity what other PPIs have you tried? IME they all have similar efficacy.

[Torsten]

As soon as you compromise the enteric coating of nexium (by splitting the tablet)

Nexium is designed to be dissolved for up to 30 minutes without compromising the enteric coating. The coating is not on the capsule itself, but on the tiny pellets the caplet contains in it's matrix. Splitting the capsule will not harm the pellets and will not compromise the enteric coating. I've been thinking about picking out single pellets and comsuming them thorughout the day to reduce dosage hit, but it would be very tedious.

That said, the PPIs are a very well tolerated group of drugs but nausea/vomiting/headache are common side effects.... nonetheless the severity of your side effects is puzzling.

Apparently migraines are not uncommon in people who get headaches from nexium. The escalating side effects do seem to be uncomon though - especially at this speed of increase.

I took a 1/6th capslet last night on full tummy and has flushes, skin tingles, mild nausea and dizziness for 3 hours.

I would go back to the doctor to eliminate other conditions... ever had an barium meal/endoscopy? Could be pyloric stenosis/hernia or as amulte pointed out a H.pylori infection/induced ulcer.

Have had ulcers before and was tested for pylori - negative. Docs been eliminating other things for a while, but to be honest the only thing that made any difference was elimnating gluten and lactose - which was my idea and it made a huge difference. The pepcids etc used to only reduce the symptoms caused by the gluten, so sine I have eliminated that they don't do anything anymore.

My doc(s) never found an endoscopy to be appropriate, but to be honest after 23 years of this I think it's about time.

Out of curiosity what other PPIs have you tried? IME they all have similar efficacy.

I don't remember the others. They had no effect. I presume they had no effect at the time because most of my reflux symptoms were due to gluten intolerance and I did not discover that until just over a year ago. ie, the gluten reflux was slightly affected by pepcid, but not PPIs. The remaining reflux condition is not affected by pepcid, but stronlgy controlled by PPIs. It's difficult to evaluate medications when the goalposts get moved all the time.

I'll be getting a script for some other ones to see how they go.

[Torsten]

I can still remember that the Doctors told me not to eat after 18.oo as well as having a diet with low protein and low fat.

My tummy never settles down, so the only way to stop it digesting itself is with antacids or food. The doc also recommended diet low in protein and fat, but I found on the internet that this is exactly the opposite of what helps most people (incl me). Cereals give me really bad reflux and anything sweetened is pure evil. Pasta and rice are also real bad. If they make up my last meal of the day I will not get any sleep even if it is many hours before.

They told me to sleep in a upright position.

yeah, this helps a lot. I also found that due to the shape of the stomach it is better to sleep on my left.

If you suffer from a very bad GERD, a surgery would be another option.

what exactly do they remove?

[Evil Genius]

what exactly do they remove?

It is possible to narrow the espophagus with a minimal invasive surgery. They only do this if it´s a very bad case and if the medicamental treatment isn´t successful. I´d keep this in mind in case you don´t get it under control using medicamentations. bye

edit: But you should definately be sure that your reflux is because the narrowness of your esophagus before thinking about a surgery. I hope you understand what i mean as I have Problems to say this in englisch. If your reflux has another cause, this kind of surgery probably won´t change a thing. In this case, The Best thing is probably a gastroscopy in order to see the anatomical structure of your esophagus. I´ve had one a few months ago. Compared to my colonoscopy, It was a very pleaseant checkup. I was pumped with dormicum and didn´t felt anything. I was very surprised because i always was afraid of that kind of checkup. I would definately do it again.

Edited March 10, 2007 by Evil Genius

[foolsbreath]

Bit off topic, but I have had some real stomach improvements of late using red rooibos tea. Initially IBS symptoms were worsened (including bloating and cramps) as well as mild head aches, but after several days these have abated and my reflux has lessened as well.

Rooibos tea contains almost no oxalic acid, making it a good beverage for people prone to kidney stones. Rooibos contains the following minerals: copper, iron and potassium, calcium, fluoride, zinc, manganese, alpha- hydroxy and magnesium. It has a high level of antioxidants (up to 50x that of green tea I have read, but cant confirm) and also contains superoxide dismutase (SOD). It also has really low levels of tannin. I used to drink coffee, and then switched to teas. All these drinks had reasonable levels of tannin, although tea was far less abrasive to my stomach than coffee, I think both were somewhat responsible for some of my problems.

It seems reducing my morning tannin intake is improving my stomach considerably. As tannin is known to reduce the intake of certain minerals and protein, it may well be related?

[Torsten]

I love rooibos. I am sure it is good for me.

I am persisting with the nexium, but I am trying a few tricks. Obviously there is a reason for the enteric coating on the pellets. I assumed this to be mostly to protect activity, but now I wonder if it might be for user comfort.

About 2 hours ago I put 1/2 nexium20 into a size 2 gel cap. then put this into a size0 and that into a size 00. I figured this will delay dissolution by about 20-30 minutes.

On a very hungry and totally empty tummy I swallowed the cap with about 300ml of weak blackcurrant juice cordial. I know that this cordial helps to minimise stomach retention time, ie the cap should be in the duodenum within 10 minutes or so.

The plan worked. I know the capsule has dissolved as I am feeling all the other side effect. In fact I am positively out of it at the moment, but this is a side effect I can handle

Other than still being very hungry my stomach is not complaining about the nexium. The secret is to make sure it doesn't dissolve in the stomach, so I've just ordered an enteric coating kit. That's a bit more reliable than triple capping.

This post is not just about the nexium stomach pains, but also about the use of triple capping to bypass the tummy with other things. eg, mdma could be ingested this way by people who have sensitive stomach walls or get bad reflux. Triple capping is by far less inconvenient than the whole 'rubber glove > pop and clinch' method

[dqd]

How long does the rubber glove have to be up there? I don't know if I could take a whole one first time, could I just cut off a couple of fingers then increase incrementally? Does the flockking increase absorbtion time?

Go with the endoscopy, I've been putting mine off for years, (no-one's sticking a handycam down my throat!! )

And yes, rooibos is the shit, helps me anyway

[strangebrew]

I've been getting bouts every 6 months or so for the last couple of years now. One or two courses of 40mg Somac (pantoprazole) taken twice a day seems to curb it , then I stop taking it and I'm right for a while. The last time it occurred my GP thought I should get it checked out but an endoscopy didn't turn up anything. It's nothing to worry about, just make sure you get a doc that knocks you out cold first.

It's frustrating, it doesn't seem to be ulcer related and I'd expect gastric reflux to be constant if the valve to my esophagous was dodgy but I guess getting it some of the time is still better than getting it all the time. Fingers crossed.

[Torsten]

strangebrew - seasonal foods? or seasonal lifestyle changes?

[strangebrew]

No, none of those, I can usually eat what I like but if I'm experiencing it I have noticed coffee and also peanut butter aren't that great.

It seems to me the last couple of times it occurred were simply due to lying down too quickly after eating. It's like once I've done that and presumably burnt my esophagus in some way, it takes ages to heal or something. PPI's are certainly a help, no side effects fortunately.