PPI Alternatives for over age 70 years

[nigelforbes]

Like many people I've been taking omeprazole and later, pantoprazole as treatment for GERD. Products such as Dexilent and Controloc  are both very effective but increasingly we're told they come with risks. The major risk that concerns me is increasing evidence of renal (kidney) damage of failure which appears to happen after 3 months continues usage, a problem that exists with all the PPI products and has been known about since 2004...some details here. https://www.drugwatch.com/proton-pump-inhibitors/lawsuits/

 

My question is, what are the alternatives, what are you using?

 

- Some people suggest bi-carbonate of soda or apple cider but the former is not recommended for over 65 years old.

 

- Others suggest antacids such as Malox or Gaviscon but these are for use after the fact, rather than preventative.

 

- H2 blockers appear useful but not for older people.

 

- Products such as Pepto and Kaopectate line the stomach and prevent damage to the stomach lining

 

- Lifestyle and dietary changes are the optimum solution but they are not always effective for everyone, all of the time.

 

Lastly, there is a medical procedure that can be done endoscopically that wraps the stomach lining around the sphincter which seems to resolve the problem.....has anyone had this done and if so, with what degree of success?

 

 

 

 

[Celsius]

Try Gaviscon advance. Yes, it does not "prevent" reflux, but it is a very good treatment. I always take it at night and just live with mild reflux during the day.

 

And to be clear, not the green Gaviscon, or the purple dual action. Advance only. It really works the best. It is expensive, but you can find it cheaper on shopee or one of those non branded Thai pharmacies (usually the place where people line up) at around 325 baht.

[setbkk]

Your cited article appears to have been written by ambulance chasing attornies.  Not sure how prevalent kidney damage risk really is. I've taken PPIs for 20+ years, blood work shows no adverse effect, although I do take B12 as recommended by my doc. Have tried alternatives  but none are as effective. Forgot to take my Prevacid yesterday and really suffered. IMHO, benefits of PPIs outweigh the risks.

[nigelforbes]

1 hour ago, setbkk said:

Your cited article appears to have been written by ambulance chasing attornies.  Not sure how prevalent kidney damage risk really is. I've taken PPIs for 20+ years, blood work shows no adverse effect, although I do take B12 as recommended by my doc. Have tried alternatives  but none are as effective. Forgot to take my Prevacid yesterday and really suffered. IMHO, benefits of PPIs outweigh the risks.

Indeed, except I wasn't trying to prove that PPI's are damaging, I used that link simply as an illustration. There is plenty of other anecdotal and medical evidence to suggest PPI's are a risk, I've taken it as written that they are a risk but I haven't attempted to quantify that risk. The mere fact that the major Pharma's are paying out on these cases is indicative of something less than risk free. B12 and magnesium depletion can be managed as side effects, kidney damage is more difficult so I intend to err on the side of caution.

[Lacessit]

I gave up PPI's ( Pantoprazole ) a couple of years ago. IMO the key is changing one's eating habits.

 

I eat a main course, low on fat, heavy on low-carb vegetables, for dinner. Dessert consists of fruit only. Alcohol only once or twice a week, before dinner. No coffee afterwards.

I eat at 6 pm, won't retire to bed until at least 10 pm. I want a 3 hour gap between eating and sleeping.

I have a raised pillow, and a bottle of water beside the bed. I drink half a teaspoon of baking soda in a glass of water about 20 minutes before going to bed.

I have not had gastric reflux in the two years since I stopped PPI's.

I am 79. I'm not saying my regime will work for everyone, it works for me.

[scubascuba3]

You could get your kidney function tested every 6 months or so if concerned, blood test 100+ baht.

 

Diet change is the key though then come off PPIs ASAP

[nigelforbes]

45 minutes ago, scubascuba3 said:

You could get your kidney function tested every 6 months or so if concerned, blood test 100+ baht.

 

Diet change is the key though then come off PPIs ASAP

Part of the reason I began to look into this issue is because my latest kidney function test came in below average, which I didn't understand. Indeed, we're going to have to change our approach to PPI's.