Heartburn Support - pepcid to prevacid...now no appetite? and..

Author

pepcid to prevacid...now no appetite? and..

Domenic

2005-03-23, 5:11 pm

Need some advice please, I'm 40, for many years (maybe 20) I've had
reflux. About a year or so ago I was diagnosed with a hiatial hernia
and h. pylori. I took the antibiotics for the h. pylori (not fun). I
assumed it worked only because my kids aren't complaining about my
breath anymore. I was put on pepcid for the reflux, this seemed to
work but recently everytime I would turn over in bed I would feel
slight nausea, I would also occasionally get a sharp pain and a
feeling like I was sleeping on a golf ball. My doc suggested I switch
to prevacid to see if it helped. I asked to have an endoscopy done.
Consultation completed, appt for procedute made for the end of March,
Now although nausea seems to have gone away at night, I have almost
zero appetite, although I could stand to lose 20lbs(5'10 193 and
dropping from 200) I'm concerned, does anyone know if prevacid causes
this? I have'nt been able to find anything related to this other than
loss of appetite being a "rare" side effect. I have'nt taken it since
Friday night and its now Sunday Morning yet I still have no appetite,
even when I eat something its only because I know I need to eat and
not because I'm hungry. Any ideas about my appetite? I'm getting a
little panicy with all the "cancer" stuff I'm reading related to
reflux and h. pylori for that matter.

Thanks for any help

Dom

John Que

2005-03-23, 5:11 pm

"Domenic" <arabia1@hotmail.com> wrote in message
news:fb540e1e.0503200644.15840b7e@posting.google.com...
> Need some advice please, I'm 40, for many years (maybe 20) I've had
> reflux. About a year or so ago I was diagnosed with a hiatial hernia
> and h. pylori. I took the antibiotics for the h. pylori (not fun).

Recently? As clarithromycin (Biaxin USA drug name) can
cause a range of adverse reactions in the GI such
a diarrhea, nausea, abnormal taste, heartburn (h. pylori
suppresses acid production) and abdominal pain in
1 to 10% of cases.

> I
> assumed it worked only because my kids aren't complaining about my
> breath anymore.

Is it wise to assume? Or did they do the breath test?

> I was put on pepcid for the reflux, this seemed to
> work but recently everytime I would turn over in bed I would feel
> slight nausea, I would also occasionally get a sharp pain and a
> feeling like I was sleeping on a golf ball.

There are so many things that can go wrong, it is hard
to know. When I was on Pepcid I got stomach cramps
which cleared up when on Aciphex. But then again
I got stomach cramps on a lower dose of
another PPI med which cleared up with a
double 40 milligram dose.

> My doc suggested I switch
> to prevacid to see if it helped. I asked to have an endoscopy done.
> Consultation completed, appt for procedute made for the end of March,
> Now although nausea seems to have gone away at night, I have almost
> zero appetite,

Are you on any other meds. Do you have an aversion to food?
The drug book lists diarrhea, dizziness, headache,
and rash in the greater than 10% catagory and
in the 1 to 10% catagory abdominal pain, nausea, increased
appetite, hypergatrinoma., fatigue (which I'll suggest is IMO
the result of depressed androgen levels as well as direct
nervous system toxicity). In the less than 1% of users proteinuria,
thrombocytopenia and anaphylactoid reaction.

Remember all these meds in the PPI med class have
adverse effects. I won't take them as a long term
solution. I am not impressed with the H2 blockers.

I will suggest sleeping in a recliner with the
back set at 30 to 40 degrees and a huge pad
on the leg rest to prevent DVTs. I believe
the bulk of reflux damage takes place
when one is laying down.

>although I could stand to lose 20lbs(5'10 193 and
> dropping from 200) I'm concerned, does anyone know if prevacid causes
> this? I have'nt been able to find anything related to this other than
> loss of appetite being a "rare" side effect. I have'nt taken it since
> Friday night and its now Sunday Morning yet I still have no appetite,
> even when I eat something its only because I know I need to eat and
> not because I'm hungry. Any ideas about my appetite? I'm getting a
> little panicy with all the "cancer" stuff I'm reading related to
> reflux and h. pylori for that matter.

Don't panic as it serves no purpose. Or is med triggering
panic attacks? I suspect it might IMO.

You could lose more weight though if you are planning
surgery an extra 15 pounds ( 7 kilograms) would be
good as the weight will melt off post surgery.

The loss of appetite is a concern. Stick to
the appointment with the Doc.

