What if: What if you have gastric reflux problems and you are on a PPI, a proton pump inhibitor such as Prilosec or the many other PPIs? And what if you have been on one of these for many years? For instance I was put on Prevacid about 40 years ago and stayed on this or some other PPI for most of the years since. No doctor of mine ever mentioned any long term side effects from this even though it is well known that these drugs are not to be taken long term. Since I am a physician I should have done my own research. But all my lab results were within normal limits and since I was very busy with my medical practice I just assumed it was OK for me to stay on my PPI. The PPI I was on controlled my GERD so I continued to take Prevacid for many years. About 10 years or so ago my family doctor informed me that I had stage 3 chronic kidney disease. Yikes!!No one in my family had ever had any kidney problems that I knew of. That family doctor did not mention to me that my long term use of a PPI could have caused my kidney disease. In the meantime I was suffering from IBS (irritable bowel syndrome). The episodes of this were devastating so I consulted a Gastroenterologist. He scheduled me to be scoped (EGD) and afterward called me personally to tell me I had Barrett’s esophagus. I was horrified as my Aunt died from esophageal cancer. I did my own research to find that Barrett’s esophagus is a risk factor for cancer but the risk is low which my GI guy did tell me. He also scheduled me for a colonoscopy which revealed a lot of diverticula in my colon and I had suffered from a couple of bouts of diverticulitis which is not fun. But my main concern at that point was my “Barrett’s” and my “IBS”. I did some major research and found that PPIs could cause IBS but that it iis controversial. All during that time I also consulted with some friends who were (are) GI guys. Two of the four I consulted actually recommended some of the several surgical remedies for GERD. Two of them did not recommend it for me. My age and other factors were under consideration. I also did not want any of the surgical options. But back to my problem of episodes of IBS which by the way were getting worse and worse with the vomiting and diarrhea, and SEVERE pain I knew I had to do something. I feel that I am living proof that PPIs can cause IBS plus the added problem of the PPIs causing my kidney disease. So I decided to go off the PPIs and just use an H2Blocker such as Famotidine.This decision was with the help of my GI guy as well as my Pharmacist. It is well documented that PPIs are much more effective to control gastric reflux than H2Blockers but H2Blockers do not damage your kidneys or cause IBS to the extent the PPIs do. So that is what I have been on; Famotidine 40 mg. twice a day. Guess what? I have not had an episode of IBS since. There is a problem of “silent” GERD which I had never heard of in all my research but a problem that needs to be addressed especially in my case. So, as long as my Famotidine works I will stay on this (plus all conservative measures including diet restrictions) as well as considerations of annual EGDs rather than every 3 years.
Now, why or how do PPIs cause IBS. My research says that PPIs cause SIBO. This is small intestine bacterial overgrowth. We all know how important bacteria are in our digestive process. We also know that we have good and bad bacteria. So, we need to be sure to increase our good bacteria. How do we do that? Take lots of probiotics. One of the best is VSL#3. This is expensive but if your doctor prescribes it your insurance may help pay for it. It can be bought over the counter also. It must be kept refrigerated though and this could be a problem for some people. Align is also good. Fermented foods such as sauerkraut are good. Kefir and Chobani Greek Yogart are good.
I do hope I have helped even one person out there that suffers from GERD and or IBS and or chronic kidney disease. Would love to hear from you with questions or comments.
Thanks.
