Millions may be unknowingly hooked on acid reflux pills—realising only when they try to come off the drugs and symptoms dramatically worsen, a top GP has warned.
Proton pump inhibitors (PPIs) are among the most widely used medications in the world, with 73 million NHS prescriptions dispensed in England in 2022-23.
Also available over-the-counter, they reduce the amount of acid in the stomach, limiting the distressing symptoms heartburn—including pain and difficulty swallowing.
But when patients stop taking the tablets, which include omeprazole and lansoprazole, the reflux returns ‘even worse’, UK-based GP Dr Ahmed Abd Elbary said.
In an Instagram reel watched 394,000 times, he explained this was because the stomach reacts to stopping the medication by ‘producing more acid’, known medically as rebound acid hypersecretion.
‘I think it is given far too often and people are unaware it can cause rebound symptoms,’ Dr Elbary said.
‘Say you get started on this for your heartburn or your reflux, when you start coming off it your stomach actually reacts by producing more acid which makes the reflux even worse and heartburn worse.
‘This means it’s very hard for you to actually come off the medication.
‘The crazy thing is the rebound is often worse than your initial symptom before you started the PPI.’
He added: ‘Everyone needs to be told about this before they start the medication.
‘Please don’t suddenly stop or change any of your medications if you’re on them. There may be a reason why you need them long term.
‘However, if you’re worried about any side effects or rebound withdrawal, please make sure you mention it to your doctor.’
Acid reflux, or heartburn, happens when stomach acid travels up towards the throat.
If it continues over long periods of time, it’s known as gastro-oesophageal reflux disease, which is usually caused by a weakness in the muscles connecting the food pipe with the stomach.
GPs have long warned that while pills like omeprazole and lansoprazole can beat heartburn symptoms quickly, ideally they should be used for only a month or two.
Although the studies are few, some have also shown staying on the drugs long term may raise the risk of developing the bone-thinning condition osteoporosis by up to 20 per cent.
This is because the drugs hinder the stomach’s ability to absorb calcium — a mineral that is vital for healthy bones.
Taking them for extended periods may also lead to other nutrient deficiencies, such as B12, essential for healthy blood cells and nerve function, and, in rarer cases, even stomach cancer.
PPIs, however, were not the only medication Dr Elbary warned may result in ‘severe withdrawal symptoms’.
Venlafaxine, which belongs to a group of antidepressants called serotonin and noradrenaline reuptake inhibitors, or SNRIs, ‘is one of the hardest ones to come off’, he added.
‘This is why, despite it being very effective, is very rarely given first,’ he added.
According to the NHS, such side effects can include headaches, feeling anxious and tired, and difficulty falling asleep.
In 2019, NHS watchdog the National Institute for Health and Care Excellence (NICE) also changed its guidelines to acknowledge that for some patients, severe side effects of coming off antidepressants can last ‘months or more’, with symptoms such as confusion, anxiety, sweating, sleep problems and ‘altered feelings’.
But Dr Elbary also said that sedative medication benzodiazepines, known as ‘benzos’, like lorazepam or diazepam ‘can have some of the most dangerous withdrawal symptoms’.
He added: ‘Here’s the dilemma. These medications are some of the most effective for treating things like anxiety and insomnia.
‘But you can build up tolerance and dependency to them quite quickly.
‘This can happen relatively quickly, which is why I’m never really a fan of prescribing these medications at all if I can avoid them.
‘Once someone’s been on them for a long time, it’s extremely hard for them to come off — weaning off them can be very very difficult.’
In 2019, health chiefs urged medics to stop dishing out benzodiazepines so freely as part of a prescribing review due to growing dependency concerns.
Benzos, including Valium, were the go-to insomnia drug for decades.
Over time, however, they have slowly fallen out of favour over addiction fears, severe withdrawal symptoms, and other problems.
