How Your Antacid Drug Is Making You Sick (Part A) | Chris Kresser

How Your Antacid Drug Is Making You Sick (Part A)

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Note: this is the fourth article in a series about heartburn and GERD. If you haven’t done so already, you’ll want to read Part I, Part II and Part III before reading this article.

Believe it or not, stomach acid isn’t there just to punish you for eating Indian food. Acid is in the stomach because it’s supposed to be there. It is found in all vertebrates. And while it isn’t necessary for life, it is certainly required for health.

Most people have no idea how many vital roles stomach acid plays in our bodies. Such misunderstanding is perpetuated by drug companies who continue to insist that stomach acid is not essential.

Meanwhile, millions of people around the world are taking acid suppressing drugs that not only fail to address the underlying causes of heartburn and GERD, but put them at risk of serious (and even life-threatening) conditions.

There are four primary consequences of acid stopping drugs:

  1. Increased bacterial overgrowth
  2. Impaired nutrient absorption
  3. Decreased resistance to infection
  4. Increased risk of cancer and other diseases

I had originally intended to cover all four of these issues in this article, but as I started to write I realized it would be far too long. So I will cover increased bacterial overgrowth and impaired nutrient absorption in this article, and decreased resistance to infection and increased risk of cancer and other diseases in the next article.

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A Stomach Full of Germs

We’re not going to spend much time on this here since the connection between low stomach acid and bacterial overgrowth was the focus of Part II and Part III.

To review, low stomach acid causes bacterial overgrowth in the stomach and other parts of the intestine. Bacterial overgrowth causes maldigestion of carbohydrates, which in turn produces gas. This gas increases the pressure in the stomach, causing the lower esophageal sphincter (LES) to malfunction. The malfunction of the LES allows acid from the stomach to enter the esophagus, thus producing the symptoms of heartburn and GERD.

Bacterial overgrowth has a number of other undesirable effects, including reducing nutrient absorption, increasing inflammation, and raising the risk of stomach cancer. Studies have confirmed that proton-pump inhibitors (PPIs) can profoundly alter the gastrointestinal bacterial population by suppressing stomach acid. Researchers in Italy detected small bowel bacterial overgrowth (SIBO) in 50% of patients using PPIs, compared to only 6% of healthy control subjects. The prevalence of SIBO increased after one year of treatment with PPIs.

Well-Fed but Undernourished

Stomach acid is a prerequisite to healthy digestion. The breakdown and absorption of nutrients occurs at an optimum rate only within a narrow range of acidity in the stomach. If there isn’t enough acid, the normal chemical reactions required to absorb nutrients is impaired. Over time this can lead to diseases such as anemia, osteoporosis, cardiovascular disease, depression, and more.

Macronutrients

Stomach acid plays a key role in the digestion of protein, carbohydrates and fat.

When food is eaten, the secretion of stomach acid (HCL) triggers the production of pepsin. Pepsin is the enzyme required to digest protein. If HCL levels are depressed, so are pepsin levels. As a result, proteins don’t get broken down into their component amino acids and peptides. This can lead to a deficiency of essential amino acids, which in turn may lead to chronic depression, anxiety and insomnia.

At the same time, proteins that escape digestion by pepsin may end up in the bloodstream. Since this is not supposed to happen, the body reacts to these proteins as if they were foreign invaders, causing allergic and autoimmune responses. I’ll discuss this more below.

Micronutrients

We can eat the most nutritious diet imaginable, packed with vitamins, minerals and other essential nutrients, but if we aren’t absorbing those nutrients we won’t benefit from them.

As acid declines and the pH of the stomach increases, absorption of nutrients becomes impaired. Decades of research have confirmed that low stomach acid – whether it occurs on its own or as a result of using antacid drugs – reduces absorption of several key nutrients such as iron, B12, folate, calcium and zinc.

Iron

Iron deficiency causes chronic anemia, which means that the body’s tissues are literally starving for oxygen.

In one study, 35 of 40 people (80 percent) with chronic iron-deficiency anemia were found to have below normal acid secretion. Iron-deficiency anemia is a well-known consequence of surgical procedures that remove the regions of the stomach where acid is produced.

Researchers have found that inhibition of acid secretion by Tagamet, a popular acid stopping drug, resulted in a significant reduction of iron. At the same time, studies have shown that adding acid has improved iron absorption in patients with achlorydia (no stomach acid production).

B12

Vitamin B12 (cobalamin) is needed for normal nerve activity and brain function. B12 enters the body bound to animal-derived proteins. In order for use to absorb it, the vitamin molecules must first be separated from these proteins with the help of – you guessed it – stomach acid.

If stomach acid is low, B12 can’t be separated from its carrier proteins and thus won’t be absorbed. In one study of 359 people aged 69-79 years with serious atrophic gastritis, a disease characterized by low stomach acid, more than 50 percent had low vitamin B12 levels.

A number of studies have examined the negative effect of PPI therapy on B12 absorption. In a study on healthy subjects treated with 20 mg and 40 mg of Prilosec per day for two weeks, B12 absorption was reduced by 72% and 88% respectively.

Folate

Among other things, folate (folic acid) is vital for keeping the cardiovascular system healthy and for preventing certain birth defects. Low stomach acid levels can interfere with folate absorption by raising the pH in the small intestine. At the same time, when folate is given to achlorydric patients (with no stomach acid) along with an HCL supplement, absorption of the vitamin increases by 54 percent.

Both Tagamet and Zantac reduced folate absorption in another study, though the reduction in the Zantac group was not statistically significant. The overall reduction of folate absorption was sixteen percent. This modest reduction is probably not enough to harm a healthy person consuming adequate levels of folate, but it may cause problems in those with folate deficiency (relatively common) or other health problems.

Calcium

Calcium makes our bones and teeth strong and is responsible for hundreds, if not thousands, of other functions in our body.

