From: john schweinfurth
To: VOCALIST <vocalist>
Subject: Re: Since we're talking about Prilosec . . .
Send reply to: VOCALIST <vocalist>

On Fri, 17 Dec 1999 21:54:20 -0500, VOCALIST wrote:

> I have a different question about prilosec for you Doctors on the list.
My family physician put me on prilosec. It was determined that I didn't have
an ulcer, but everytime I try to go off the prilosec within 3 or 4 days I
have major reflux. Is this strange or have others had the same experience?
Also, are there any bad side effects for long term use?
> Lisa Miller

Lisa,

It's possible that you just have major reflux. It's also possible that this
is your main problem, and not your gall bladder...

Prilosec has been in use for about 15 years. Over that time, there have
been no long term effects. Whether that's really long enough, I don't know.
One of the issues with it's long term use is the 'imbalance' that it sets up
in your acid secretion system. Acid secretion is stimulated by a hormone,
gastrin, which acts directly on the acid-producing cells in the stomach.
When you block this acid production, the levels of this hormone naturally go
up, becuase the brain doesn't understand why there's no acid being produced,
so it tries to 'fix' this
situation by producing more gastrin. This might possibly explain your
reflux after stopping the medication, which makes sense although I've never
heard of it before.

The fear is that these high levels of gastrin over time could lead to
problems, ie. tumors. So far, in animals and people, this has not been the
case. But I wouldn't call it a guarantee...

You should always try diet first. Some of the same problems that cause gall
bladder disease also lead to reflux disease (high fat, low fiber, obesity,
low water intake...). See my response to Laura Sharp's question. In
addition, I hope to have my web site up soon which will have a long peice
about this stuff.

John M. Schweinfurth, MD
Laryngology and Professional Voice Care
Assistant Professor
Vanderbilt University
Nashville, TN
(615) 322-6180





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