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

by Chris Kresser

Last updated on

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

In the last article, we discussed the first two of four primary consequences of taking acid stopping drugs:

  1. Bacterial overgrowth
  2. Impaired nutrient absorption

In this article we’ll cover the remaining two consequences:

  1. Decreased resistance to infection
  2. Increased risk of cancer and other diseases

Our First Line of Defense

The mouth, esophagus and intestines are home to between 400-1,000 species of bacteria. However, a healthy stomach is normally almost completely sterile. Why? Because stomach acid kills bacteria.

In fact, that’s one of it’s most important roles: to provide a two-way barrier that protects the stomach from pathogenic bacteria.

First, stomach acid prevents harmful bacteria that may be present in the food or liquid we consume or the air we breathe from entering the intestine. At the same time, stomach acid also prevents normal bacteria from the intestines to move into the stomach and esophagus, where they could cause problems.

The low pH (high acid) environment of the stomach is one of the major non-specific defense mechanisms of the body. When the pH of the stomach is 3 or lower, the normal between-meal “resting” level, bacteria don’t last more than fifteen minutes. But as the pH rises to 5 or more, many bacterial species can avoid the acid treatment and begin to thrive.

Unfortunately, this is exactly what happens when you take acid stopping drugs. Both Tagamet and Zantac significantly raise the pH of the stomach from about 1 to 2 before treatment to 5.5 to 6.5 after, respectively.

Prilosec and other PPIs are even worse. Just one of these pills is capable of reducing stomach acid secretion by 90 to 95 percent for the better part of a day. Taking higher or more frequent doses of PPIs, as is often recommended, produces a state of achlorydia (virtually no stomach acid). In a study of ten healthy men aged 22 to 55 years, a 20 or 40 mg dose of Prilosec reduced stomach acid levels to near-zero.

A stomach without much acid is in many ways a perfect environment to harbor pathogenic bacteria. It’s dark, warm, moist, and full of nutrients.

Most of the time these bacteria won’t kill us – at least not right away. But some of them can. People who have a gastric pH high enough to promote bacterial overgrowth are more vulnerable to serious bacterial infections.

A recent systematic review of gastric acid-suppressive drugs suggested that they do in fact increase susceptibility to infections (PDF). The author found evidence that using acid stopping drugs can increase your chances of contracting the following nasty bugs:

  • Salmonella
  • Campylobacter
  • Cholera
  • Listeria
  • Giardia
  • C. Difficile

Other studies have found that acid stopping drugs also increase the risk for:

Not only do acid stopping drugs increase our susceptibility to infection, they weaken our immune system’s ability to fight off infections once we have them. In vitro studies have shown that PPIs impair nuetrophil function, decrease adhesion to endothelial cells, reduce bactericidal killing of microbes, and inhibit neutrophil phagocytosis and phagolysosome acidification.

A Gateway to Other Serious Diseases

As we discussed in the first article in this series, a decline in acid secretion with age has been well documented. As recently as 1996, a British physician noted that age-related stomach acid decline is due to a loss of the cells that produce the acid. This condition is called atrophic gastritis.

In particular relevance to our discussion here, atrophic gastritis (a condition where stomach acid is very low) is associated with a wide range of serious disorders that go far beyond the stomach and esophagus. These include:

  • Stomach cancer
  • Allergies
  • Bronchial asthma
  • Depression, anxiety, mood disorders
  • Pernicious anemia
  • Skin diseases, including forms of acne, dermatitis, eczema, and urticaria
  • Gall bladder disease (gallstones)
  • Autoimmune diseases, such as Rheumatoid arthritis and Graves disease
  • Irritable bowel syndrome (IBS), Crohn’s disease (CD), Ulcerative colitis (UC)
  • Chronic hepatitis
  • Osteoporosis
  • Type 1 diabetes

And let’s not forget that low stomach acid can cause heartburn and GERD!

In the interest of keeping this article from becoming a book, I’m going to focus on just a few of the disorders on the list above.

Stomach Cancer

Atrophic gastritis is a major risk factor for stomach cancer. H. pylori is the leading cause of atrophic gastritis. Acid suppressing drugs worsen H. pylori infections and increase rates of infection.

Therefore, it’s not a huge leap to suspect that acid suppressing drugs increase the risk of stomach cancer in those infected with H. pylori (which, as we saw in Part III, is one in two people).

In a recent editorial, Julie Parsonnet, M.D. of Standford University Medical School writes:

In principle, current [acid suppressing drug] therapies might be advancing the cancer clock by converting relatively benign gastric inflammation into a more destructive, premalignant process.

One way PPIs increase the risk of cancer is by inducing hypergastrinemia, a condition of above-normal secretion of the hormone gastrin. This is a potentially serious condition that has been linked to adenocarcinoma – a form of stomach cancer.

