You Have Not Reset Your Progress—Here's Why You Can Relax
Your 2-day period of not eating due to the flu has not undone your gastritis healing, and the sourness and bloating you're experiencing are temporary symptoms related to the acute illness and fasting, not a recurrence of NSAID-induced gastric damage. 1
Why Your Stomach Lining Hasn't Been Re-Damaged
PPIs like Nexium (esomeprazole) work by suppressing acid production continuously, not by requiring constant food intake to maintain their protective effect—the drug continues protecting your stomach even when you're not eating 2, 3
Fasting itself does not cause gastric ulceration or reverse ulcer healing in patients on adequate acid suppression therapy 4
The healing process you experienced over the first 1.5 weeks represents actual mucosal repair, which doesn't simply disappear after a brief period of reduced food intake 2
What's Actually Causing Your Current Symptoms
Acute viral illness (the flu) commonly causes temporary GI symptoms including nausea, bloating, and altered gastric motility that can mimic gastritis symptoms but are unrelated to your previous NSAID damage 1
Not eating for a full day followed by resuming eating can cause temporary bloating and discomfort as your GI tract readjusts to processing food again—this is a normal physiological response 1
The "sourness" you're experiencing is likely reflux or dyspepsia related to the viral illness, not new ulceration, especially since you're still on Nexium which provides potent acid suppression 2
Your Nexium Taper Plan Remains Appropriate
Continue your current Nexium regimen exactly as prescribed: complete the 3 remaining days of daily dosing, then transition to every-other-day dosing for the final week 1, 2
The taper schedule is designed to prevent rebound acid hypersecretion, not because your stomach needs continuous PPI therapy indefinitely—your mucosa has already healed 1
Esomeprazole 40mg provides superior acid suppression compared to other PPIs, and your current symptoms do not indicate treatment failure 2
What You Should Do Right Now
Continue taking your Nexium as prescribed—do not extend the course or change the taper schedule based on these temporary flu-related symptoms 1, 2
Resume eating normally as tolerated, starting with bland, easily digestible foods as you recover from the flu 1
Avoid NSAIDs completely—this is the single most important factor in preventing true recurrence of your gastritis 5, 1
The DGL licorice can be continued as it may provide additional mucosal support, though the Nexium is doing the heavy lifting 4
Red Flags That Would Actually Indicate a Problem (You Don't Have These)
Hematemesis (vomiting blood) or melena (black, tarry stools) would indicate active bleeding—bloating and sourness do not 1
Severe, unrelenting epigastric pain that doesn't improve with your PPI would warrant concern—temporary discomfort during a viral illness does not 1
Inability to eat anything for more than 3-4 days or significant weight loss would require evaluation—you're already recovering 1
The Bottom Line on NSAID-Induced Gastritis Recurrence
True recurrence of NSAID-induced ulceration requires re-exposure to NSAIDs or other ulcerogenic agents—fasting alone doesn't cause it 5, 6
Your stomach lining has been healing under acid suppression for 2 weeks, and that structural repair doesn't vanish after missing meals for 2 days 2, 3
Once you complete your Nexium course and avoid NSAIDs, your risk of recurrence is very low (less than 7% if you remain NSAID-free) 5
Moving Forward After Your Taper
After completing the Nexium taper, you should not need maintenance PPI therapy unless you have other risk factors or must resume NSAIDs 1
If you ever need pain relief in the future, use acetaminophen (Tylenol) instead of NSAIDs like ibuprofen, naproxen, or aspirin 5, 1, 7
If you must use NSAIDs again for any reason, you would need to restart PPI co-therapy immediately to prevent recurrence 5, 1