- Omeprazole: Prilosec, Losec
- Lansoprazole: Prevacid
- Dexlansoprazole: Dexilant
- Esomeprazole: Nexium
- Pantoprazole: Protonix
The above named generic and brand named medications respectively, used for acid reflux, are known as proton pump inhibitors or PPI’s.
This class of medication work on the stomach’s parietal cells that produce the gastric acid, to inhibit or prevent the production of gastric acid.
Although they are extremely beneficial when used appropriately for a short course of no more than 6 – 8 weeks, when used on a regular, chronic basis, they are associated with many dangerous effects.
Excessive abuse of PPI’s can lead to:
- Chronic inflammation of the lining of the stomach
- Atrophic gastritis
- B12 deficiency
- Magnesium deficiency
- Intestinal gas increase and bloating
- Clostridium Difficile bacteria overgrowth producing diarrhea to life threatening colitis*
- Pneumonia – 30% increased risk*
- Osteoporosis and increased risk of bone fractures*
- Renal insufficiency*
- Esophageal Cancer*
- Dementia, 33% increased risk*
- Alzheimers dementia, 44% increased risk* … JAMA Neurologyfeb2016*
- Heart Failure and Death, independent association^ … PlosOne jan192017^
As we get older, the amount of gastric acid we produce decreases. Gastric acid is vital for an appropriate digestive system. Not only is gastric acid beneficial component of a healthy digestive and immunologic system, it is essential for the breakdown of protein and absorption of minerals and vitamins. Taking PPI’s on a chronic basis and suppressing the stomach’s normal acid environment, also allows pathogenic, disease causing bacteria to grow and overtake the good bacteria that make up the microbiome, and that keeps us healthy.
Heartburn and reflux often can be temporarily become worse after stopping PPI’s because of a rebound effect. This is diminished by weaning off PPI’s.
Histamin 2 blockers. Cimetadine (Tagamet), ranitidine (Zantac), & famotidine (Pepcid) also suppress gastric acid production by inhibiting the H2 or histamine receptor of the parietal cell instead of the proton pump.
Antacids. Maalox, Mylanta,Gaviscon, Tums and others). These work by neutralizing stomach acid. Many of these are composed of aluminum and magnesium hydroxide and simethecone.
Others. Mint tea, chamomile tea, deglycyrrhizinated licorice (DGL), probiotics, aloe vera, D-limonene (orange peel extract), have helped decrease heartburn.
Eating smaller sized meals on a more frequent basis, elevating the head of the bed, smoking cessation, avoiding caffeine, alcohol, chocolate, and acidic foods also decrease gastric acid production.
We need to remember that while most medications are beneficial when used as indicated, they can produce serious side effects when abused.
I hope you use the information I have written here to discuss with your own doctor. And always, keep reading and learning for yourselves so you can become better informed in your own healthcare.
Written by Dr. Jorge Bordenave