Taking a standard 20 mg daily dose of Prilosec typically results in up to a three-to-fourfold increase in gastrin levels. In people whose heartburn fails to respond to the standard dose, long-term treatment with doses as high as 40 or 60 mg has produced gastrin levels as much as tenfold above normal.

Another theory of what causes stomach cancer involves elevated concentration of nitrites in the gastric fluid.

In a healthy stomach, ascorbic acid (vitamin C) removes nitrite from gastric juice by converting it to nitric oxide. However, this process is dependent upon the pH of the stomach being less than 4. As I discussed earlier in this article, most common acid stopping medications have no trouble increasing the pH of the stomach to 6 or even higher.

Therefore, it’s entirely plausible that acid stopping medications increase the risk of stomach cancer by at least two distinct mechanisms.

Gastric and Duodenal Ulcers

An estimated 90% of duodenal (intestinal) and 65% of gastric ulcers are caused by H. pylori. It is also recognized that the initial H. pylori infection probably only takes place when the acidity of the stomach is decreased. In a human inoculation experiment, infection could not be established unless the pH of the stomach was raised (thus lowering the acidity) by use of histamine antagonists.

By lowering stomach acid and increasing stomach pH, acid suppressing drugs increase the risk of H. pylori infection and subsequent development of duodenal or gastric ulcers.

Irritable Bowel Syndrome, Crohn’s Disease and Ulcerative Colitis

Adenosine is a key mediator of inflammation in the digestive tract, and high extracellular levels of adenosine suppress and resolve chronic inflammation in both Crohn’s disease and ulcerative colitis. Chronic use of PPIs has been shown to decrease extracellular concentration of adenosine, resulting in an increase in inflammation in the digestive tract. Therefore, it is possible that long-term use of acid stopping medications may predispose people to developing serious inflammatory bowel disorders.

It has become increasingly well established that irritable bowel syndrome (IBS) is caused at least in part by small bowel bacterial overgrowth (SIBO). It is also well known that acid suppressing drugs contribute to bacterial overgrowth, as I explained in Part II and Part III. It makes perfect sense, then, that chronic use of acid suppressing drugs could contribute to the development of IBS in those that didn’t previously have it, and worsen the condition in those already affected.

Depression, Anxiety and Mood Disorders

While there is no specific research (that I am aware of) linking acid suppressing drugs to depression or mood disorders, a basic understanding of the relationship between protein digestion and mental health suggests that there may be a connection.

During the ingestion of food stomach acid secretion triggers the release of pepsin. Pepsin is the enzyme responsible for breaking down protein into its component amino acids and peptides (two or more linked amino acids). Essential amino acids are called “essential” because we cannot manufacture them in our bodies. We must get them from food.

If pepsin is deficient, the proteins we eat won’t be broken down into these essential amino acid and peptide components. Since many of these essential amino acids, such as phenylalanine and tryptophan, play a crucial role in mental and behavioral health, low stomach acid may predispose people towards developing depression, anxiety or mood disorders.

Autoimmune Diseases

Low stomach acid and consequent bacterial overgrowth cause the intestine to become permeable, allowing undigested proteins to find their way into the bloodstream. This condition is often referred to as “leaky gut syndrome”. Salzman and colleagues have shown that both transcellular and paracellular intestinal permeability are substantially increased in atrophic gastritis sufferers compared to control patients.

When undigested proteins end up in the bloodstream, they are considered as “foreign” by the immune system. The resulting immune response is similar to what happens when the body mobilizes its defenses (i.e. T cells, B cells and antibodies) to eradicate a viral or bacterial infection.

This type of immune response against proteins we eat contributes to food allergies. A similar mechanism that is not fully understood predisposes people with a leaky gut to develop more serious autoimmune disorders such as lupus, rheumatoid arthritis, type 1 diabetes, Graves disease, and inflammatory bowel disorders like Crohn’s and ulcerative colitis.

The connection between rheumatoid arthritis (RA) and low stomach acid in particular has been well established in the literature. Examining the stomach contents of 45 RA patients, Swedish researchers found that 16 (36 percent) had virtually no stomach acid. Those people who had suffered from RA the longest had the least acid. A group of Italian researchers also found that people with RA have an extremely high rate of atrophic gastritis associated with low stomach acid when compared with normal individuals.


In the last ten years, more than four hundred scientific articles concerned with the connection between asthma and gastric acidity have been published. One of the most common features of asthma, in addition to wheezing, is gastroesophageal reflux.

It is estimated that between up to 80 percent of people with asthma also have GERD. Compared with healthy people, those with asthma also have significantly more reflux episodes and more acid-induced irritation of their esophageal lining.

