[01100011]

For me: lose weight and take a daily PPI.

"But PPIs have terrible side effects!"

Doing great so far. One esomeprazole a day, 30 mins before I eat breakfast and I'm almost normal. This is with bad GERD, a hiatal hernia and some changes to my esophageal tissue. Oh and schatzki rings. I was in immense pain for years and now I can eat normally and enjoy spicy foods again.

[jmcgough]

A PPI is preferable to Barret's esophagus secondary to chronic gastric reflux, and certainly sounds reasonable in your case.

There are others who start using omeprazole OTC without understanding the difference between it and Pepcid. Omeprazole (and its enantiomer esomeprazol) can cause rebound heart burn with discontinuation, are not meant to be used "as needed" compared to antacids / H2 drugs due to their slower method of action, nor do we fully understand the long-term risks of PPIs. There have been observational studies which, while not able to show a clear cause and effect, have found evidence of higher risk of fractures among those on PPIs long-term.

[janice1999]

> do we fully understand the long-term risks of PPIs

The potential link between PPIs and dementia worries me a lot. I switched to H2 blockers when my symptoms decreased but they're not as good and you need to periodically get your liver function checked.

[nunez]

PPIs can take a (long) while for its side effects to present. Also, not everyone experiences the side effects, though some people definitely do!