The importance of stomach acid in the absorption of calcium has been known since the 1960s, when one group of researchers noted that some ulcer patients were barely absorbing any calcium at all (just 2 percent). When they investigated they found that these subjects had a high gastric pH (6.5) and very little stomach acid. However, when the researchers gave them HCL supplements, lowering the pH to 1, calcium absorption rose five-fold.

Zinc

Zinc takes part in several metabolic processes related to keeping cell membranes stable, forming new bone, immune defense, night vision, and tissue growth. In one controlled trial, Tagamet treatment reduced zinc absorption by about 50 percent. Another study found that Pepcid, which raises intragastric pH to over 5, had the same effect.

Although there is little systemic research on the absorption of other nutrients, there is good reason to believe that low acid levels may also effect levels of vitamin A, vitamin E, thiamine (vitamin B1), riboflavin (vitamin B2), and niacin (vitamin B3). Theoretically, the absorption of any nutrient that is bound to protein will be inhibited (PDF).

In Part B of this article I will explain how acid stopping drugs decrease our resistance to infection and increase our risk of stomach cancer and other diseases.

241 Comments

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  1. Dear all! Now I can surely say, I have overcome my reflux, for which I am very happy. There is no any difficult cure and one thing is obvious – the doctors really fool us and just keeping us on meds – PPI and antacids. I too took esomeprazol 40mg, antacid gaviscon, a very strict diet for a year, which basically made my reflux worse and worse. I began having more heartburn, more discomfort in my throat and a strange taste in my mouth and etc. Finally I decided just to quite my meds and while finding this site 4 months ago, I changed the way I lived before.
    First of all we have to understand, that Dr Kesser is right – heartburn is because of LOW HCL and stomach acid, so the stomach doesn’t produce as much acid as needed and it throws back the food in it with some acid, which cause the heartburn. So the main thing is to make stomach work properly and to produce a normal amount of HCL and enzymes.
    The 1st thing I did – I started to drink a cup of honey-water, its 1 cup of water+1 spoon honey (just an ordinary domestic honey), and the country I live it’s a cultural thing to use honey in medicine. It’s just has to be a cold mixture, not hot, as they say the cold honey-water makes stomach produce stomach acid, and the hot vice versa.
    The second thing – I really started to pay attention on the amount of my food – I have to say that my last doctor who helped me a lot with this, advised to eat everything I like, but in low amounts, to eat 4-5 times, every 3 hours, and the last meal should be 3 hours before sleeping. Every time I eat any “dangerous” thing, I also eat 1 apple, and it decreases the heartburn. I don’t know if others practice the apple, but it greatly helps me till today.
    The third thing is to relax! It’s veryyyy very important that a person with GERD practice relaxation. I do meditation, breathing exercises before sleep, and just telling myself that I am healthy and that my stomach just didn’t know it yet, but it has to improve itself :)) it’s funny but helps. You have to find what’s best for you, but meditation is wonderful for me!
    And the last but not the least is WATER! – Drinking water is very important. However, it’s more important to drink it in a right way- 1 hour before meal and min. 1,5 hour after. And consider the water as another little meal.
    Just quit the meds, they do not help, they really make GERD worse. Good luck

    • Hi Lusina, so glad you found what worked! I also use apples to help with digestion. Also honey is good for wounds, coughs, and digestion. I think with honey, like apples, it’s the fructose which speeds the emptying time of the stomach. Correct me if I’m wrong.

      • Yes Ginny, I suppose apples have fructose which help and ascorbic acid. Both of them really help with digestion. As we all know the heartburn occurs, because the stomach can’t properly digest the food, and because digestive juices are not effectively produced. And apples, honey, peppermint gums, ginger, fennel, etc come to help. I am not a doctor, but these products really help me with my reflux. Hope you all find what works for you!

    • I’m very interested in this thread! I’ve dealt with heartburn issues since I was a child… used to throw up at night sometimes because of it, though at the time neither I nor my parents knew what it was. As an adult I have used Tums often, and for the past 3 or 4 years have been taking Zantac every night before bed. It seems to keep the heartburn issue at bay most of the time, but I’m concerned about negative effects it may have on my health cumulatively. I’ve never heard about drinking honey water, but I will try that. I’ve tried apple cider vinegar in the past, but my ENT/voice doctor strongly discouraged that, saying that it would exacerbate the problem rather than help.
      Thoughts?

    • Hi there. I have a question, how exactly does the honey with water help? Does it help the body absorb nutrients better?

  2. I was taking 20mg of omeprazole daily. After about 6 months, I became chronically fatigued, and began having regular regurgitation episodes, mostly at night. Everything would come up on me including stomach contents as well as bile. Despite sleeping fully propped up, nighttime episodes grew increasingly regular and more dangerous as I would aspirate fluids. At that point, I completely discontinued the omeprazole. The regurgitation took many months to subside, and gradually ceased. I was PPI free and regurgitation free for 2 years, during which time I attempted to control my GERD via other non-prescription means, with only moderate success.

    I then started on 40mg of pantoprazole daily. Within 7 short days, I had a horrific nighttime regurgitation episode that nearly choked me to death. Again, I stopped cold turkey.

    My gastroenterologist still refuses to believe that the regurgitation has anything at all to do with the PPIs, despite the fact that it never happens otherwise.

    The problem as I see it is that MDs are basically indoctrinated. They only believe what they’re told to believe. If regurgitation is not a listed side effect in the pharmaceutical pamphlet, then it’s not real as far as they’re concerned. There is little room, time or energy for creativity in their profession. 90% of what they do involves dispensing prescriptions.

    • Wow! I’d get another GI doctor STAT! Amazing how they dismiss plain evidence, isn’t it? And scary! They contradict their very first oath which is “do no harm”.

      I too got off prevacid and like you it took months for the reflux and heartburn pain to subside, but it did, slowly.

