Ask Leyla: What’s your advice for discontinuing Nexium?

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| By Leyla Muedin MS, RD, CDN

Q: My 65 year-old sister has been treating her acid reflux by taking Nexium for years. Her new doctor would like her to go off Nexium. I’ve heard you talk about how difficult that can be. 

What are your guidelines for going off of Nexium? And how long does it take for the rebound reflux to stop?

ts_discontinue_sm2A: First, I’m very happy to hear your sister’s new doctor wants her to discontinue Nexium. I wish more doctors would recognize that it’s not meant for long term use. Here’s why according to www.drugs.com

To make sure Nexium is safe for you, tell your doctor if you have:
• severe liver disease;
• osteoporosis;
• low bone mineral density (osteopenia); or • low levels of magnesium in your blood.

Taking a proton pump inhibitor such as Nexium may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medicine long term or at high doses, and in those who are age 50 and older. It is not clear whether Nexium is the actual cause of an increased risk of fracture. 

Nexium controls acid reflux (GERD) by reducing the production of stomach acid. But this is a problem. We need stomach acid to help digest food and protect against food-borne illness. Without enough stomach acid, we can’t digest and absorb nutrients such as calcium and magnesium (to name just a few) which are critical to bone health. So, indeed, repeated use of Nexium can cause osteopenia, osteoporosis and bone fracture. 

Moreover, the long term alkalinizing effects of proton pump inhibitors on the GI tract can cause SIBO

Now, having taken Nexium for such a long time, it can be difficult to stop without rebound reflux. For starters, avoiding foods that can cause reflux should be eliminated. These include foods that are: spicy, greasy/deep-fried, acidic foods such as citrus, coffee and tea, certain raw vegetables and fruits, chocolate (sorry!) and certain carminatives such as peppermint which can weaken the lower esophageal sphincter. A nutritionist can help you navigate around problematic foods and help with meal plans and a supplement regimen. 

Tapering off Nexium should be done under the supervision of a qualified healthcare practitioner. Critical supplements for healing and reduction of symptoms include DGL and Endefen

To your health! 

Leyla Muedin has clients all over the country via telephone consultations. No need to travel to New York City for a nutrition consult at the Hoffman Center. Should you require her services, please call our office to set up an appointment: (212) 779-1744.

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