Even doctors can spread misinformation: the truth about PPIs

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Even doctors don’t always get things quite right sometimes. Like all things in medicine, PPIs are safe if used appropriately and they put patients at risk if used inappropriately.
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Опубликовано:

4 фев 2024

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Комментарии : 95

@Screwpaulrose 3 месяца назад

This type of sweeping generalisation is no way to practice medicine. Whatever happened to person-centred care and evidence based medicine? Thank you for educating people about this.

@garbleduser 3 месяца назад

Most of what we have now is virtue signal based medicine.

@lostinsiberia 3 месяца назад

It feels like I'm arguing with my General Practitioner every month to get a new prescription, I'm good on 30mg of lansoprazole, no symptoms and happy life. They made me trial 15mg to try and get me off it and it was acid acid acid, I was waking up in the night with it and staying awake for hours, I have another call today to discuss it with the clinic pharmacist, please just give me the medication 😢

@tsukikage 3 месяца назад

Thank you for this. I have GERD and weaning off PPIs has failed, so it's an important reminder that the benefits can outweigh the risks, and complications can be managed.

@ConstantlyDamaged 3 месяца назад

Same. GERD sufferer here, and tried to ease off my PPI and it didn't work, though I have managed to sustain a lower dosage requirement (monitored by my doctor, of course) by using a tilted bed (foam wedge under the upper end of my bed). I'm getting 2-3 monthly blood tests for a pile of other issues, so my doc just monitors any negatives of the PPI at the same time.

@jodil1209 3 месяца назад

Same with me

@feistsorcerer2251 3 месяца назад

This! And regular antacids can't be used to manage it for me because I only really tolerate tums. I'm a dialysis patient and using Tums as often as I'd need to for GERD without the PPI would raise my calcium levels too much.

@VioletsOnMars 2 месяца назад

How long have you had GERD? I have damage related to NSAIDs and it's taken longer to heal than expected. I was on Pantoprazole for three months and tried weaning off but was put back on it another two months. Recently weaned off again and having rebound again. My GI suggested using things like Pepto etc. and hanging in there until the rebound leaves the body completely. I'm curious how others feel about the failure to wean off PPIs. How do I know that I'm officially healed from NSAID related gastritis if I keep having rebound related issues from PPI dependency. Will your GERD ever go away with lifestyle changes? How would you know if your system can't get off PPIs? I've been struggling with this lately as I don't wish to be on PPIs long-term. My GI said it could take as long as 2-3 months for rebound to fully subside. I doubt I could hold out from these symptoms that long! All they did was hand me Pepcid AC as an OC alternative to pantoprazole. It's still a PPI though! I feel like long-term PPI treatment may end up causing more underlying problems. Like continuing your GERD or Gastritis with its severe rebound effects. What are your thoughts? Is that something you'd be worried about?

@ConstantlyDamaged 2 месяца назад

@@VioletsOnMars I've been on pantoprazole for, uh, years. 40mg a day, taken just after dinner. My GERD is most active when I lay down, so taking it after dinner means the stomach acid is lowered when I'm sleeping. The reason it was brought on was mostly chemical: mezavant, metformin, and about 3 other meds I'm on (to a lesser extent) all cause stomach problems. And now I'm on Ozempic too. My poor GI tract is full of stuff it would rather not have in it at all.

@eloisepharmacist 3 месяца назад

Its always benefits vs risks and there is always individual factors and nuance. Great job at putting that across in less than 2 mins. 👍

@MeppyMan 3 месяца назад

I take PPI as needed because nothing else works as well. I definitely know the risks and try to not take the all the time. Docs like that guy you featured who make blanket statements like that give me reflux. So it’s his fault I’m taking PPIs!!

@strugglingproficiently7947 3 месяца назад

Thanks, Doc. My medical brain was alarming the moment he generalized it to all antacids, and it just felt off. I frequently use these videos to supplement the knowledge I use in my care. As a nurse, you're great!

@waffles3629 3 месяца назад

Yep, not a medical provider but a chronic patient, and sweeping generalizations are good for nobody. Everything has side effects, it's just whether those side effects outweigh the benefits. It's like if a surgery had a 10% fatality rate, you wouldn't risk it just because it might improve your quality of life. But if not getting it means you have a 90% chance of dying in the next two weeks, it would be worth the risk. That doesn't make it a bad surgery, it just means it's not right for everyone.

@kayhey3426 3 месяца назад

Heartburn was ruining my life. People NEED sleep! Omeprazole to the rescue. I ❤ Omeprazole. It should have a cool song like Jardiance.