      I’ve found that lying on my back with 2 pillows under my head is much better than turning on my side. Side lying, for me either left or right (but especially right), ensures I will have reflux. Probiotics help with the heart burn too. I take Dr. Ophira’s which doesn’t have to be refrigerated.

        • In my experience I have been very ill since starting Prevacid and nexium. Was on it for many yrs as stated in my other post. I still wasn’t feeling well after stopping . So requested another colonoscopy and thank god I did . I learned that my large intestines grew enormous polyops 7 of them. Blocking my ileocecal valve causing a blockage . I never had this problem before taking this medication and I will never take again. I have been struggling many yrs . After they removed I was rush to hospital for severe hemorrhage in June 2015 be very careful on these medications not good to take for yrs could cause complications and polyops . Now today I feel 90 % better no pain at all. I eat healthy and follow up with colonoscopy. Very scary expierience .

      • Ginny, I don’t know with your casebook Esomeprazole-Mag does help me a lot. My belching, heartburn, registration at night reduced to nearly normal. Of course I also use diet free of alcohol, caffeine, spicy, fizzy drink and put under my bed two bricks and three pillows. Diet and med must go together. Have you tried Nexium the original ones? You better ask doctor for Nexium and tried for a month and see how it goes. My doc described me something similar to Zantac it doesn’t work and I have to go back to Zantac combine with Nexium. Zantac at night and Nexium at breakfast. Each individual is different.All the best.

        • Hi Thi!

          Actually I never get heartburn any more unless I eat something I know I shouldn’t, like sugar or pasteurized milk or grain and especially wheat. Those things always get me. But lately I’ve been on a wonderful probiotic that has really helped my digestion plus some basic enzymes. I feel like a normal person when I take those. I still have to watch what I eat but I don’t have to be quite as particular as before. And the good thing is, there are no side effects with the probiotics and enzymes. There are tons with any PPI and they are dangerous. I hope you can find relief in a more natural and less pharmaceutical way like I have! Take care!

          • Hi Ginny,
            I have been taking probiotic for years. Now it seems doesn’t work. I have had episodes of cramps under belly or pelvis area. I have had diarrhoea. I went to doctor and she thinks I may have colon cancer. Scary though. I had it before so don’t know what is going on. About my reflux, it seems gone not totally but I don’t need three pillows, two is enough now. I gain some weigh which I am happy. Still taking probiotic and bean from time to time. I can’t find any good probiotic even I used the ones for the infant, not really effective. I wonder what brand do you have ?THANKS

            • Hi Thi, I’m having a moment of dejavu, lol, because I think I already posted the answer once. But who knows….I may have dreamed it! So this may be a double post, but better twice than none at all. I use Dr. Ohhira’s Probiotic, Original Formula, which I got at the health food store. I’ve heard you can order it online directly from Dr. Ohhira’s website. They also say they can’t guarantee the potency if you order through Amazon.

              I also started taking digestive enzymes about 2 weeks ago. It’s really helped! I take one with each meal to help digest food. Before I started taking them, I felt like food just stayed in my stomach too long. It helps me be more regular as well! Hope this helps!

              • Thi, one more thing. I initially started taking Dr. Ohhira’s only once a day because a 30 day supply costs $60 plus tax. The directions say twice a day but I only took once to save money. It works better to take it twice a day.

    • You know, here in Brazil we have a test that’s called Orthomolecular, and tests you for thousands of symptoms and all, I believe it exists in the US, it’s totally non intrusive will actually tell even how much body mass, oxygen, water content, and thousands of other things. I did it because of other symptoms other than my reflux or hiatal hernia, and discovered something as weird as that I was pre diabetic simply because of a parasite that was destroying my pancreas so it wasn’t producing insulin, 2 boxes of pills for that and I’m free of the parasite, but mainly the dr. said that the reflux and h. hernia were all a result of other organs being off frequency and thus causing the reflux problem, and that it wasn’t just a “fix the reflux problem alone and you’re good”, situation. I’m sure everyone here already knows this but for easing the symptoms and helping it to heal, and this actually helps me even though I continue to use Omeprazol 20m, is no foods or liquids after 6:00 pm, no acidic fruits like lemons or oranges, no fries or fried foods, and like was mentioned by Lusina earlier, drink around an hour before a meal and the only 1.5 to 2 hours after the meal, no drink while eating at all because with all that liquid, you turn your stomach into a big bag of food and liquid and your stomach acids can’t digest your food, so seems to make sense to me and has seemed to help a lot. For what it’s worth.

  3. I’m dizzy, low glucose, fatigued and I’m taking omeprazole and I’m young and healthy! Help!

  4. Hello! First of all I’d like to thank the Dr and to all of those people who share their stories here. I too have GERD, and as the most of the others, I was also taking tons of medication – nexium 40mg, geviscon and other PPI drugs for some 8 months. I was also following a certain diet – no fruits (except banans and pear), no veggies, no fat, no oil. I was eating meat, potatoes, grains and all the stuff which make the stomach acid lower. What a misunderstanding! What an illiteracy doctors do with us- patients with GERD! Now I see that I was doing everything the wrong way, I was eating the things which make my reflux worse. It’s a month I don’t take those meds anymore and as I have found this articles, I started to change my diet. After every meal I eat an apple ( I don’t want to drink other meds like HCL tablets, and I did not find them in my area) and you know apple helps a lot! I don’t have a heartburn, may be only some discomfort, but not as much I have had.
    I don’t know if you try it…
    Thank you for all the advices!

  5. Thank you for the article! I was diagnosed with MALT Gastric NH Lymphoma in January 15. I went through 20 rounds of radiation and have been cancer free since. My Gastroenterologist prescribed that I take a Nexium pill a day for life as I am prone to heavy ulcers. 12 months later (and being too tired to walk up a flight of stairs some days), I had my blood work done. My Ferritin is at 7! My Vitamin D is at 10.5 (which my gastro swears is not because of the PPIs but I’m certain it is). My Oncologist said, “No wonder you’re so tired.” They now want to start giving me vitamins via an IV twice a week so they can continue me on the PPIs. Although we disagree, at my request, my gastro approved me taking the Nexium every other day so I could possible absorb these essential vitamins on the days off. Do you think this could help?