When acid gets into the windpipe, there is a tenfold drop in the ability of the lungs to take in and breathe out air. Physicians who are aware of this association have begun prescribing acid stopping drugs to asthma patients suffering from GERD. While these drugs may provide temporary symptomatic relief, they do not address the underlying cause of the LES dysfunction that permitted acid into the esophagus in the first place.

In fact, there is every reason to believe that acid suppressing drugs make the underlying problem (too little stomach acid and overgrowth of bacteria) worse, thus perpetuating and exacerbating the condition.


As we have seen in the previous articles in the series, heartburn and GERD are caused by too little – and not too much – stomach acid. Unfortunately, insufficient stomach acid is also associated with bacterial overgrowth, impaired nutrient absorption, decreased resistance to infection, and increased risk of stomach cancer, ulcers, IBS and other digestive disorders, depression and mood disorders, autoimmune disease, and asthma.

Chronic use of acid stopping medication dramatically reduces stomach acid, thus increasing the risk of all of these conditions. What’s more, acid suppressing medications not only do not address the underlying cause of heartburn and GERD, they make it worse.

Is the temporary symptom relief these drugs provide worth the risk? That’s something only you can decide. I hope the information I’ve provided here can help you make an educated decision.

In the next and final article of the series, I will present a plan for getting rid of heartburn and GERD once and for all without drugs.


Join the conversation

  1. KATHY, indeed I think the Zantac may be making you feel this way, I am having the same problems after taking it for only a week. I will never take it again. Hope you are feeling better since this post? cindy

    • Hi Cindy: He now has changed me to Nexium OTC 20 mg once a day. I am on day 5 and today I woke up feeling not as rough but still not great. I also started the no acid diet a week ago. I will not stay on this PPI for over a month but am willing to give it a try for a short period of time. If I’m not markedly better at the one week point I will discontinue. What are you doing now may I ask?

  2. After a routine endoscopy my gastro told me I had an inflamed esophagus and put me on Zantac as the omprezole and pantropozole gave me headaches. After taking 23 tablets of 150 mg Zantac (took twice a day) I am having stomach aches, throat feels blocked and acid mouth. I had no symptoms before except maybe thinking I was getting a mild sore throat once in awhile. I think taking the Zantac caused me to feel this way?

  3. Hi I’ve been taking omeprozale for five months and I cannot honestly say I have not had one day were I have felt ok I went to my doctor with constant burping burning in the stomach and was given this drug to ease it well after five months of an upset stomach awful symptoms I looked at the side effects and wondered why I was taking them I bought slippery elm and changed my diet and I feel great the side effects of this drug and what it did to me was terrible I would sooner burp than have my hair fall out brittle bones you name it they are lethal and should be banned I would definatly tell anyone to change there diet and try slippery elm Diet Coke was the culprit with me and I did nt know this good luck to anyone with gastris sometimes it’s the simple things that can make you better

  4. I ‘m glad to learn more about taking anti acid medication for I’ve been taking a high dosage of prolisec, protonic, zantac, pepcid for more than 3 years now and I just stop it for I’m not feeling any better anyway, so what I’m taing as of now is the natural cure sufflement witch is, Aloe cure and I will see if it will help me, for I’m scared of all the Anti acid that my Dr’s had prescriving me and it’s higher dossage and I’m already going to be 70 and I’ m 4″8 and 86 lbs I just cant gain weight for I’m very stricked about my diet, staying away from fatty food mostlyall what I’m eating is loe fat food, staying away from all, spicy food, deef fried food, red meat and pork, to make it short I’m avoiding all the food that is bad for acid reflux especially sugary food I love nuts especially peanuts, but then I found out that it is bad for acid reflux too so I really don’t know what to do I’m confused, but your article give me Idea that I really have to stop taking anti acid medication . Thank U very much

  5. My son is now 2 1/2, at 6 weeks old he was diagnosed with Laryngomalacia and severe acid reflux. At first he was prescribed Zantac in liquid form. When that was not strong enough to keep acid down his pediatric ENT Dr prescribed Prilosec, against his pediatrician’s plan of action. It did keep his acid down long enough for his Larynx to form and he was off all meds by 6 months old. Fast forward to a year old and months of chronic constipation, now at 2 1/2 its the same thing. All the while pediatrician after pediatrician have said Miralax is the answer to his constipation. I don’t believe it is, and he will not drink it disguised in anything. He seems to be exhibiting signs of gluten intolerance with the constipation and discoloration of his stool. I don’t know what to do and no MD will help other than suggesting Miralax. I wish I knew then what I know now, but hopefully find a way to restore his health. Are there any diets or options you can suggest to help restore his gut health after prolonged infant use of antacid medications?