The one of the Yahoo groups is rather
active though it is inhabited only by patients.

>
> Thanks for any help
>
> Dom

Vanny

2005-03-23, 5:11 pm

Hi Domenic,

I can't say anything specifically about pepcid (famotidine - H2 blocker) or
prevacid (lanzoprazole - Proton Pump Inhibitor - PPI), but I have been on
nexium (esomeprazole, PPI, 2 years) and now am on protonix (pantoprazole,
PPI; 2 months). I have experienced fewer side-effects with protonix. The
PPIs have been shown in the literature to be very effective when compared to
the H2 blockers (search PubMed or www.medscape.com).

I can empathise with the lack of appetite, etc., because I have recently had
the same thing happen to me. I had 30cm small intestine removed (Crohn's
Disease) on the 16th February plus a complete adhesiolysis. With all the
antibiotics that was pumped into me in addition to the nature of the
operation, I ended up with chronic diarrhoea and lost 6kg (from 55kg to
49kg, 160cm). I also had no appetite and understand completely how you feel.
This was cured by loperamide, yeast extract and ionic drinks after a few
weeks and I am now putting on weight. However, I am assuming that you do not
have diarrhoea.

In my non-qualified, non-medical opinion, your lack of appetite is possibly
due to one or more of the side-effects of prevacid - for example 'change in
taste'. See www.rxlist.com All the PPIs are in the same chemical molecular
family, but the side-effects of each individual PPI can vary depending on
the patient' metabolism. I suggest that you discuss this with your doctor
and perhaps try, for example, protonix or nexium as an alternative. I am
also taking reglan (metoclopramide) for GERD nausea. Reglan strengthens the
LEV (lower eosophagal valve).

There are a number of schools with respect to the timing of the medication.
I take 20mg protonix and hour before breakfast and 20 mg an hour before my
evening meal (which is always taken as early as possible). Some take the
full treatment or maintenance PPI dose in the morning, but a lot of reflux
does take place at night. With respect to reglan, I take 5mg (half dose/half
a tablet for my small person) half an hour before breakfast to get my
stomach working and then 5-10mg before further meals or as required should I
have further nausea and depending on the extent of the nausea on the day.

I assume that you have made all the necessary changes to your lifestyle to
enable the GERD medication to work:
http://www.gicare.com/pated/ecdgs39.htm The medication alone will not remove
all the GERD symptoms.

With respect to H.pylori a simple breath test will ascertain whether or not
you have this. I would not worry about cancer at this stage, but ask the
doctor at the end of March to do the full spectrum of tests on you to
eliminate all possibilities. Write everything down prior to going into the
docs office, otherwise you will forget something.

Appetite will not return in a split second and I think that if you are
panicky this will act also as an appetite-inhibitor. Try to get this under
control and perhaps start to take a child's vitamin tablet a day to
supplement your diet and have 6-8 small meals instead of 3 large meals each
day. A chef said to me in December, there should be 3 colours on your plate
at each meal (not including the tablets). I find this a good piece of advice
to organise my nutrition. Generally, one does not need vitamin tablets when
one is eating properly (balanced diet) and has no absorption problems.

Discuss everything with your doctor.

All the best,

Vanny

"Domenic" <arabia1@hotmail.com> schrieb im Newsbeitrag
news:fb540e1e.0503200644.15840b7e@posting.google.com...
Need some advice please, I'm 40, for many years (maybe 20) I've had
reflux. About a year or so ago I was diagnosed with a hiatial hernia
and h. pylori. I took the antibiotics for the h. pylori (not fun). I
assumed it worked only because my kids aren't complaining about my
breath anymore. I was put on pepcid for the reflux, this seemed to
work but recently everytime I would turn over in bed I would feel
slight nausea, I would also occasionally get a sharp pain and a
feeling like I was sleeping on a golf ball. My doc suggested I switch
to prevacid to see if it helped. I asked to have an endoscopy done.
Consultation completed, appt for procedute made for the end of March,
Now although nausea seems to have gone away at night, I have almost
zero appetite, although I could stand to lose 20lbs(5'10 193 and
dropping from 200) I'm concerned, does anyone know if prevacid causes
this? I have'nt been able to find anything related to this other than
loss of appetite being a "rare" side effect. I have'nt taken it since
Friday night and its now Sunday Morning yet I still have no appetite,
even when I eat something its only because I know I need to eat and
not because I'm hungry. Any ideas about my appetite? I'm getting a
little panicy with all the "cancer" stuff I'm reading related to
reflux and h. pylori for that matter.