  6. at age 42 and a mother of 2 small children, I was giving nexium which didnt agree with me so then he gave me previcid that was taken for the past 6 yrs. The DR told me once you go on these drugs it is very unlikely you could get off. About 2 yrs after starting this medication I started to literally get extremely ill. Uncontrollable diarrhea which kept me home with no life, can’t work, extreme stomach pains, massive spasms in the entire belly. Severe burning and volcanic insides. The drs basically tried to put me on anxiety med because they thought I was creating these symptoms. I told them something is wrong and I am not crazy. I dont need anxiety meds , I need answers but know one listened. I was living in hell for yrs. Every test I made them do turned up nothing then I requested another coloynoscopy which he found and removed 3 extremely large flat polyps he went deep when he cut which caused me to have a severe hemorrhage 12 hrs later and spend 4 days in a cardiac unit in the hospital, I lost so much blood. I thought that was it for me. When I came home from hospital I was worse then ever with pain and now so weak from blood loss. I was so fed up with drs that I decided to go off my previcid, I went off aug 19th , it seemed like my body detoxed from that crap. My inside went through an awful month but now finally after yrs and yrs of suffering I feel like a human again, NO PAIN< NO DIARRHEA NOTHING it is a wonderful feeling to feel good .I feel weird because I forgot how no pain felt. I truely believe that previcid made me ill . I don't have acid reflux at all anymore and all symptoms subsided. I just want to get my story out in case someone is experiencing the same . .The moral of this, don't give up and listen to your body you know you the best.

  7. I truly can’t believe all these health problems I’ve been getting since I’ve been on Protonix . I just needed it for heartburn now I have X Y Z on top of that !! That’s just Crazy stuff why in the world wouldn’t your Dr. tell you what the long term affects are ? Sure you can read the side affects , but they don’t mention messing up other parts of your body . I’m so upset I could slap a Law Suit on my Dr.

    • What other health problems have you had since taking Protonix? How long have you been on it? I’m not doing well on it, either. Insomnia, dizzy spells, anxiety, diarrhea.

  8. Hi. I’ve started getting symptoms of GERD last year around the summer. So my doctor prescribed me some antacids. The problem went away. But it came back 6months ago. I’ve completely changed my diet, and I have tried my doctors prescribtion again and it didn’t help. So i saw a specialist and she prescribed me to a 40 milligram antacid. The pain I get is in the middle of my two ribs and it radiates to different parts of my stomach. I’ve been the new prescription for 2 days and I don’t feel better. Can someone give me some advice? Not to mention I’m neither obese or old. I’m 16.

    • I went through the same thing when I was your age. Every thing they proscribed me only work for a short time or has some other effect I didn’t like. My advice, STOP TAKING THOSE MEDS! Change your diet, drink a lot more water, when you have flare ups drink alooooooooot of water. Try mediating, stress triggers flare ups. Mediating helps clam and balance your entire body. Try using aroma therapy as well.

  9. I see all this information on why not to use these acid reducing drugs, but no alternatives for relief of acid reflux. The drugs might not be the best for me, but for the last month, it’s been bad and nothing else seems to help. I’ve tried lemon water, acv, antacids, probiotics, etc. what else can I do to stop the reflux and get off of the meds?

    • @Rob
      First of all, very sorry you are going through all of this.

      Unfortunately, the answer isn’t necessarily uniform to every person, and the path to relief also varies in its difficulty.

      But to truly get off of the meds, you need to figure out the underlying cause of the reflux.

      To do this might require some research and trial/error on your own as well as seeing a functional medicine doctor vs. An allopathic doctor (as they tend to treat your symptoms with PPIs and send you on your way). The underlying cause could be vitamin deficiencies, bacterial and/or candida over growth, leaky gut, food intolerances (which can also be merely a symptom) or other things. Most causes are resolved through diet and lifestyle changes, but it will take several months to get back to normal.

      You might need to be on the PPIs to function until you can to the bottom of things. I think the real push here isn’t to encourage you to stop taking them altogether. It’s just that long term use is showing some harm in some people with studies coming out all the time linking PPIs to some pretty terrible stuff. What’s important is figuring out what’s causing the problem because reflux is generally a symptom of something else. Once that’s determined, you’re on the path to being PPI free.

      As an alternative to PPIs, I’ve had good luck with zinc l-carnosine and dgl. I’ve also had some improvement with chiropractic treatment. Sometimes a pinched nerve in the spine interfering with sending messages to your digestive system or issue in the hiatal area can cause or make a problem worse. Of course, you should consult with a medical professional before doing any of this. And if I were you, I’d get the opinion of a doctor willing to help find the underlying cause rather than putting you on pills to cover your symptoms.

    • Rob you need to find out whats causing the extra acid treating symptoms masks underlying problems which will still continue.

      John Bergman is an excellent doctor look for him on youtube he will explain how to get to the root of your problem.

      Tara

  10. Digestive problems seemed to always be part of my family growing up. Now in my 60s, I am having more difficult ones; feels as though there is something deep in my throat; coughing and misery with off-and-on symptoms like a bad cold including sneezing and mucous. I am sleeping in a recliner in the living room for over a week awaiting new bed risers. Yesterday I had an endoscopy. Dr. prescribed Lansoprazole, 30 mg. After reading these very informative articles, I am not so worried about the results of a biopsy taken yesterday, but wondering if Lansoprazole is the best way to go. I studied and put myself on a strict diet a couple weeks ago to see if it helped ease symptoms. Losing 5 lbs. (so far) certainly helps but the more outstanding symptoms remain difficult. Thanks for your great information and I am sure glad I found your articles. Hope to hear your advice soon.

