Have you been taking omeprazole for quite some time now? Then you know that after taking omeprazole for a while, it might be difficult to come off because of some side effects. Today, we’ll be talking about your problem ‘why I feel terrible coming off omeprazole.’
Before we get to the side effects of omeprazole, let’s talk a bit about the drug itself to understand better what happens.
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Long Term Use of Omeprazole and Its Effect
Omeprazole is a drug that is used for gastroesophageal reflux disease and peptic ulcer diseases. These are chronic diseases and may require long-term treatment with the drug. So, it’s not uncommon for people to take omeprazole for weeks to months.
Due to treatment, the condition of the gastric mucosa will improve. It’ll be able to provide adequate protection. In that case, there is no reason to continue therapy with omeprazole.
However, coming off omeprazole might not be so easy for some people.
Withdrawal Symptoms Of Omeprazole
Many who have taken the drug on a long-term basis have complained of several withdrawal syndromes. Some of the most common side effects of omeprazole due to discontinuation are:
Immediately after quitting omeprazole, you may have heartburn. This intense pain is much similar to the ones caused by GERD or peptic ulcer disease. The pain after discontinuing omeprazole may even be worse than before.
If you’ve been taking omeprazole for quite some time now, then quitting may cause dyspepsia. Dyspepsia is another term for indigestion where the food digesting capability of the stomach is greatly reduced.
Gas in the Stomach
You may feel bloated after discontinuing long-term proton pump inhibitor omeprazole. The acid in the stomach causes the formation of more gas which might make you feel bloated. In this way, omeprazole can cause weight gain.
Intense Pain due to Acid Reflux
Acid reflux causes acid to travel up from the stomach. This causes extreme pain in the chest and may even extend up to the throat. The acid may even reach your mouth, in which case you’ll be able to taste the acid (which is very sour, by the way).
Nausea and Appetite Reduction
After discontinuing omeprazole, you might feel nausea and suppression of appetite. This can also reduce your body weight.
Neurological and Psychological Changes
Several mental changes have been noted with omeprazole withdrawal. Some of these have a physiological basis, where others are purely psychological. They include:
- Feeling a sense of fatigue
Why I Feel Terrible Coming Off Omeprazole?
To better understand these adverse effects of long-term omeprazole administration, we must realize how normal acid secretion works.
Normal Acid Secretion
Normally, when you eat food, it travels through the esophagus to the stomach. At the stomach, the presence of food stimulates the production of gastrin. Gastrin is a local hormone that causes the secretion of acid.
Gastrin travels through the blood to where the acid-secreting cells are. This all happens inside the stomach. Gastrin then stimulates these acid-secreting cells to pump out protons through the proton pump.
A proton pump is a type of cellular pump present in certain cells of the stomach. The job of this pump is to secrete proton or hydrogen ions. This hydrogen ion gets into the lumen of the stomach. Then, it combines with chlorine to form hydrochloric acid.
The hydrochloric acid in the stomach has many functions. It helps break down the food substances that you take. It also kills many of the harmful organisms which are present in the daily food you take. It is also necessary for the absorption of many nutrients.
However, this acid is harmful to the cells inside the stomach as well. So, there is a layer of thick mucus overlying them. Because of this layer, the cells lining the inner layer of the stomach remain protected.
In diseases like peptic ulcer disease, gastroesophageal reflux disease, heartburn, etc. The acid produced is excessive.
This damages the cells of the stomach and causes cell death and ulceration. This results in the stimulation of the pain sensors giving the intense ‘heartburn.’
What Role Does Omeprazole Play In Acid Secretion?
Omeprazole is a drug that reduces acid secretion. They accomplish this by inhibiting the proton pump. Omeprazole molecules bind irreversibly to the ‘sodium hydrogen ATPase,’ the scientific name of the proton pump. Thus, the proton pump can’t secrete acid anymore.
The reduction in acid secretion is what causes the relief of the symptoms of the disease. Also, this reduction gives time for the damaged cells of the stomach to heal. So, omeprazole helps in recovering the stomach cells.
How Does Omeprazole Cause Withdrawal Symptoms?
That’s all well and good, but why do these withdrawal symptoms occur? The human body has something that’s called a negative feedback system. This is necessary to keep the constant condition in the internal parts of the body.
A negative feedback system means that the output of a procedure reduces the cause of the procedure. You can think of it like this: The temperature outside decreases. Then, you’ll feel like putting on more clothes to keep your body temperature constant. If the temperature decreases even further, then you might even turn the heater on.
Your body’s acid-secreting system works similarly. If the acidity of the stomach increases, less gastrin is secreted. This inhibits acid production. Alternatively, if there’s less acid in the stomach, more gastrin is secreted to increase acid production.
Long-term omeprazole administration throws this stomach acid-gastrin system. Because the acid-secreting proton pumps are inactivated, normal gastrin levels can’t increase acid production as they used to normally.