@HappyCat3096 3 месяца назад

I have a hiatal hernia and had esophagitis. I've been on PPIs for 5 years. My last upper endoscopy was clear except for a couple of polyps. No more GERD either! Still can't eat anything I want, but can eat most things in moderation. See my GI doc every 6 months.

@shelbyhufnal7760 3 месяца назад

Killed it! We learn about these side effects extensively in PA school with the knowledge that they’re there to MANAGE- not scare patients away from necessary medications

@marieonishenko 3 месяца назад

As a child I needed daily PPI’s for 8 years because I had GERD luckily now as a 31 year old I haven’t had GERD for over 20 years. But even after going off PPI’s I still needed an elevated pillow to keep my head above my stomach till I was 13.

@Jaxomh 3 месяца назад

Generally, advice consisting of sweeping generalizations is bad advice :)

@mandeehusky 3 месяца назад

They didn't want me to go back on a pair for reflux until I was able to get testing to prove that I still had hiatal hernia and I'm not a surgical candidate because the doctor is afraid the repair will fail. It was repaired about 12 years ago.

@MrMwmussel1 3 месяца назад

Yeah my dad died from esophageal cancer, it’s really really nasty SOB. He made it 3 months after diagnoses.

@Quince828 2 месяца назад

Sorry about your dad. Statistically only 20% of esophageal cancer patients survive after five years unless it is caught early and doesn’t get through to the lymph nodes. I beat the odds and am on PPI for life.

@Xyradia 3 месяца назад

Sadly because of what that TikTok doctor is describing, my insurance will only cover my PPI prescription for 90days out of the year. It's enraging.

@Marewig 3 месяца назад

Isn't 28 capsules roughly 17-18 dollars or so, though?

@QuinnEthanR 2 месяца назад

@@Marewig Sure, but when you need to take it every day for years, that adds up REALLY fast. Either way, insurance should cover necessary medications regardless of if they think it's necessary. Insurance companies effectively practice medicine without licensure.

@Marewig 2 месяца назад

@@QuinnEthanR I still don't see why insurance companies have to be involved in it. Then again, I'm currently living in a country where the state dictates the highest prices any pharmaceutical manufacturer or distributor can sell any generic medicine. They can either follow that, or not sell in the country at all. The prices I quoted above are the ones I vaguely remember from England.

@QuinnEthanR 2 месяца назад

@@Marewig it's not like that on the US. Companies get to set prices at basically whatever they want, making life-saving medications like insulin completely unaffordable to the vast majority of Americans. Without insurance, I wouldn't be able to pay for 9 out of the 12 medications I take. Insurance is 100% necessary here because our healthcare system is entirely privatized and profit driven; they do not care about patients, only profit.

@jennhicks1858 3 месяца назад

THANK YOU!!!!! So many people could see this and be misinformed. It so important for patients to talk with their doctors before making any decisions about stopping a medication. Everyone situation is different and unique to them and the needs they have. As a home care nurse my biggest job is properly educating patients on their needs not generalizations

@susan6880 3 месяца назад

Thank you for clearing up the use of medication and GI disorders.

@twankuijpers947 3 месяца назад

My professional opinion: your last 30 seconds are most accurate. I think PPI's are on general safe medications for short or long term, and there are indications for using long term PPI's. On the other side there is a small chance of deficiencies of elektrolytes and vitamines, which could for example give osteoporosis on long term use fo PPI's. The problem is that PPIs are available as OTC medication in my country and could be used long term by patients without a proper indication for it. On general this won't give complications, however for a few people it might if used as long term medication. As with all medications the question is: is there an indication and do the negatives outway the benefits.

@grudgebearer1404 3 месяца назад

Had a Malory Weiss and bled almost 50% of my body's blood volume because insurance didn't want to authorize my ICU hospitalization and had almost 72 hours of bleeding. Esomeprazole treatment for a few months and continued with smaller dosage after treatment. I can't emphasize enough how much of a quality of life improvement this medication offered to someone that suffered for heartburn and esophagitis.

@joker_g7337 3 месяца назад

I said this to a doctor once, because I had no clue what he said to me: "I'm an aircraft engineer, we use a lot of abbreviations. We do whole sentences of abbreviations. Imagine if, in order to take a flight, everyone had to speak like we do." Maybe I was being mean or he didn't notice his work environment is a language bubble, of which patients are not part.

@morganparker821 3 месяца назад

Good points. Please address reasons why we might deprescribe and also the high potential for rebound acid secretion after long-term use and then attempting to taper off if no need to be on it for one of the indications you mentioned?

@autumnm2075 Месяц назад

We have EOE in our family, thank you for the reminder

@jenniferbates2811 3 месяца назад

Thank you so friggin much!!!