    • Hi Denny,

      Digestive problems of different kinds run in my family too. I’ve always had heartburn, reflux, constipation for years and treated it unsuccessfully with OTC meds like Tums, Pepcid AC, Mylanta, etc… Finally about 3 yrs ago my MD put me on Prevacid 30 mg twice a day for 6 months then once a day thereafter. It helped a lot, but I could still tell the problem was there. If I ate within 6 hours of bedtime, I still awoke in the night choking on stomach acid, and I had a very worrisome tender spot in my esophagus where food got stuck or burned when I drank sodas. I had to chew very small bites thoroughly or else I would be in pain when I swallowed. I had a cough too, which came and went, at times it was worse that at others.

      After almost 2 yrs on Prevacid, I began having symptoms of hypomagnesemia which is a serious side effect of Prevacid, not to mention that reduced stomach acid leads to inability to properly digest food, kill pathogens, make intrinsic factor and on and on. Prevacid, or any PPI is bad news especially when it’s given based on a wrong diagnosis. Actually, I didn’t have ENOUGH stomach acid to properly digest the poor diet I ate. So the OTC meds and Prevacid only made things worse. I changed my diet radically after I ended up in the ER with numbness/tingling/heaviness in my legs and feet plus dizziness and falling down. I asked them to check my magnesium level since I was on Prevacid. I was told my level was within normal limits. What I didn’t know (and apparently the MD didn’t either, thats what’s so scary) is that only 1% of all the body’s magnesium is contained in the blood. The rest of it is in our cells and muscle tissue. Blood tests don’t show hypomagnesemia in your muscles. I was sent home with a diagnosis of exhaustion.

      I stopped the Prevacid the week I started the Paleo diet. I noticed a difference at first but continued to have heartburn anyway, at times it was horrible. But I stuck with the diet, observing the intermittent fasting as a way of treating the heartburn. (I didn’t know then that dill pickles treat heartburn very well!) But fasting helped too! It took several months before the heartburn went away for good, still on the diet, and it was then that I realized the tender spot in my esophagus was no longer there. I could swallow large bites of food with no problem! I’m glad you’re noticing a difference with your diet, but stick with it! A few weeks really isn’t long enough to reverse your problems which may be a little worse than mine were.

    • I had the same symptoms with the mucous, sore throat and acid reflex. I had food allergy testing (IGG antibodies ) done and I am allergic to dairy, garlic, beans, and wheat. The dairy was the worsen. I stopped all caffeine, dairy and wheat, beans, sugar for a year. All symptoms went away. I lost 15 lbs too. I started eating wheat products and sugar again on a limited basis and the GERD did not come back but I gained the weight back.

    • Hay guys iv been suffering with acid gurd pain under my left rib its been affecting my life pretty bad my doc said he thinks i have a heitus hernia anyway was put on the meds and it worked at first been on them for a few months but deciced to come off of them cos i was so tired and feeling like crap i went health shop got pro biotic digestive emzymes and alo vera been taking for two days and my energy has come back already im so glad i researched these drugs very early never taking them again

  11. I will tell you this…I had all the same symptoms and finally went and had an X-ray for the nagging cough and clearing of throat. They found a large mass on my right lung. I was totally freaked. The CAT scan showed a 5cm mass on my right lung. Come to find out after 2 months of strict diet, and a very strong antibiotic that nearly did me in, (they gave me a choice of needle biopsy or see if antibiotics worked which might indicate an infection). well. Thank the Good Lord it shrank to only half a millimeter! I have always had bad acid reflux and so they believe I might have aspirated contents from my stomach into my lungs. I am now seeing a pulmonoligist for checkups to make sure it doesn’t return. My point is this, I do not take the acid reflux pills because the actually cause me MORE harm than good! I have found eating extremely small bites, very slowly, and NOT eating to fullness or satiety. Actually, I eat just enough to satisfy but still a little hungry. I find also and it has been the advice of my Physcian as well, to eat 3 hours before bed. I have to stop 4 hours before bed because of delayed emptying. I do go to bed hungry but generally it doesn’t bother me that much. It is certainly better than growing another fungus party in my lungs!

    • I have found sugar to be the main cause of acid reflux, followed by milk and wheat. Sugar is the worst by far. So if I cheat, I try to make sure I have sugar as early in the day as possible, not near bedtime or else I will wake up coughing up acid. Otoh, I can eat high fat and a real food carb AT BEDTIME and have NO problem with acid reflux! But sugar? Forget it.

  12. About a year ago I developed a cough that wouldn’t go away. The cough was not triggered in my lungs, but a tickle in my esophagus. Of course, doctor put me on PPI’s. Then I read an article Chris had written and immediately quit taking them. The cough is very annoying. It will get better for awhile, but then comes back. I know it is diet related, I just need to find out the correct way to eat. Has anyone else experienced a cough instead of heartburn with GERD? Sometimes the tickle is a mild burn, but very localized in the esophagus.

    • Yes I’ve had a cough. In fact, I didn’t realize that’s what it was because I’m also an ex-smoker. Go Paleo. It should get better but may take months. I also had a tender spot mid-esophagus where food and pills got stuck, which could be very painful. I was very concerned about that and so was my MD. That’s completely well now! It took time though. Good luck! You will be very pleased with the positive changes in your health as you proceed.