Thanks for any help

Dom

Domenic

2005-04-02, 5:10 pm

Ok, I had the endoscopy done and the doctor said he saw nothing of
concern, yes he saw the hernia but nothing "serious" like cancer. Even
though this reflux is causing me some serious grief, I'm releived
about the negative on cancer. He did say he saw what looked like some
sort of irritation at the beginning of my small intestine. So he took
a biopsy and will let me know if its an infection that can be treated
with antibiotics. I'm not sure how much anxiety may have played a
factor in all this but I suspect it has atleast a little.

So, although I'm still not feeling 100%, I am feeling better. No
explanation for my nausea at night although that seems to have
subsided, only once in while now. I think I'm going to be looking into
a reclyner and maybe even one of those hospital type beds you see on
tv.

I really get the sense that doctors really haven't got this Gerd
figured out at all yet. I honestly believe that one day it will be
common knowledge that it has a lot to do with arrhythmia and anxiety.
For eg. when I mentioned to the doc that when I get the feeling to
burp and I hold it in so as to not make the noise in public I'll
sometimes throw my heart into tachycardia. He just shrugged, and said
I don't think its related. Well I don't see how its not if everytime
I've gone into tachycardia, its been after some sort of burp. I don't
mean just over 100bps, I mean 170bps range for up to half an hour. If
that's ever happened to you, you know how scary it can be. I can
usually get down with breathing and cold air. I don't blame him for
anything, its just what they're teaching him in the schools. My family
doctor with a lot more grey believes there is a relationship however.
Oh well, must be boring you guys.

Thanks for the responses.

arabia1@hotmail.com (Domenic) wrote in message news:<fb540e1e.0503200644.15840b7e@posting.google.com>...
> Need some advice please, I'm 40, for many years (maybe 20) I've had
> reflux. About a year or so ago I was diagnosed with a hiatial hernia
> and h. pylori. I took the antibiotics for the h. pylori (not fun). I
> assumed it worked only because my kids aren't complaining about my
> breath anymore. I was put on pepcid for the reflux, this seemed to
> work but recently everytime I would turn over in bed I would feel
> slight nausea, I would also occasionally get a sharp pain and a
> feeling like I was sleeping on a golf ball. My doc suggested I switch
> to prevacid to see if it helped. I asked to have an endoscopy done.
> Consultation completed, appt for procedute made for the end of March,
> Now although nausea seems to have gone away at night, I have almost
> zero appetite, although I could stand to lose 20lbs(5'10 193 and
> dropping from 200) I'm concerned, does anyone know if prevacid causes
> this? I have'nt been able to find anything related to this other than
> loss of appetite being a "rare" side effect. I have'nt taken it since
> Friday night and its now Sunday Morning yet I still have no appetite,
> even when I eat something its only because I know I need to eat and
> not because I'm hungry. Any ideas about my appetite? I'm getting a
> little panicy with all the "cancer" stuff I'm reading related to
> reflux and h. pylori for that matter.
>
> Thanks for any help
>
> Dom

Vanny

2005-04-02, 5:10 pm

Glad to hear that you are feeling better. You might find that changing your
medication will give you better relief of the GERD symptoms. I am doing a
lot better on protonix than I was on nexium. I can also go to 80 mg (2 x 40
mg) protonix per day without any noticeable side-effects. On nexium if I
raised the dose that high I felt poisoned.

An adjustable bed would be a very good idea. I have a 3 ins latex mattress
and have raised it with a foam wedge and thus sleep raised. In addition, to
the general lifestyle changes http://www.gicare.com/pated/ecdgs39.htm you
might have to do a bit of research on other foods, etc. that affect you as
an individual. I felt considerably better when I gave up milk. I can still
eat yoghurt and a little low lactose cheese (emmentaler and parmesan). Avoid
cough sweets and syrups and if you need to eat sweets then buy the
sugarless. If you need something sweet a little white chocolate works for
me, with no lashback.

Once you have a handle on the GERD then you can start to get more
adventurous with your diet again, but you might find it just not worth the
ensuing pain. If I am feeling adventurous then I ensure that I do not
experiment in the late afternoon or evening and then if anything happens I
can take a raised dose prior to my evening meal.

