In my young and incredibly dumb days, I was a smoker.

I’d like to say I started this nasty habit because of peer pressure. I’d like to say I was out with a group of friends, and they all started firing up their Marlboro Reds, gave me semi-judgmental looks, and told me all the cool kids were doing it.

I’d like to say that—but I can’t.

The closest thing I can point to is a friend who smoked Swisher Sweets and would always give me some when we hung out. But I had already tried cigarettes by then. He just taught me how to inhale.

No, I started smoking because I had just turned 18 and was simply curious what the big deal was. My mother had smoked for most of my childhood, and lots of people I knew smoked. So when I turned 18, I went to the store and bought a pack of Winstons (of all brands, lol). Thus began a habit that took me 18 years to break.

Pretty soon, I was smoking a pack a day. But that’s not what this post is about. It was that habit that led to some pretty gnarly heartburn. I’d always had very mild heartburn—nothing that a few Tums every once in a while couldn’t fix. But once I started smoking, it opened the floodgates. I was downing Tums every day.

So, I went to the doctor, who told me the heartburn was because of my smoking. And in my young, dumb ignorance, I scoffed. I thought there was no way smoking could cause heartburn. It sounded ridiculous.

And the doctor did what doctors do best: gave me a prescription for Prevacid. This was back in the days when you needed a prescription for that kind of thing. It wasn’t available over the counter yet. And I gotta say: it worked like gangbusters.

I didn’t realize you were only supposed to take it for a two- or four-week period before stopping. But the doctor kept writing me prescriptions, and eventually, when PPIs became available over the counter, I switched from Prevacid to Prilosec OTC. And I’ve been taking them ever since.

In 2018, I finally managed to quit smoking. In the past year, I quit drinking. I’ve even cut out caffeine—not entirely, but I no longer require several cups of coffee a day. I hardly drink coffee at all now, and most of the caffeine I consume comes from the chocolate I rarely eat or the occasional Milo’s Sweet Tea (so good).

In other words, I’ve managed to cut out the big three when it comes to GERD: smoking, drinking, and caffeine. So, in my mind, I thought maybe I could finally come off the Prilosec.

But I also noticed that if I missed a day, the heartburn came roaring back.

So, I turned to the internet for answers. Turns out, these pills are incredibly hard to quit. Even though I’m no longer smoking, drinking, or guzzling caffeine, I’ve spent years—decades, actually—training my stomach to turn off the pumps that produce acid. The pumps that haven’t been shut off have overcompensated and now produce more acid than they normally would.

So when you quit PPIs, all the pumps come back on at full blast. But the ones that were working overtime are still going strong, so now you’ve got all of them firing off like crazy. It’s like turning every faucet in your house on high just to fill a single glass of water.

The medical community calls this phenomenon “acid rebound.” And it sucks. Big time.

Most sources online say you shouldn’t quit PPIs cold turkey. Instead, you should taper off. Take them every other day for a couple of weeks, then use Tums and/or Pepcid to help manage symptoms when you stop entirely.

And that’s exactly what I tried to do. I even got a calendar to track the days I took my meds. I made sure to have as perfect a diet as possible. And I managed to make it nine days before I couldn’t take it anymore and gave up.

The first week was tough, but mostly manageable, just heartburn that I handled with the occasional Tums and a Pepcid only when it got really bad. That happened twice during the first week.

But on Day 8, it all changed. It went from heartburn to nausea, diarrhea, and serious disorientation. I obsessed over it. I dove into Reddit threads to see how others were handling it. And, as you might expect, I saw everything from “It was easy; I got through it in a couple of weeks,” to “ZOMG it’s been months and my stomach is on fire!!11!”

I did find and read a great book about acid reflux and GERD: The Acid Watcher Diet by Jonathan Aviv. There was a lot of useful info in there. Here are some things I learned:

• The best food for people with GERD is food with a higher pH. So you should train yourself to select food based on pH level—not just nutritional value.
• Some healthy foods (like tomatoes, onions, and garlic) are a no-go for people with acid reflux because they’re too acidic.
• Literally every salad dressing in the world has something that’s a GERD trigger. Before I gave up, I was using just olive oil and oregano which was actually tastier than it sounds.

The book also explained a “healing phase” and a “maintenance phase.” The healing phase is a 28-day period where you don’t eat anything with a pH lower than 5. After that, you can introduce foods with a pH of 4, but never go below 4.

I ate a lot of subs with just mayo and lettuce. Subway was probably the only restaurant I could eat at with less-acidic options. I also ate a lot of ice cream to help with the heartburn, but learned that the high fat content only made it worse in the long run.

I learned about silent reflux—how PPIs and H2 blockers can mask symptoms but not necessarily stop the damage. That’s because they reduce acid in the stomach but don’t address the part of the gut that allows acid into the esophagus.

In the end, I made a judgment call. On the ninth day without Prilosec, I decided that the acid rebound might be causing more harm than the potential risks of staying on the medication long-term.

Most of the risks associated with long-term PPI use have no proven causal link. In other words, studies found an association between PPI use and those risks, but no smoking gun. (Here’s a link to an article discussing those risks.)

Which makes sense. Otherwise, PPIs probably wouldn’t still be available over the counter. For example, Zantac was found to have carcinogenic effects and was pulled from the shelves. If there were solid evidence that other heartburn meds were dangerous, they’d likely face the same fate.

Ultimately, I decided that risking the damage acid rebound might cause by quitting Prilosec was more dangerous than the possible side effects of staying on it. I’ve been taking these pills for 25 years now, and I suppose I’ll be on them for life. Maybe one day I’ll give quitting another shot, but for now, I’m comfortable with my decision.

I discussed most of this with my doctor, and she seemed unconcerned.

So for now, I continue to take the pills. Maybe one day I’ll find a way off of them that doesn’t cause more damage than it prevents. But for now, I’m laying this one to rest.