    • Yes iam experiencing same symptoms as you. It’s just started 2 weeks ago and i feel that tickles is coming from my esophagus.. And each time iam breathing i get feeling that i want to puke but i don’t. Not such any types of ppi medication is working with me

    • I have had an annoying cough for 3 yrs ( at least ). I started with an ENT doctor who put me on a couple different antacids, said I had GERD. The cough showed no improvement. I was then referred to a lung doctor who put me on two different inhalers. I felt better for a while, but after using several months I was cough so hard after using it I thought I was going to break a rib! In between doses that cough was still there-no the answer either. Next was the gut doctor- he gave me an even stronger antacid, he did an endoscopy to check things out. No ulcers, but yes I did have GERD-evidence of the burn marks on my esophagus. My instructions were to stay on the antacid and probably for the rest of my life! I joints started to ache and I just felt run down. I was so frustrated with all of the doctors. I started to research on my own to try to help myself. I came across a couple sites ( Chris’s was the best ) that explained that I had LOW stomach acid. I quit the antacid and started with apple cider vinegar( the natural kind with the’mother’ in it like was recommended for about 2-3 weeks. I could tell I was on the right track, but needed more. I ordered ‘Doctor’s Choice brand Betaine HCL w/ pepsin and gentian bitters, a probiotic and a separate ultimate digestive enzyme. I have been taking them for about 2 mos. The dose of HCL started out high-like 7-9 capsules with NO warming/burning felt. Today I need to take 2 with a high protein meal. I think my stomach is still healing. I hope to someday not have to take any. I want to have a blood test done to see if I have a H-Pylori bacterial stomach infection. I spent 3 yrs. living in Athens Greece- maybe I picked it up there or in some other undeveloped country. It may be playing a part in all of this.

      • Can you please tell me about gienbitter ? powder or tablets? where do you order? Is pepsin antacid or caffeine? Betaine HCL is Hydrochloride? Thanks

    • You have a hiatal hernia, that’s when the neck of the stomach protrudes into your esophagus. I had mine repaired 20 years ago. The stomach should stay below the diaphragm muscle, but when it moves up, it opens the spincter of the hiatal valve (the valve that keeps hydrocloric acid) from going up into the esophagus. This causes gerd, burn and a cough. Sometimes you can feel the acid in your ears. You should see a surgeon who will scope you (put a camera down your esophagus to see how badly your valve is opened. They can fix this laproscopicly, yet occasionally they have to make an incision from your belly button to the to the bottom of you sternum. You can take prescription Prilosec while you are being tested. It will releave you symptoms temporary. If it doesn’t get fixed you can develop scare tissue in your esophagus which leads to cancer. If you don’t want to be on Prilosec, check out on the web what foods are low acidicly: apricots, all greenery, plain chicken, ginger tea, no soda, coffee, chocolate, tomatoes or sauce or citric fruits. Put 6″ blocks until the head of your bed so when you sleep all the acid stays in your stomach. It’s a balancing act until you get all this resolved. Some people get hives too.

      • I did have the scope done. The doc said there was no hernia, no ulcers and he said he checked things through the stomach into the intestine- he said no problem was found. The PH test was also done at that time. He attached a device to the side of my esophagus which sent out signals that were recorded by a device on the outside. He later told me that my PH level was 16. Normal is 1.5-3.5 A high number indicates low stomach acid-but he never mentioned that!
        So it seems that it remains a mystery to all of the doctors I have seen.
        I did eliminate the acid triggering foods mentioned -I did this for about 2 mos. with no noticeable improvement.

        • Tammy,

          I continue to be amazed and appalled at the cluelessness of MD’s, especially in your case. If your pH was so high, why didn’t he do anything about it? Clearly you need to lower your pH to normal range, and it looks like you are on your own to accomplish this. I would look for a better doctor. I’ve mentioned this before and it’s something simple you could try. Eat a dill pickle after your meal to naturally increase your stomach acid and lower the pH. See if it works for you. Works like a charm for me. I’ve found the main cause of heartburn for me is sugar and grain. Hope this helps.

          • Tammy,

            One more thing. If your cough remains even if the acid problem improves, then there might be another cause. In any case, get a better doctor. Functional medicine practitioners can be located online that are in your area or region. Good luck!

          • Last year I was diagnosed as having a Gerd related Ulcer. I was put on a Prilosec/Pepcid combo. The Prilosec which I took once a day caused EXTREME joint pains. I stopped it and continued using the Pepcid. I got some relief from the Pepcid, but still had breakthrough reflux. One day I just randomly bought a single dill pickle from the local store. I was only able to eat half of it because it was too salty. But AMAZINGLY it stopped ALL SYMPTOMS of GERD. 1 pickle 5 mos ago is all it took. By the way, chewing gum (Trident) also helped relieve my heartburn prior to eating the pickle.

            • Thanks Dinna! I have a friend who tried the dill pickle heartburn cure and it worked for her too! I guess we should call it a proacid instead of antacid.

    • I had these symptoms and the consultant told me it was because my stomach wasn’t emptying properly and it was acid coming back He prescribed me some tabs and after a course it cleared up.

      • I am diagnosing with Gerd and my specialist described me Nexium 40mg and Tazac. It works for a while but then the symptoms come back. I feel a lump in my throat again and swallow difficult again. I went for gastroscopy and they found my z line irregular. I ask the specialist and he said it is not cancerous by looking at the pic. I took medication but it seems it didn’t work. So I just wonder what do you have or may be your is not serious as mine.

    • You may not have GERD – but silent reflux in early stage. (Known as LPR) It causes cough, excess mucous in throat, often lump-like feeling (globus sensation) in throat and often some altered or difficulty swallowing. Get checked out.

    • You have LPR, different than the typical acid reflux. Instead of the acid giving you heartburn, it goes right to the throat area. I was diagnosed in 2006 with GERD. Took PPIs for 8 years! Had a routine bone scan and now have Osteoporosis! Took myself off the PPIs. Have been very strict with my diet, but I am still getting symptoms daily. I am very thin, always ate well, exercised regularly, so I don’t fit the typical profile. I have tried everything, I am now looking into surgery to tighten the LES. Check out the book “Killing me softly from the inside” by Dr Jonathan Aviv, its all about LPR which is “silent reflux” As serious, or worse because there is no pain, just cough, constant clearing of throat, hoarseness, etc.

