Thread: omeprazole not working as well anymore

Thanks for the replies all. I would of course love to get off these meRAB, but I've had such chronic, persistent GERD for so long I doubt whether it would work. At the moment I don't know if even doubling the dose I'm taking will get things under control, much less trying to cut back.

My reflux presents itself as pretty much constant heartburn that seems to have little to do with what I eat. (i.e. even if I fast for a day or two I get heartburn.) I rarely drink, don't smoke, am not overweight. I do sleep on 3 pillows but I am planning to get one of those wedges to sleep on. There are some other remedies I haven't tried yet like the apple vinegar and honey. Are there others I'm missing?

I read the term "lifestyle changes" alot and I think for a certain class of sufferers they can be quite effective, but unfortunately I don't think I'm one of them. I do think that PPI's can heal damage caused by acid of course (i.e. with ulcers and/or erosions), but I don't think they actually heal the main problem in my case which I believe is simply a very weak LES.

However that said I'm reluctant to up my PPI dose if at all possible. I'm hoping what I'm going through is some kind of "flare-up" that if I can just hang on with occasional Tums / H2 blockers that at least I can just stick with my 20mg omeprazole a day. Who knows, maybe if I'm bold I can try switching to the 10 mg pill one day.

I've been on omeprazole 20mg (generic Prilosec) for 12+ years (I'm 44) and it has been a miracle drug for me. It has controlled my symptoms wonderfully and as evidenced by a recent endoscopy has really protected my esophogus well. I was sort of hoping, concerns about long-term use aside, that I could pretty much just stay on it indefinitely.

Unfortunately in the last couple months it's effectiveness seems to be fading as I'm now getting breakthrough heartburn episodes - mainly burning and pain in the chest and night-time coughing problems. I'm worried that now I'm going to slide down a slippery slope of having to keep experimenting w/ different PPIs and H2 blockers at different dosages to try and get back the same control I've enjoyed for so many years.

My question is do people have much luck with switching meRAB & dosages once they've started getting a "tolerance" to a PPI like omeprazole? I'm really reluctant to go the surgery route unless I absolutely have no other choice, so I guess I'm looking for a little encouragement that I can perhaps continue getting by with the meRAB, thanks.

And all that time have you been taking some sort of reflux medication (PPI, H2 etc.) for the problem? Do you take other medications?

Do you have any stress, anxiety or depression currently?

What does your diet consist of?

I was like that as well, and switched to Nexium, it helps to control the burning.

I had the same thing happen. I just tried other PPI's until I found another that worked for me. That worked for years and years. Prevacid Solutabs were my preference after Protonix stopped working.

Eventually, though none of the PPI's helped. I had extremely severe reflux and was on double doses of PPI's thouigh.

Before I started jumping around with PPI's, my GI doc recommended supplementing with Gaviscon. Might be worth a try.

I agree that lifestyle changes aren't the answer for everyone. I do think it can keep things from getting as bad as they could. If your LES is physically not functioning correctly, no amount of medication and lifestyle changes will actually fix that. You are just trying to find the best way to control the symptoms.

This is just my opinion, but I would suggest kicking the Reflux drugs altogether. Once they've done they're job - heal/repair damage done by the disease - then there is no use for them. You will likely suffer a rebound effect from the drug for a little while, but that will level off and you should only need an OTC anti-acid for occasional heart burn. The problem most people suffer from reflux drugs is that they are a crutch. We think we can't live without them, because every time we have an upset stomach or heartburn we think we have acid reflux - both are common issues that everyone will get from time to time.

I don't say any of this stuff lightly, as I have suffered from the worst of it and I felt like you. When I was prescribed Zegerid (my last PPI) I thought I had found the miracle drug for acid reflux - then the charm wore off and I was back to square one, and had to make a choice - find a new drug or figure out a life without them. I am proud to say I have been doing great without the use of reflux drugs. It's not an easy thing to do, requires a good deal of lifestyle modification, but it can be done.

Like I said in the beginning, this is just an opinion. Everyone should take the advice of a medical professional over something they read in an online forum. But every once in awhile when you get frustrated that nothing they do seems to work then you have to take a chance.

I wish you well with your journey with GERD.

~Don

Yep I've been on antacid medication for probably 15 years or so. First was on Zantac for several years which worked great then eventually faded in effectiveness, then went on omeprazole 20mg and have been on that for around 12 years, and it has really been a miracle drug, allowing me to live life almost reflux-free until now (although I think it may have contributed to my IBS, which is another story).

It really seems to be a mechanical problem or something, as I will just reflux acid on a daily basis regardless of what I eat/drink. My diet isn't great I'll admit, but I have in the past gone on all kinRAB of different diets (for my IBS) and never noticed any difference with my GERD. When my acid is controlled with meRAB I can eat pizza, cheesburgers, burritos, etc. and drink beer, soda etc. and no worries. When it's not controlled then even the mildest, blandest diet of non-greasy, non-spicy fooRAB does nothing to stop it.

As far as stress, anxiety .. well feeling alot now but I believe it's rather a response to my recurring heartburn and not a cause. Stress and worry etc. are never good for any chronic condition, but I also believe with all due respect that it's often just a catch-all that the doctors use when they can't explain your problems.

Hi melkon,

have you thought about switching to Nexium, which is esomeprazole? Pretty much the same thing, except it is more bioavailable, more is absorbed better by the body. If you don't have insurance, the company that makes Nexium, AstraZeneca, has a prescription help program that is fairly broad with its income level limits, making it easy to qualify and get.

hello, the GI specialist recommend taking a PPI twice a day if a single dosing schedule stops working......30 minutes prior to eating and not before bed time....i.e., morning and dinner....the fact that your EGD is fine is very reassuring...have you tried BID dosing yet???
dr. cjp