Should I Take an Acid Blocker for Heartburn

Should I Take an Acid Blocker?

Do you struggle with heartburn, acid reflux, indigestion, or peptic ulcers? Some of the most commonly prescribed drugs to treat these conditions are a class of medications called proton pump inhibitors (PPIs).

You might be asking—should I take this medication?

👉 Most importantly, you should always talk to your doctor and never change your medications based on a social media post 👈

Still…if you’re taking a medication, it’s important to understand how it works, what the side effects might be, and whether or not there are other options!

PPIs work by stopping the production of stomach acid. That sounds great if you have acid reflux, but then we have to think about all the downstream effects.

Without enough stomach acid, you could…
• Compromise nutrient absorption (like vitamin B12, calcium, and magnesium)
• Change your gut microbiota (possibly even leading to overgrowth and SIBO)
• Affect the health of organs outside the gut (including the kidneys and heart)
• Plus…

👉 A new study of more than 200,000 Americans found that regular use of PPIs increased the risk of developing diabetes by 25%.

The risk for diabetes was highest in people who took PPIs for the longest duration of time. That’s important because PPIs were approved only for short-term use of 2 weeks. Sadly, many people take these medications for a much longer time because they don’t know what else to do!

This is similar to the treatment of depression. When I was in medical school, medication for depression was approved for a short term use of about three months. While medicating, other measures such as counseling and cognitive behavioral therapy were to be used in order to tackle this problem. However, most doctors felt it was easier (since they didn’t do counseling or CBT) to continue writing prescriptions for antidepressants long term. We became Prozac Nation!

PPIs are in the same category of a short term use drug that becomes a long term crutch. Let’s examine the physiology of what happens when you take a PPI for the long term. It’s not good.

Your stomach generates a pH (acidity level) of 2 for a reason. The pH range is acidic if less than 7 and basic if more than 7. There is a physiologic reason for different pH levels in different parts of the body. Since I have a gynecology background, I’ll explain this in terms of vaginal pH. For vaginal health and hygiene, the pH of the vagina should be slightly acidic at 4.5-5.0 and if you have continuous vaginal infections, your gynecologist can easily measure your vaginal pH during a routine examination. The pH of menstrual blood is 7.4 and the pH of semen is about 8. A pH level in the vagina higher than 5.5 leads to bacterial overgrowth in the vagina resulting in a condition known as bacterial vaginosis. Most women who think they have a yeast infection have bacterial vaginosis due to this pH imbalance. So there is that. I’ll write a whole article about vaginal pH imbalance coming up since it is so common.

So let’s next look at what happens in the stomach. Hydrochloric acid is produced by the cells lining the stomach and produces a pH level of 2 which is what the first part of your small intestine (the duodenum) is expecting to come from your stomach. Hydrogen is the proton of hydrochloric acid and PPIs inhibit the production of this stomach acid in order to elevate the pH of the stomach juices.

So what happens if you elevate the pH of the stomach juices? You fail to absorb certain things that are necessary for your basic physiologic homeostasis. In other words, your digestion and absorption are off balance.

Here are the health effects of taking long term PPIs:

1. Reflux (GERD, Heartburn) medications harm your digestion. Hydrochloric acid is required for breaking down protein in your diet. PPIs slow that process and proteins may actually rot due to the slow down in this process. PPIs make your stomach work harder to provide the physiologic process for what it was designed. Your duodenum is also expecting to get acidic chyme (the food that is processed in the stomach) and when it does not, it impairs the production of bile and pancreatic digestive enzymes leading to difficulty digesting your food properly.

2. PPIs can give you anemia by interfering with Vitamin B12 absorption. The cells in your stomach produce intrinsic factor which is necessary absorbing the Vitamin B 12 in your diet. A deficiency of Vitamin B12 can lead to a condition called megaloblastic anemia which can give you muscle weakness, shortness of breath, a swollen tongue, paleness to the skin, loss of appetite, faster heart rate and gastrointestinal symptoms. Long term PPI use has also been associated with iron deficiency anemia.

3. Reduction in bone health can occur with long term PPI use. Stomach acid is used to absorb minerals from the food we eat. Stomach acid converts minerals such as calcium, magnesium, iron and zinc into their free forms so they can be absorbed. A reduction in stomach acid production from PPIs can create a relative deficiency of these minerals so that supplementation becomes necessary. One of the major side effects of long term PPI use is an increase in the number of bone fractures.

4. Acid blocking medications during long term also increase your risk of dementia, heart attack and kidney failure.

The real question we should be asking is whether there are other options.

I say yes 👍

Functional medicine health coaching has an extensive toolkit of options for optimizing digestive function and eliminating symptoms like heartburn for good. Instead of covering up the symptoms with an acid blocker, we’ll search for the root cause and help your gut recover naturally.

Want to get started on a better path to health?
Hit me up at www.healthwithoutrisk.com or send me an email at bryanjtreacymd@gmail.com and I’ll help you figure out the root cause of your GERD, indigestion and heartburn issues. There’s always more to the story and I’ll help you figure it out.

#reflux #heartburn #guthealth #rootcause

Reference
Yuan J, He Q, Nguyen LH et al. Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies. Gut. 2020. https://gut.bmj.com/content/early/2020/08/29/gutjnl-2020-322557

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