In the literature it is stated that GERD patients are more aware of their
hearts and its rhythm changes (do a search on PubMed) for the reason Pam
stated. The heart rate increases and decreases when you put your body under
stress and then relax and this happens to everyone, its just that we don't
normally notice it. If your oesophagus is irritated/slightly inflammed then
the heart is right next door and thus GERD patients feel it - when the GERD
is not under control. I had this problem for a couple of years, but now with
protonix the GERD is under control. Just say to yourself, this is quite
normal and just allow it to happen. You will not have a heart attack - even
though with the GERD pains it will feel like it.

With respect to burping, I agree with Pam, you have to let rip and just
excuse yourself or leave the room - either way it is no sin. It happens to
us all GERD or no GERD.

Anxiety has, from what I have read, nothing to do with GERD. But, anxiety is
natural with chronic disease, in particular when you don't have it under
control. We have all been where you have been believe you me. The problem in
your case is that you have the hernia and this is a confounding factor in
getting the GERD under control. The hernia most probably must be operated on
to give you the means of getting the GERD under control with lifestyle and
medication. You will have to discuss your options with a competent doctor
(you might have to shop around here). With respect to GERD knowledge, my
doc. actually has GERD and was not aware of the lifestyle changes necessary.
I printed information out of the internet and gave it to her. Protonix has
these illustrated in a patient information booklet, which comes with every
pack. If one wants to get better the way to accelerate this is to do a lot
of own research - just as you are doing. Don't lose heart.

Vanny (Crohn's Disease, ileostomy, GERD, heart failure, 7 operations)

"Domenic" <arabia1@hotmail.com> schrieb im Newsbeitrag
news:fb540e1e.0503301616.4ff9b6e1@posting.google.com...
Ok, I had the endoscopy done and the doctor said he saw nothing of
concern, yes he saw the hernia but nothing "serious" like cancer. Even
though this reflux is causing me some serious grief, I'm releived
about the negative on cancer. He did say he saw what looked like some
sort of irritation at the beginning of my small intestine. So he took
a biopsy and will let me know if its an infection that can be treated
with antibiotics. I'm not sure how much anxiety may have played a
factor in all this but I suspect it has atleast a little.

So, although I'm still not feeling 100%, I am feeling better. No
explanation for my nausea at night although that seems to have
subsided, only once in while now. I think I'm going to be looking into
a reclyner and maybe even one of those hospital type beds you see on
tv.

I really get the sense that doctors really haven't got this Gerd
figured out at all yet. I honestly believe that one day it will be
common knowledge that it has a lot to do with arrhythmia and anxiety.
For eg. when I mentioned to the doc that when I get the feeling to
burp and I hold it in so as to not make the noise in public I'll
sometimes throw my heart into tachycardia. He just shrugged, and said
I don't think its related. Well I don't see how its not if everytime
I've gone into tachycardia, its been after some sort of burp. I don't
mean just over 100bps, I mean 170bps range for up to half an hour. If
that's ever happened to you, you know how scary it can be. I can
usually get down with breathing and cold air. I don't blame him for
anything, its just what they're teaching him in the schools. My family
doctor with a lot more grey believes there is a relationship however.
Oh well, must be boring you guys.

Thanks for the responses.

arabia1@hotmail.com (Domenic) wrote in message
news:<fb540e1e.0503200644.15840b7e@posting.google.com>...
> Need some advice please, I'm 40, for many years (maybe 20) I've had
> reflux. About a year or so ago I was diagnosed with a hiatial hernia
> and h. pylori. I took the antibiotics for the h. pylori (not fun). I
> assumed it worked only because my kids aren't complaining about my
> breath anymore. I was put on pepcid for the reflux, this seemed to
> work but recently everytime I would turn over in bed I would feel
> slight nausea, I would also occasionally get a sharp pain and a
> feeling like I was sleeping on a golf ball. My doc suggested I switch
> to prevacid to see if it helped. I asked to have an endoscopy done.
> Consultation completed, appt for procedute made for the end of March,
> Now although nausea seems to have gone away at night, I have almost
> zero appetite, although I could stand to lose 20lbs(5'10 193 and
> dropping from 200) I'm concerned, does anyone know if prevacid causes
> this? I have'nt been able to find anything related to this other than
> loss of appetite being a "rare" side effect. I have'nt taken it since
> Friday night and its now Sunday Morning yet I still have no appetite,
> even when I eat something its only because I know I need to eat and
> not because I'm hungry. Any ideas about my appetite? I'm getting a
> little panicy with all the "cancer" stuff I'm reading related to
> reflux and h. pylori for that matter.
>
> Thanks for any help
>
> Dom

Vanny

2005-04-08, 9:54 pm