Proton-pump Inhibitors

Proton pump inhibitors (PPIs) are drugs that are used to reduce the amount of acid produced by the stomach lining. They are used in the treatment of heartburn or gastroesophageal reflux disease (GERD), gastric ulcers, and to prevent damage to the lower esophagus. Omeprazole, Lansoprazole, Rabeprazole, and Pantoprazole are some of the commonly used drugs of this group.

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Can prolonged use of proton pump inhibitors cause loss of papillae on the tongue?

Query: Hi doctor,Part of my tongue seems to have lost some papillae. I have attached some pictures. Is this something to worry about? I take Nexium 40 mg daily. Kindly give your opinion.  Read Full »


Dr. Krishna Swaroop Achanta

Answer: Hi, Welcome to icliniq.com. I have seen the images attached (attachments removed to protect the patient's identity). The tongue will definitely be affected by tobacco usage or by drinking wine (alcohol consumption in any form will have an impact). Also, Nexium (Esomeprazole) 40 mg is used f...  Read Full »

Even after taking treatment for stomach pain, my pain persists. Why?

Query: Hi doctor, I had severe back pain and stomach pain two days ago. I visited my family physician, and he prescribed me Omcar 40 mg along with other medicines. He advised me to take Omcar 40 mg in the empty stomach daily morning, but I took it after lunch and dinner by mistake. Since last 3 hours, I a...  Read Full »


Dr. Ramesh Kumar S

Answer: Hi, Welcome to icliniq.com. Omeprazole (Omcar) and all other proton pump inhibitors are very safe medicines and can be taken for years without any side effect. As you are having pain, antispasmodics like tablet Cibis (combination of Clidinium, Chlordiazepoxide, and Dicyclomine) can be taken thrice...  Read Full »

After stopping Gabapentin, I have chills, vomiting, and anxiety. Why?

Query: Hi doctor, I have been taking Celexa 10 mg for two years. Recently, I was prescribed Gabapentin 100 mg twice daily, which I took for about a month, but started having stomach issues. So, I titrated it down to 100 mg a day for a week by myself and then stopped it. It has been almost three weeks and ...  Read Full »


Dr. Aditya Gupta

Answer: Hello, Welcome to icliniq.com. Withdrawal symptoms seem to be unlikely after three weeks of stopping Gabapentin. Check if you have a fever. If not I would suggest you try taking PPI (proton pump inhibitor) for vomiting and Benzodiazepines for anxiety and insomnia. Skip Celexa for a couple of days....  Read Full »

Kindly go through my blood report and provide your suggestion.

Query: Hi doctor, I visited gastroenterologist for my stomach problems. He carried out blood tests and gastroscopy. The result of gastroscopy was antral gastritis. The medicines caused it and I do not take them anymore. With this problem, I started losing hair and observed brittle nails. Always I feel hun...  Read Full »


Dr. Prakash H Muddegowda

Answer: Hi, Welcome to icliniq.com. Based on your query and report, my opinion is as follows: MCHC or folic acid elevation has no significance in the absence of other abnormal values. Brittle nails and falling hair signify multiple nutritional deficiencies. A balanced diet including all vitamins and mineral...  Read Full »

I underwent GERD surgery. Should I have to take PPI life-long?

Query: Hi doctor, I am concerned about my husband's health. He is taking PPI medication for ten years now called Omeprazole. We think he has to quit the medication. Could you please recommend to us what to do? How to start? I am also extremely worried about his liver. I know about the damage PPI may cause...  Read Full »


Dr. Ajeet Kumar Lohana

Answer: Hello, Welcome to icliniq.com. Well, there are very few indications of lifelong PPI (proton pump inhibitors). 1. Patient has GERD with Barrett's esophagus and premalignant findings such as dysplasia 2. Post fundoplication (GERD surgery) if the patient on follow-up has Barrett's esophagus or evid...  Read Full »

Blood in vomit after drinking too much alcohol. Kindly help.

Query: Hello doctor,I am a 20 year old male. About three days ago, I vomited bright red blood after consuming excessive alcohol. This is the first time I have consumed more than one beer and I was also unconscious. I have not been having any pains or any other symptoms. After the first vomit of blood, I pu...  Read Full »


Dr. Ashaq Hussain Parrey

Answer: Hello, Welcome to icliniq.com. I went through your post. At this age, bleeding with vomiting is likely due to an injury to the lower esophagus because of the force of the vomit. If the bleeding was severe, then an upper GI (gastrointestinal) endoscopy is necessary for two reasons. Alcohol drinking ...  Read Full »

What should I do to prevent my recurring GERD symptoms?

Query: Hello doctor, I was diagnosed with eosinophilic esophagitis, GERD, and hiatal hernia three years back through an endoscopy. My symptoms during the period were non-cardiac chest pain (all cardiac tests were negative), infrequent regurgitation, and muscle tightness in my abdomen and shoulders. The do...  Read Full »


Dr. Ajeet Kumar Lohana

Answer: Hello, Welcome to icliniq.com. Well, the biopsy report (attachment removed to protect patient identity) does not show eosinophilic esophagitis, nor it showed that you have Barrett's esophagus. You have a sliding hernia and had significant reflux related esophagitis. I feel that this is again the ...  Read Full »

How to treat a swollen and sore throat?

Query: Hello doctor, For six weeks, my throat has felt swollen, constricted, and I have an odd kind of soreness on the right side of my throat and sometimes the upper right side of my sternum. I feel the constriction all the time, but the soreness only when I swallow. The soreness begins at the top of my ...  Read Full »


Dr. Mohammed Osama Aboborda

Answer: Hello, Welcome to icliniq.com. I think that it is the effect of reflux. I advise you to stop Famotidine and start Omeprazole 40 mg, which is a proton pump inhibitor. It is more effective than Famotidine, especially in severe persistent cases like your case. You can start with two tablets before b...  Read Full »

What can cause bloating, irregular bowel and watery stool?

Query: Hi doctor, I am suffering from irregular bowel. I feel burning sensation in the stomach and anus. If I eat anything spicy, I need to go to restroom immediately. My poop smells and is semisolid, sometimes watery but not like diarrhea. I am suffering with this condition for past one year. I am tak...  Read Full »


Dr. Anshul Varshney

Answer: Hi, Welcome to icliniq.com. You are suffering from a condition known as irritable bowel syndrome (IBS). Your history is a classical suggestive of that. However, IBS is a diagnosis of exclusion. So, we need to be sure it is not anything else like ulcerative colitis, thyroid disorder or autonomic neu...  Read Full »

Kindly suggest a permanent remedy for my long-term acid reflux problem.

Query: Hi doctor, I have suffered from reflux for over 10 years now, but usually quite manageable. It waxes and wanes. There are periods where I can have no symptoms, eat trigger foods without problems, and take Gaviscon now and then, and there are periods where I have to take 40 mg of PPI daily to keep ...  Read Full »


Dr. Ajeet Kumar Lohana

Answer: Hello, Welcome to icliniq.com. I have read your history and seen the report of gastric scintigraphy (attachment removed to protect patient identity). You do not have gastroparesis, a fraction of 25% at 2 hours post-meal within the stomach is a normal finding. Ideally, it should have been done for...  Read Full »

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