      • Omg!!! This is it… This is me!!! Throat, Ears, Sinus… It’s endless….chest is tight, cough to bring up frothy mucus.. Asthma acting up… no.. I’m telling you.. it’s this form of reflux.. no indigestion… 40 mg of Nexium daily.. 1 year now.. don’t know that it’s helping…have had 3 intense sinus infections in 8 mo.. ears get plugged for 3 or 4 days… just keep taking or increase PPI’s to hear esophagus.. That’s what I’m told.. goes on and on!!!

      • Susan and Mary:

        What I’ve done to treat my LPR (and GERD before that) with pretty good success (granted what works seems to be different for everyone), is I have followed the various advisement of how to treat leaky gut (found on Chris’s site as well as others such as Dr. Axe… They all pretty much recommend the same things).

        If you have any sort of bacterial or candida over growth in your small or large intestine and your gut biome is out of whack, the bloating this causes can force the acidity upward into the esophagus, even without making the stomach feeling all burning and miserable. Plus if you have leaky gut, the sinus/allergy symptoms could be an allergic reaction to food entering your blood stream. That drainage irritates the espophagus from the other end, and causes all the other symptoms of cough, hoarseness, etc.

        Oddly enough, the final thing that’s helped tremendously is chiropractic treatment. Let the chiropractor know about your digestive problems. There are a series of adjustments that can help this too. Sometimes it’s just the communication line in your spine not effectively telling your system how to digest properly.

        I’d also get a second opinion with a doctor with some understanding of functional medicine, (a physician with a DO after their name rather than an MD is a good indicator.. though there are some MDs that practice this method as well). They tend to focus on finding the underlying cause of your misery rather than covering your symptoms with PPIs. It wasn’t until I did this that an effective treatment plan was put into place.

        In my case, the PPIs were actually making the underlying problems worse. They tend to create an environment in your gut hospitable to candida and bad bacteria, inviting an overgrowth and crowding out the probiotics your body needs to function. PPIs also lend to all sorts of vitamin deficiencies (something the standard American diet already doesn’t promote very well). And these deficiencies are a house of cards that can make recovery take a long time.

    • I clear my throat every time I eat, despite what I eat. I was on Prilosec for five years. It took me two attempts and many months to stop taking Prilosec but I eventually succeeded! Now I am grain free, sugar free and for the most part dairy free. I am making progress but it’s slow. The past 92 panel food allergy blood test I had done was last week. The results showed I am now creating IgGs to a different set of foods to the last which was test 11 months ago. This is the third time I have had the test and the results show different foods each time, the foods I am allergic to reflecting what I eat. Clear evidence my gut is leaking!
      Has anyone else had this symptom of excessive mucus but not much heartburn?

      • I have “ear fullness” like plugged tubes, & was told I also have Acid Reflux (had a scope). I never have heartburn, but I do have “hoarseness” & when I get a cold, the cough lasts forever.

        My stool analysis showed I have very little pancreatic enzymes being made, so that has produced digestion problems. I suspect they are all connected.

    • I have a chronic cough but its from my post nasal drip. I believe its from my acid reflux. Had this cough for 15 yrs. I haven’t been able to make it stop. The Dr. Put me on nasal pills but nothing does anything. Then put me on ppis. Didn’t help with the cough but helped with my acid reflux. Been on ppis for off an on for several yrs. Every time I go on the ppis I get constipated. Now I have hemrroid problems real bad. I hope its nothing more serious. Although that’s enough.

  13. I had been diagnosed with an ulcer during a surgery over two years ago. My Dr has since put me on Ranitidine 150mg 2X day. Over the past year, and even worse over the last month I have been experiencing extreme amounts of burping/ gas throughout the day and night, especially after eating. Do you think this could be related to the Ranitidine and it’s effects on stomach acid?

    • It certainly could be. All I know is I’ve been off all antacids for over a year now, after being on them for more than 20 years (OTC/prescription) and I have never felt better! I no longer have that tender spot in my esophagus where food got stuck, and I no longer even get heartburn the way I used to. Now it lasts 5 or 10 minutes, untreated. When I treat it, I eat a dill pickle and the heartburn is gone within a few minutes.

      So, I clearly didn’t have enough stomach acid which led to the heartburn. And neutralizing what little stomach acid I did have made things even worse. I am thankful for Chris and his website and especially this article because I am completely off antacids for good now.

      Word of warning. Getting off antacids after being on them for so long was NO picnic. Be prepared for some of the worst heartburn of your life at first. Skip the next meal or until the heartburn is gone, then do not eat the trigger foods like sugar and wheat. Sugar is probably the single biggest cause. It took about 3 or 4 months before I had no more heartburn, but at the time I wasn’t treating heartburn with dill pickles.

  14. I started taking Omeprazole 20mg nightly for 5 nights but I started having the feeling that I needed to use the restroom even after I was done, the feeling is like minor gas. I quit taking the Omeprazole after getting this feeling but now I’m on my fourth day still feeling “not empty”.
    How long could it take to build the acid back to kill any bacteria throughout?

    • The Omeprazole may have caused constipation. I had that same feeling when I was taking it. Although you’re going to the bathroom, you may not be completely emptying. I drank one cup of Prune Juice and 45 mins later, I was relieved. Try it, it can’t hurt.

      • I have a Hiatus Hernia and my doctor prescribed me Nexium or Pariet. I don’t take them regularly as I am aware of the dangers. I only take them on special occasions like Christmas or Weddings so I can have a drink without all the discomfort but I do get Irritable Bowel Syndrome type symptoms when taking them and once I stop it can take up to two weeks before I start evacuating properly again. I use apple cider vinegar in warm water with a teaspoon of honey every morning before any food and I find this helps get me regular again.

