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I’ve read that long term use of Ommeprazole can contribute to bacterial overgrowth.  I’ve taken Ommeprazole for like… forever.  When i don’t take it, my stomach acid is unmanageable.  

I’m going to start taking Xifaxan for SIBO (just diagnosed).   I’ve taken it successfully before, years ago, and it greatly improved everything, especially (!) my joint aches.

i was hoping to avoid a continuing cycle of bacterial overgrowth/antibiotics/Ommeprazole after this course of Xifaxan hopefully gets me back on track.  Does anyone know of anything i can do to get off the ommeprazole? Even one day without, and I’m throwing up, and feel acid in my throat constantly, no matter what i eat.  This past week, in preparation for my SIBO breath test (No ommeprazole for a week), i ate very carefully, and still had terrible acid issues.

I also suspect that I’ve had SIBO for a long while.  I had to suggest the possibility to my Dr, and it explains years of frequency, diarrhea and gas.  

Any advice?

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I have found it very challenging to wean off of acid blockers, and omeprazole was the worst. The rebound acid reflux was so bad that it seems to have contributed to permanent damage to my teeth.  Nevertheless I did successfully wean off omeprazole on two occasions. Here are a few things you might consider, based on what I experienced:

  • The rebound (especially with omeprazole) seems to be much worse than whatever baseline GERD is going on. It’s temporary but miserable and destructive
  • You need a plan for life after acid blockers. GERD doesn’t generally get better on its own, though significant weight loss may lead to improvement. If you had GERD before starting the omeprazole then you’ll probably have it after stopping, even if you get through the rebound period.
  • The two things that worked best to get me through rebound were tempo and supplemental acid control. I went *extremely* slowly or switched to a very different acid blocker in lower dose, and I added antacids (Gaviscon chewable tablets are the best, IMO).
  • For the go slowly version I added a few hours to the gap between doses, bumping it up after a few days, and setting a target of *no* symptoms. For example, I went from 24 hours between doses to 27 hours, then 30 hours, then 33 hours, etc. By the time I was at every other day I was well past the worst of it. I did my best to avoid having a dose scheduled in the middle of the night during this process.
  • For the substitute acid blocker I selected one that was available in a lower dose. At the time that was Zantac, which worked great, but the ranitidine is no longer on the market. Pepcid is what I’d probably use these days. Weaning off of the substituted Zantac was surprisingly easy, perhaps because I hadn’t been taking it for long.
  • Use plenty of antacids when symptoms threaten. Heartburn is destructive as well as painful.

I hope this is clear. I’m happy to clarify anything, within the limits of my memory.

Ellen - I would love to hear more about your SIBO journey. After years (16+) of ongoing concerns I finally have a great gastronologist who diagnosed SIBO but as soon as I stop the  Xifaxan all the pain and symptoms come back to a debilitating degree. I am starting to look at diet and anything else I can do to help get my quality of life back.

I can’t actually say anything for certain, because my symptoms change from day to day, with apparently little explanation.  But my insurance wouldn’t approve xifaxan, so i took something else… i forget right now exactly what.  After the course, i started loading up on pre and probiotics, and didn’t resume the ommeprazole unless i really need it.  I now take Ommeprazole  about once or twice a week, sometimes less.  But i do have the occasional sleepless night with a yucky stomach.  I think what some people have said rings true for me… if you stop Ommeprazole, it’s likely to have a rebound affect, and if you can get through that, it gets a bit easier.  Please let me know if you find a better path!  I’m still struggling, though not quite as much…

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