# Pantozol in the evening instead of morning



## Little Hedgehog (Dec 2, 2008)

Hi,I've been diagnosed in June last year (2008) with GERD. From that moment on, I have to take Pantozol 20mg once a day. It has always helped. I did realize that when I stop taking them, it goes well the first day, the second day I start feeling pain and from the third day on the pain gets really annoying. So, following my doc's advice, I keep taking them every day and she said it was best for me to take it in the morning before breakfast.yesterday morning I forgot to take one and I felt pain the entire day (stressful days at work lately probably don't help). So when I got back home, I took my Pantozol in the early evening. It relieved the pain and I didn't take one this morning thinking it wouldn't be necessary since I had one yesterday early evening which was not so long ago. However, as the morning progresses, I feel pain behind my chest and a burning sensation in my stomach and oesophagus combined with frequent "small burping" and just an overall sensation of a volcano stomach.I didn't eat anything special yesterday. I had a dinner I often eat (fish and rice). I'm 26 years old, I never smoked and I drink only one cup of coffee per day. I also only drink one or two glasses of alchohol per week in the weekends.It's the first time Pantozol fails on me... and it kinda scares me. I don't want my acid reflux problems to become worse and worse till no medication can relieve it any more. Could it be because I took it in the evening instead of morning yesterday and didn't take one this morning? Is it possible for GERD to become worse over time till no medication can help it any more?Thanks


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## Cherrie (Sep 1, 2006)

HiI feel that it's probably because you didn't take it in the morning. pantozol and all PPI's (proton pump inhibitors) should be taken in the morning due to the mechanism of this type of drug. PPI's prevent acid from forming before (not after) the acid has already formed. The majority of stomach acid is formed early in the morning, and by the time the stomach is painful in the evening, the acid is already there and the PPI's can't reduce existing acid in the stomach. I sometimes forget to take my meds, too, so in this case I'd skip a day and take it the next morning. If I get stomach pain in the evening, I'd take an acid reducer (such as Gaviscon, Malaax, Mylanta, or a pinch of baking soda in a big mug of water). Unlike the PPI's that prevent acid from forming before it forms, these acid reducers nuetralize existing stomach acid. So I'd give the dr./pharmacist a call and ask them if they think you could take an acid reducer in case you have pain in the evening.


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## madge (Oct 1, 2006)

I take a PPI (Nexium) in the morning, and a cherry-flavored Mylanta tablet or two in the evening if I have reflux then. My doctor said Mylanta is one of the better things to take in the evening, since it has both calcium and magnesium. I usually need Mylanta once or twice a week. Another thing...a friend said to use the cherry-flavored Mylanta, not mint, because mint can actually make reflux worse by relaxing the valve at the top of the stomach. So why, then, do so many acid reducers sell "cool mint," and "soothing mint" or citrus flavors like orange???? Doesn't sound like a good idea to me.


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## Little Hedgehog (Dec 2, 2008)

Hi and thanks for the replies.I have been taking my Pantozol at correct times again but I still get some acid reflux while for the past 10 months, Pantozol always worked perfectly... first I thought it was because I took one in the evening but aparently I still have it.I have to admit, the thought that Pantozol doesn't work at this moment makes me kinda anxious and I do live under stress lately. Mainly my job: you know... I put a lot of pressure on myself at work because I constantly want to show my boss that I'm motivated (trying to get a promotion to a more challenging job within the company) plus the economical crisis going on... I'm a bit on the edge at work.I saw my mom today and we were having a simple chat. She said it was really striking how I was talking fast and rather nervously. She said she could just hear the stress in my voice. And last year when the GERD started, I've established that the main trigger of my acid was stress. It started like 6 months after I finished school and started working. I could eat whatever I wanted before and now a pizza with some garlick gives me terrible cramps and acid (I have an irritable bowel too).I asked the pharmacist if a human body could become "used" to receiving PPI's and stop reacting to them after a while. The pharmacist said there is no risk of that occuring. She blamed it on the stress and suggested I'd take some Gaviscon in addition to the Pantozol till the stressful perdiod blows over.Could it be just that? Stress? Can stress give heartburn and GERD problems even when taking Pantozol?


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## madge (Oct 1, 2006)

I know that stress makes my reflux worse. I also have irritable bowel, and that's affected a lot by stress also. I really have to work on relaxing and getting enough rest. And I try to help my digestive system out by not eating things that I know are difficult for it to handle...like pizza, spaghetti, and other trigger foods. So, yes, I think that at least for some of us, stress can make our digestive problems worse.


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## Cherrie (Sep 1, 2006)

Hi I'm the same. Stress can totally make my GERD much much worse even when taking the PPI's. It doesn't even have to be some big stress, my stomach reacts big to even small stress -- the scare of accidentally tripping the alarm system a year ago, for example, gave me severe chest pain and burning from throat down to the stomach. So, yeah, personally I feel that it's the stress you've been under, not the meds. Maybe try some relaxation techniques? Like deep breathing, or listening to relaxation CDs before bed? I find deep breathing helpful with the anxiety to some extent...


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