@lorobogers4198 2 месяца назад

One issue is that doctors don’t tell you the risks of long term PPI use, leaving patients out of the decision making process

@dlarsen325 3 месяца назад

Please do one of these for bowel meds!!

@wrongname2702 3 месяца назад

Bowel meds? I know about the ones for opioid related constipation. Or the ones for pain in that area. I think there's some biologics I can't spell to help with crohns and IBS symptoms. Have they made new ones since I was in the pharmacy? I'm super into researching drugs but I'm not sure which bowel meds you mean? I would love a deep dive into those since most drugs aren't designed to target that area.

@SomeGuy-yl1bx 3 месяца назад

Honest question, not a troll. I've heard in some of my college classes that taking PPIs long term can lead to an upregulation in proton pumps in the stomach, requiring the use of more PPIs to have the same effect. Does this not really happen, or is it to such a small degree that it isn't really affecting the patient that much? Thank you for the advise, and I really love your videos. Keep 'em coming!

@mattiasmartens9972 2 месяца назад

You are right in your main point but i want to point out a pattern regarding how doctots prevailingly think about PPIs: 1. Patient comes in for hard-to-pin-down pain 2. Doctor follows protocol of "if you don't know what it is, it's heartburn" and prescribes PPIs 3. Turns out the issue was SIBO and it becomes chronic because of the effect of the PPIs (lots more bacteria make it past the stomach and into the ileum) I've seen this basic pattern twice, once in myself and once in a friend. While I can't prove the PPIs worsened our respective conditions the link between PPI use and SIBO is well-attested by research. It is more severe than a side effect.

@elei417 2 месяца назад

He has a good point though you should know better not to criticize him. Since he said for long term takers

@funkyk5086 3 месяца назад

May I ask for some advice, speaking of generalisations. My Hepatologist keeps telling me I can’t have liver pain as there are no nerves in the liver. But I do get severe pain in that area, most likely from the sac the liver sits in. But I am totally dismissed each time. Should I seek a second opinion (I’m in Australia so I can do so, but whether there’s any further exploratory tests that can be done than biannual ultrasounds - especially as my current hepatologist/GI has never seen my liver in real life)? I HATE asking this way, but no one ever gives me a clear answer.

@mattiasmartens9972 2 месяца назад

As an example, liver inflammation causes a pinching sensation on the right side of the abdomen that can range from merely noticeable to severe. It's the expanded liver pressing against the abdominal wall. It would be a good idea to investigate your symptoms further with a professional who will take them more seriously. Pain in that area could also be evidence of digestive problems -- another good reason to get a sonogram or similar.

@QuinnEthanR 2 месяца назад

I've had an ulcer and GERD since I was 12, and I've had to be on Omeprazole for a while. My GP warned me about the side effects from the start, and it's worth the risk for me

@lisaabroad1192 2 месяца назад

My 7-year-old has been on a PPI for a couple of years now for his EoE. We tried budesonide first, but he still had a lot of damage and eosinophils so we had to start him on a PPI. With both together, he's been doing very well.

@Krannski 2 месяца назад

It's telling that this isn't taking the form of a disagreement to a valid concern, but instead is a personal attack against a practitioner who is being painted as incompetent and schooled by the "board certified GI doctor". While at the same time not keying into the main issue of "you may or may not have medical reasons to take a medication long term, if you don't you probably shouldn't be taking it", and presenting the medication to a patient audience in a way that will make them think that it's its A-OK actually and they shouldnt worry about it.

@suzettesanborn5659 Месяц назад

Well I was on high doses of PPIs for several years and ended up with serious side effects. I was on the verge of being diagnosed with Huntington's disease and later an ER doctor discovered that all my symptoms were linked to PPI use. Symptoms went away after stopping the meds.

@ginadellgrottaglia6897 3 месяца назад

Ooof. Knee-jerk had me eyeing the unsub button buuuut, after watching... Legit, doc. Legit. 😁

@catwinterberryneo 3 месяца назад

Yes!! My dad has barret's esophagus and he tried stopping omeprazole because he heard it is bad for bones. He read a book about controlling reflux with the keto diet and he tried this for a while (he says it did help), but his doctor told him to get back on omeprazole because the barret's is much more concerning than bone density in his case.

@xboxfullauto1000 3 месяца назад

LMAO, I was going to bring up my EoE in this comment until you brought it up a second later!

@HarWatSin 3 месяца назад

Hello!! Severe allergies, asthma, silent reflux with dietary fixes already used, mast cell issues (I have all of the above, and have a celiac diet, low histamine diet, rotation diet, etc in place already,) pepcid is commonly used for the conditions I have. :) I can't imagine going back to not using it.....