This results in more and more production of gastrin. Long-term administration of omeprazole chronically elevates gastrin levels.
When you come off omeprazole, the proton pumps are activated once again. However, the gastrin levels are super high. So, these cause excessive acid production in the stomach by the newly activated proton pumps. This is known as rebound gastric hypersecretion.
This elevated level of acid is what causes most of the symptoms of omeprazole withdrawal. Since the acid increases, it damages the stomach cells causing heartburn, and you start asking why I feel terrible coming off omeprazole?
The acid levels may be so high that they may come up through the esophagus to the throat. This is called gastric acid reflux. Nausea and dyspepsia, which occur, are also due to elevated levels of acid.
It is still uncertain why the neurological symptoms occur. However, scientists hypothesize that long-term use of omeprazole also changes the levels of important chemical regulators. If you stop taking omeprazole suddenly, these regulators are altered rapidly. This also causes anxiety, insomnia, depression, etc.
How Long Do Omeprazole Withdrawal Symptoms Last?
If you’re wondering when these symptoms go away, we have good news for you. The symptoms subside within two to four weeks of stopping omeprazole.
We’ve seen that the main reason for the withdrawal symptoms is increased gastrin levels. After activation of the proton pump, these levels go down as well gradually. So, when these chemicals return to normal, the symptoms go away as well.
The levels of gastrin, as well as other chemical regulators, normalize within this period. So, the withdrawal symptoms of omeprazole administration go away within that period.
How To Come Off Omeprazole?
You should never discontinue a drug without your physician’s prior notice. If you feel like your stomach is doing better, then it’s best to visit your physician. They can decide whether you should stop the drug or not.
If you need to discontinue, below are some of the methods which can help:
Reducing the dose slowly
Instead of suddenly stopping the drug, you can try reducing the dose. This gradual decrease of the dose is called weaning off. So how can you wean off omeprazole? Let’s look at an example below:
Let’s consider that you’re taking 20 mg omeprazole twice a day. So, to wean off, you’ll take 20 mg only once a day. This will continue for one to two weeks. After that time is over, you can take 20 mg every other day. This, too, will go on for around one or two weeks.
You can try reducing the dose as well. Thus, you can reduce the dose like this before completely stopping the drug and tapering the dose of omeprazole before it minimizes the withdrawal symptoms.
You have to change some of your dietary habits to reduce acid secretion.
You can decrease the amount of carbonated soda. These beverages contain carbonic acid. This acid increases the acidity of the stomach. So, by avoiding these, you can reduce the acidity of the stomach.
Caffeine is a big culprit in this case—caffeinated products like tea, coffee, etc., cause increased acid production. So, limiting caffeinated products goes a long way.
Don’t lie down immediately after a meal. This can ensure proper digestion of food.
Eat smaller quantities of food, but more often. By doing this, you ensure that your stomach doesn’t remain empty. So, the acid in the stomach can’t build up. Thus, the symptoms of rebound acid hypersecretion reduce significantly.
While going off omeprazole, you have to make several lifestyle changes towards the healthy side. Otherwise, you will still ask why I feel terrible coming off omeprazole. So, let’s look at the changes you need to make.
You have to give up smoking. Smoking increases acid production in the stomach. So, by avoiding this, the stomach remains protected from excess acid.
Ensure to keep your head raised while sleeping. This will prevent the excess acid from backing up to your esophagus and throat. You can use an additional pillow if necessary.
Decrease alcohol consumption to a minimum.
Drink plenty of water because water dilutes the stomach acid.
Wait for a while after your meal before exercising.
Treating the Withdrawal Symptoms
If you’re experiencing withdrawal symptoms, your doctor can help you treat those symptoms specifically. Several medications are available for these symptoms.
Probiotic supplements are another helpful way to reduce rebound acid hypersecretion. The beneficial bacteria present in these supplements accelerate the normal digestion process. They also restore gut biome balance.
So, if you want to come off omeprazole, a probiotic supplement may help you get relief.
What are the side effects of stopping omeprazole?
Withdrawal effects of omeprazole include rebound acid hypersecretion, heartburn, acid reflux, gas, anxiety, nausea, insomnia, etc.
How long does PPI withdrawal syndrome last?
PPI withdrawal symptoms last for around two to four weeks.
Can omeprazole cause nerve damage?
Omeprazole doesn’t cause any permanent nerve damage; however, some nerve inflammation is present. Symptoms include tingling sensation or numbness.
Can I stop taking omeprazole suddenly?
If you’ve been taking omeprazole for longer than two months, you shouldn’t stop suddenly. You can try tapering the dose little by little.
The bottom line, getting off omeprazole isn’t easy. If you suddenly start asking why I feel terrible coming off omeprazole, this article will be a great help.
With the proper dosage reduction, lifestyle changes, and medications, it is possible to discontinue omeprazole without side effects.