  15. My daughter (5 years) is on ketogenic diet for seizure control.Hence she takes very little carb and no sugars but vegetable oil intake is high. She has lot of bloating and acid reflux issues along with acute constipation. Her dietician has given a dose of baking soda saying her CO2 levels are low and miralax for constipation.Recently her acid reflux and bloating has increased so much that she keeps on belching and throwing up water with slimy stuff continuosly through out the day. Seems she has developed GERD. I try fasting and have started giving caraway seeds water. Should i stop baking soda completely. Please advise

    • I would entirely eliminate the vegetable oil and replace it with organic virgin coconut oil. Then, she probably won’t even need the bicarb. Really, that’s the wrong treatment for GERD anyway. As Chris says the problem is not too much stomach acid, in many cases, it’s too little stomach acid. I have had some heartburn lately after kind of falling off the wagon, eating sugar and other stuff that causes heartburn. Instead of grabbing a Tums, I ate a dill pickle. And it worked!! I mean, like a dream. When you are feeling the burn in your esophagus, it seems like the last thing you want is something acidy, but it really put out the fire. Must have increased my stomach acid which then put out the bubbles which were causing the LES to open and reflux. I’ve tried it a number of times and it has worked.

      Also, I have been taking Magnesium Glycinate at bedtime. That has helped my reflux too even without changing my diet (which is not commendable, I know) as well as eliminating my migraines altogether and helps me sleep. Reduces my chocolate cravings also!

  16. Hi, I have been feeling discomfort in area just above tummy and in between the end of our Rib cage. This area seems to be kind of bloated all the time and I am not able to relax my belly and to be comfortable i have to keep it pulled inside which again is very problematic for me.
    I showed to doctor and he advised to go through endoscopy which resulted in SLIGHTLY LAX LES.
    Doctor has given me domestal,rabeperazole and anta-acid syrup.Can u help me out with any valuable suggestions which can help me to set things right..?

    • My advice? Get a smarter doctor. Drugs usually aren’t the answer. As Chris has said, in many cases the problem isn’t too much stomach acid but too little. Try an experiment and see if this works: eat a dill pickle and see if that helps put out the bubbles in your stomach. Better yet, stop eating those foods that cause the bloat to start with. Or you could try betaine HCL, but it is better to let food be your medicine.

    • I had the same issues. Huge bloating and almost felt like a softball just below my sternum. I started taking the HCL and it’s helping my gut heal. I am not taking the HCL consistently anymore but I’m not having the same issues anymore.
      I was thankful to have come across this article.

  17. Hi!

    I have been suffering with a hoarse voice and nausea right by my solar plexus since I had my son – 20years. I have a real sweet tooth and love carbs. Trying really hard to remove them from my diet, but I am always hungry. I am not overweight but I have a hiatal hernia and I have symptoms of GERD. I read your articles. How do you get tested for H Pylori. How do you know if your stomach acid is decreased?

    Thanks!

    • As Donna mentioned, H-pylori is a stool sample, but the sample can’t be taken accurately until you’re off acid blockers and various other things generally prescribed for relief and/or cure by allopathic medicine. I think it’s possible that certain pro-biotics may affect it too.

      There is also a blood test to check for the h-pylori anti-bodies. When I went to see my OD, we decided to do the blood test first. If there aren’t any antibodies, that should rule out h-pylori. If positive, I think the plan was to take care of the infection, then do the fecal later to confirm it’s gone.

      In my case, I’ve been taking Zinc L-Carnosine (generally marketed as Gastric Soothe or Pepzin-GI (not PepSIN). I’ve had very good luck with this so far, and some studies have shown that it is effective in battling H-Pylori naturally.

  18. About 5 years ago I first got digestive troubles, this after working in ‘developing countries’. This got worse 2 years ago, and I had anti-parasitic diagnotics, treatments and a matching diet.
    Almost a year ago endoscopy showed ‘Sliding HD’ at the stomach inlet: they gave me 2 PPI pills per day as a month long treatment. Also they advised 1 PPI daily for forever, though I only took them when I felt it necessary.
    My actual complaints persisted unchanged, though they said that the stomach inlet looked much better now. Things then eased in the summer only to get bad again in autumn. Got advised by an independant doctor to stop with PPI’s entirely, eat smaller meals, put my bed at an angle and try acid supplements.
    Now my intestine started to behave nicer again, proper stooling and less gas, but the stomach is now daily trouble.

    This is just the background history, the thing is: I tried lemon juice with water first, then stopped that being unsatisfied. Later tried to Betaine HCl 250mg with every meal. 3 times a day, which felt fine initially, but I had to stop after the 5th day already. My stomach was paining me increasingly; the grumbling and belching noises suggested that my stomach inlet was unable to close? Fortunately the disturbing stomach noise was gone the day after.
    Now bought some Apple Cider Vinegar with empty capsules, but fear that acid supplementing is just not gonna be a fix for me at the moment?.

    Will try to get my Vitamine B12 level checked tomorrow…
    No probiotics for me BTW.
    And as I learned from this article: CarboHydrates are again trouble, even when not longer doing anti-parasitic diet. So let me follow that advise.

    • With Betaine HCL, you are supposed to take just the amount that helps. When it causes pain, reduce the dose.

      • Yes. Yet I already took the minimum with each of the three meals: One pill of 250mg. And was informed that in case the dose was on the high side, one should feel warmth in the stomach within minutes. For me the effects seemed to set in later, and differently.

  19. This is all starting to make sense and to describe the life I have lived for the past 3 years. Major bloating/constant burping (unproductive burping — the kind that gives you no relief), straining to deficate. All kinds of tests were done but no answers were given. After many months of this, I tested positive for lupus — which I think is a false positive… and finally diagnosed with fibromyalgia.
    I truly believe this is all caused by these stomach issues that came on hard with a vengeance the past two days. No sleep last night. My guts were on fire. I laid there thinking that if they cut me open they would surely find an abdomen full of something that’s not good for me. This is really scary stuff for me…. but the knowledge I’m gaining by reading your articles is so helpful. Thank you.
    It seems that getting tested for H Pylori would be beneficial. I will be much more careful and make sure I’m taking my priobiotic. And hopefully, the more I read, the more I will learn what else I should be doing.

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