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Have Fatty Liver With Slightly Elevated Enzymes. Nausea And Swollen Abdomen After Taking Nexium

Posted on Thu, 4 Apr 2013

Question: I have been taking nexium and it is causing me to be quite swollen in my abdomen and bouts of nausea. I have been diagnosed with fatty liver with slightly elevated enzymes in the past. Could this medication be irritating my liver.

Answered by Dr. Prasad Akole (15 minutes later)

Dear friend,

Welcome and thanks for entrusting your query here at XXXXXXX

I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.

Nexium is a PPI (proton pump inhibitor) to block the acidity increasing cellular mechanisms and acts on the stomach lining only.

Nexium is generally well tolerated and liver affection is not its side-effect.

It may occasionally cause bloating. Fatty liver is not a contra-indication and does not irritate the liver.

Could you please specify what dose and for what duration are you taking Nexium?

How well controlled is your diabetes and hyperparathyroidism is?What other medications are you on?

Is there pain in the abdomen, vomiting, bowel problems?

Cause of nausea and bloating is most probably different from Nexium.

Waiting for your response,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Prasad Akole (1 hour later)

My A1C is 5.8 and I take 2 metformin per day (500 mg per tablet) My primary hyperparathyroidism was diagnosed 5 yrs ago and is "mild and stable". They were unable to locate an adenoma during a sestamibi scan so are just watching for now. I have blood work done every 6 months. In January my bloodwork was stable. My liver enzymes were slightly elevated (no more than usual) I had an abdominal ultrasound done a year ago which showed the fatty liver. Everything else was good.
In November I started taking cellebrex from time to time for arthritis pain in my joints. I started experiencing stomach distress so went to the Doctor. As GERD is one of the side effects of the parathyroidism she started me on Nexium 40 mg once per day . I then realized that if I didn't take the Cellebrex I was fine. In total I have taken Nexium for 45 days. I have felt nausea , contipation and my abdominal area seams bloated . I quit taking the Nexium 3 days ago and have been using Zantac instead which seems to be helpful. How long will it take to get the Nexium out of my system and the inflammation to subside. I am leaving for a 2 week vacation in Mexico tommorrow so concerned. I am not a drinker or smoker and eat very healthily.
I have no pain just discomfort and bloating..feel like I am swollen.

Thanks for your comments

Answered by Dr. Prasad Akole (7 hours later)

Thanks for the answers.

If ranitidine (Zantac) is helping, you can continue it. It has different mechanism of action for the same purpose. Nexium does not stay for long. So, it should not worry you.

Your bloating could be part of dyspeptic syndrome.
As your other parameters are stable, they are likely not contributing.

You can try addition of a coating agent like Pepto-bismol (sucralfate 10ml 4 times a day) which covers the lining and prevents acid contact. It may help. Simethicone containing medication also may reduce bloating. You can easily obtain a prescription from your doctor. I am not sure if it is available over the counter at your place. You can try it.

Keep a high fiber diet or take a fiber supplement like ispagula to avoid constipation.
Drink plenty water. Avoid spicy/ junk food while out on a vacation. Can take ranitidine 150 mg twice a day.
If nausea persists, can take domperidone or tablet ondansetron 4mg (mouth dissolving).
If possible, it is better to be guided by your usual doctor.

Happy vacationing!!

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Above answer was peer-reviewed by : Dr. Vaishalee Punj