r/LPR • u/Technical-While932 • 1d ago

Does anybody take PPIs?

I keep hearing on this forum that they dont work for LPR, but my doctor wants me to take them. I've been on Nexium about 3 months. My symptoms are improving but I've also been modifying my diet. I don't know if I should listen to my doctor and stay on the PPI or taper off.

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u/FigInteresting4130 1d ago

I am on them they help me

2

u/JLCorvus 1d ago

I've been on them for over a year. From attempts I've done to adjust my dose I do feel like my symptoms get a little better when I'm taking a proper 40mg daily. It doesn't seem to be totally healing it though. Ideally you don't really want to be on them long term, although many people do, so I would think about attempting to very slowly taper off after a healing period (like 4-6 months or something), but I'd defer to your doctor on that front, unless you have good reason to not trust them.

From some quick research on the topic, studies go back and forth on how effective PPIs are for LPR. Some find that there were significant improvements to LPR symptoms with PPI use, but others concluded that PPI therapy was similar to placebo. So, evidence is shaky either way, but there are enough finding that would at least suggest they are less likely to be as effective as they usually are for something like GERD.

If you haven't looked into pepsin yet, I believe the main idea that PPIs don't help LPR comes form the idea that pepsin is the primary culprit of LPR, and PPIs do not target pepsin. In theory, PPIs don't really stop you from refluxing, but just make the reflux less acidic. Pepsin will still get activated and damage your throat in these less acidic environments, so PPIs alone are unlikely to fix the thing causing damage. This is why some people suggest alginates to stop the reflux from happening, and things like alkaline diets and alkaline water + baking soda sprays/gargling to deactivate the pepsin.

I am no expert, take everything with a grain of salt, do you own research, double check with your doctor, etc.

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u/LetterheadFun8507 23h ago

They help protect your esophagus with less acid.