Proton pump inhibitors are among the most prescribed drugs in the United States at this time (omeprazole or prilosec; lansoprazole or prevacid; pantoprazole or protonix; and nexium are a few). Many patients are placed on and continued on these drugs and are not sure why. Many hospitals are starting stop orders to prevent patients from continuing to receive these at discharge because overprescribing has been such a widespread problem. These medications can be helpful in cases of severe esophagitis or Barrett’s esophagus (a pre-cancerous condition of the esophagus). However, if continued without good reason, there are risks that should be considered. Some of these include a risk of nutritional deficiencies, clostridium difficile colitis infection, pneumonia, and osteoporotic fracture. Weaning off these medications under the direction of a physician is recommended when it is deemed appropriate. One such regimen I use is using d-limonene 1000mg tablets and using melatonin 3mg tablets. The regimen is used for 20 days. After 6 days, the dose of the PPI is reduced by 50%. After the 6 days, an “H2 blocker” (pepcid or zantac) or DGL (deglycyrrhizinated licorice) can be used for as needed symptoms. This should only be done will the assistance of a physician to make sure it is done properly and for the proper medical indication.

d-Limonene from orange peel oil