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Take protonix in morning and omneprozoles in afternoon?

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Gastroenterologist, Surgical
Practicing since : 1984
Answered : 922 Questions
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Dr. Ajit,

Regards to our previous conversation. Could i take 1 40 mg protonix in the morning and then take 2 20mg omneprozoles in the afternoon?
Posted Tue, 22 May 2012 in Digestion and Bowels
 
 
Answered by Dr. Ajit Naniksingh Kukreja 2 hours later
Hi

Thanks for posting your query
XXXXXXX you appear well read, but as you doctor now I would prefer going for protonix twice a day

One before breakfast and one before dinner

In case you are comfortable with Omeprazole the dose is same and it should be one 40 mg capsules both the times and not two 20 mg tabs

The compliance reduces if the number of pills increase

Another observation that I have on a personal end is in patients with history of Alcohol consumption

I prefer giving them one Rabeprazole or Pantoprazole before breakfast and one 40 mg pill of Famotidine before dinner

Hope this helps
Am always there for followups
Wishing you a speedy recovery
Above answer was peer-reviewed by
 
Follow-up: Take protonix in morning and omneprozoles in afternoon? 15 hours later
Dr. Ajit Naniksingh Kukreja,

Medical History : IBS-GERD-2cm Sliding Hernia

My internist has taken me off protonix and omeprazole all together and has prescribed a Prevpac. Do you think this is a good approach to this?

SYMPTOMS: food feeling like it is stuck in the throat not digesting quickly. Feels like it just sits there. Not much chest burning or anything like that.

In 2008 after I had my Upper Endoscopy I was i diagnosed with H. Pylori and given the Prevpac. Do you think this is a good idea at this time and worth a try or would I get better results taking omeprazole 80 mg a day?
 
 
Answered by Dr. Ajit Naniksingh Kukreja 4 hours later
Hi
XXXXXXX thanks for your query

I would suggest going for a H Pylori test in blood or stool before going for PrevPac and if it is normal go for Protonix or Omeprazole choice is yours

Symptoms of food sticking in throat are common in Gerd that is why in the first instance I had advised you to add Domperidone once a day with PPI

Hope this helps
Do revert for followup queries
Get Well Soon
Above answer was peer-reviewed by
 
Follow-up: Take protonix in morning and omneprozoles in afternoon? 27 hours later
Dr. Ajit Naniksingh Kukreja,

Had a chest cat scan done yesterday and these and this is the impression:

IMPRESSION:
No evidence of acute thoracic pathology.

Dilated esophagus containing air fluid level with mild thickening of the gastroesophageal junction that can be due to underdistension. This needs to be further evaluated bu endoscopy.

Right lower lobe calcified granuloma.

Left lower lobe nodule that can be benign but needs 6 months follow - up in the absence of typical benign calcifications.

My question is what is this as this alarms me:

Dilated esophagus containing air fluid level with mild thickening of the gastroesophageal junction that can be due to underdistension. This needs to be further evaluated bu endoscopy.
 
 
Answered by Dr. Ajit Naniksingh Kukreja 13 hours later
Hi
XXXXXXX I can understand the concern

There is nothing to worry about, because your earlier Endoscopy has been normal

Underdistension is seen in patients with small caliber esophagus or in patients with gerd and Hiatus hernia which has mild thickening of lower esophagus, precisely the last 5 cms before the gastroesophageal junction

I recollect a similar study was done in around 33 patients where 7 patients [21%] had marked esophageal thickening and these patients had findings of diffuse esophageal spasm on barium studies

So I would recommend you reassure yourself and get a fresh endoscopy done to gain more confidence, but if the last endoscopy was few months back only forget and go for a followup scan after 6 months

Apart from these I do not think the nodules need to be worried about as ClinicoPathological Correlation is not suggesting anything

I mean you have no symptoms to the nodes it is an accidental finding, and you can very well go for a followup scan after six months

Hope this helps
Am available for any followup queries
If there are no further doubts, do accept my reply and rate it

Get Well Soon

Above answer was peer-reviewed by
 
Follow-up: Take protonix in morning and omneprozoles in afternoon? 46 minutes later
My last endoscophy was in Dec 2008. So it has been 3 plus years. Do you think this deserves immediate attention?

The having the feeling like the food sticking in the throat happened within the last 5 days and havw not XXXXXXX going on any other time then that. Do you really feel i am worried for nothing?
 
 
Answered by Dr. Ajit Naniksingh Kukreja 30 minutes later
Hi
XXXXXXX Welcome back

Just because your endoscopy was in 2008, I am of the opinion that you should go for a fresh endoscopy to just recheck the status

When so many reports confuse a patient it is likely the the patient gets worried, even If I had been in your place I would have been concerned

But in a phase wise manner when we can rule out most of the diseases I think you should be a relaxed person by now

Just one more normal endoscopy and you should be done

I will wait for your reports and we can again discuss the matter to your satisfaction

Am really always there
Get Well Soon
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