@_____alyptic 3 месяца назад

So Proton Pump Inhibitors ≠ Anti-acids

@Doc_Schmidt 3 месяца назад

PPIs are antacids. But not all antacids are PPIs

@emsservices6090 3 месяца назад

Have you reported him to your medical board ?. In the UK, he'd be struck off for falsehoods like that

@Jen-X333 3 месяца назад

I’ve been on omeprazole for several years to control the symptoms from a hiatal hernia. Couldn’t function without it.

@josiahfreep7765 3 месяца назад

I’m early, and I’ve got worms

@Sanity016 3 месяца назад

I take famotidine and/or an antacid for occasional acid reflux. I wouldn't take a ppi without a doctor's recommendation

@warwickv9481 Месяц назад

ty Doc. a cathartic rant but I have EoE and Eosinophilic colitis. Every time I change GP it's a battle getting PPIs and loperamide long-term + budesonide inhalant for EoE, budesonide tablets for colitis flare-ups. I get precaution, but why do I need to go through an extensive battle every time that causes months of symptoms. look at the person in front of you, not generalisations

@michachyra3513 3 месяца назад

Hey Ben, what's Your opinion on giving PPIs to every patient treated with NSAIDs or steroids just cause they're taking them, without any other indications for using PPIs?

@em688 2 месяца назад

Ehhh, from a pharmacy standpoint, I dispense FAR more chronic PPIs for GERD, in which the patients are probably now dependent on them, than the more complex cases where they are indicated for treatment or chronic management. The truth is probably more in the middle. A lot of primary physicians don't go through the process of counseling their patients off PPIs that arent indicated, but at the same time patients shouldnt just be stopping based on a tiktok.

@user-sm6lt9mf9t 3 месяца назад

Lately the doc in question (not Doc Schmidt but the one in the video) has been turning from facts into cherry picking scare tactics. No longer a fan.

@craiganderson5556 3 месяца назад

Scaring people gets clicks! The algorithm was not devised to make our lives better.

@jodil1209 3 месяца назад

Just saw my gi doctor today and booked my second colonoscopy, and he wants to scope into my stomach. Make sure why I keep getting terrible gerd, and am anemic.

@HappyCat3096 3 месяца назад

I had anemia last year, it's no fun. My doc scoped both ends and made me swallow a pill camera too! Good luck. I feel so much better on iron pills and we fixed the bleeding too.

@A---ti3zz 3 месяца назад

I literally wake up at night after aspirating acid and according to my dentist my teeth look like I throw up a lot. That doctor is an idiot

@erinmc418 3 месяца назад

I've been told by my GI doc and PCP that I'll need to be on Omeprazole for the rest of my life! I'm 37. Have slight hernia at the top of stomach into the esophagus, collagenous colitis, and undifferentiated connective tissue disease. Even my naturopath has given into this idea. Is this safe? Sounds insane! I've been on it for over a year now and cannot get off it without extreme consequences, mostly silent reflux... Sore throat, cough, loss of voice, etc.

@erinmc418 3 месяца назад

@@Eet_Mia low fodmap, sibo protocol, elimination diet, allergy testing both skin and blood. I want to fix the hernia but not sure if it will get rid of the problem. I've been on and off Omeprazole for 20 years but this is the longest I've been on it now.

@janedoe6704 2 месяца назад

I dont think science is at a point where they can know for certain you will need it for life. Some people spontaneously heal from reflux and no one knows why. Hopefully you are one of them.

@marek9741 3 месяца назад

Don't get your medical advice online, especially tiktok

@K.Spade7902 2 месяца назад

What's a PPI?

@erinnorwood6124 2 месяца назад

Proton pump inhibitor medications

@erinnorwood6124 2 месяца назад

Proton pump inhibitor medications for stomach acid

@TheonlyVoidr 3 месяца назад

Plz see inkslasher he needs help 😢

@donaldcedar7574 2 месяца назад

PPIs can make it near impossible to visualize the inferior wall of the heart on a nuclear stress test. Just sayin.

@virginiamoss7045 2 месяца назад

You could have clued viewers in to what PPI is and stands for. There's far, far too much usage of initialization in our language today; it really does get tiresome.

@Croz89 Месяц назад

My mind immediately went to payment protection insurance, because that was the subject of a mis-selling scandal in the UK a few years back and there were endless adverts from legal firms offering to get you compensation for mis-sold PPI (which of course they got a nice cut of!).

@Ghostrepear 3 месяца назад

Hi doctor Schmidt I come from a RU-vidr by the name inkslayer who needs help his girlfriend is having problems and said you can help if possible please help this RU-vidr he really needs it