  6. relax don’t panic in whatever u do and definitely never abuse any medication use it as a last resort let the body get use to the ailment. When used too much even good beneficial things become bad for u. Don’t panic eat don’t panic excercise ie walk for too long don’t panic burp ie don’t burp too much and definitely don’t let it become a habit. Acid reflux is not just one thing so it gets confusing and we panic well I do anyway but it’s always the same also I’ve realised my stomach is always tense it’s like I’m keeping it tense and that isn’t how it’s suppose to be so when I relax my acid reflux/indigestion symptoms relax a little. It’s hard but I think the best way to overcome it is to get use to it… If we are sensitive then we will be sensitive to all illnesses and it’s OK to get a little scared but it isn’t worth it because it’s just a vicious cycle we keep going through and we need to learn to break this circle. Anyway what’s helped me is a family friend gave me some 150mg ranitidine which I took for about a month or 2 and I boiled ginger in water and sipped the harsh but amazing drink every time my reflux was unbearable and it helped so much I could sleep my stomach wouldn’t be tense anymore I found my relaxant. ginger is great for acid reflux etc give it a try it may help 🙂 i had it for about 6 years only recently started treating it before that my GP said it was in my head or was just anxiety Nope it was acid reflux which was causing my anxiety. As soon as I took the first ranitidine it helped a lot cleared my brain fog I started to think clearly again. don’t abuse the meds just find the best times that suit ur schedule and the diet is most important cut down on stuff u are addicted to and stop completely things like spicy food fried junk food chocolates and having large servings, have smaller servings spread out through the day. Well that’s what I had to do and it gets better don’t worry 🙂

  7. Calling out this article. I was on losec for about 15 years off and on..20mg per day from the age of 35 to 50ish. I never had muscle problems of any kind or any of the other symptoms people complain about. I have bad anxiety, but have had that forever since a youth. I now only take ratinidine..I find it has worse side effects than losec but is suppose to be easier on you than losec. Who knows. I also exercise heavily every day..and drink a coffee a day plus i drink.

    • I took Prilosec for a good 20 years. Docs kept prescribing it. I was worried about long term affects & was told I had nothing to worry about. About 3 years ago I started feeling very sick. Felt like I was dying of cancer or some horrible disease plus had bad joint & muscle pain & awful fatigue.Had multiple blood tests and everything came back normal. Docs made me feel like it was all in my head. Told me I needed to take antidepressants. If I was depressed it was due to feeling terrible 24/7. I took a antidepressant for about 2 months & found myself thinking of suicide. Depression is not my problem. I asked my doctor if it could be Prilosec & was told no let’s try a different antidepressant. Since then I have been researching Prilosec & found my problem. Stopped Prilosec 4 months ago and am feeling better. The first two months I felt like I was going through heroin withdrawals. It was awful. Thought I was dying! Then came terrible heart burn which I still have. Working on my diet now.

      • Same here! Took it for years. Because my doctor said I had Barrets esophagus (due to steroid use to treat UC). I had no idea it actually makes everything worse yet the GI docs still hand it out like candy. Come to find out it makes UC AND GERD worse, not to mention the withdrawal.

  8. I have been coughing for years and in the last year or so my voice keeps changing when J talk too long. Have to keep coughing to clear my throat. The past few weeks I have a sore area inside my throat. I went to the doctor a week ago and she couldn’t see down far enough. So she suggested I try Lansoprazole for a few weeks to see if that would help. I took them for 5 days and by yesterday the heartburn got way worse. So did not take one this morning. Prior to this I didn’t notice heartburn but felt I had reflux. I’ve tried Apple cider vinegar with water. Sometimes that helped other times it seemed to make it worse. The back of my throat is not a normal pink colour but yellow looking. Which I think is very unhealthy looking.

  9. I’ve been on PPI’S for 26 years because I have Barretts and GERD. I want to get off of prilosec but I’ve tried before and had horrible heart burn and can’t eat anything. Please help me I know I have a very bad gutty stomach and have a horrible time having BM.

    • If you were good on ppi don’t change. It is normal that you have heart burn. If you have GERD don’t change medication. Don’t take ACV because it is not working for everyone. The only thing you can do is spreading your meals instead of 3 times a day , small meals 5 times a day. And very important , you need to chew enough on your meal ( 10 to 20 times) because than there is enough saliva which include the enzymes for your stomach!

  10. I have been diagnosed with mast cell disease and Zantac is the only thing that allows me to lead a normal life. Do you think using digestive enzymes and probiotics will help allay the ill effects of the Zantac?

    • Ask your doctor for a gastrin blood test. You have to be free of the PPI’s for 2 weeks prior to the test but it will tell you whether you have high acid or low acid. If you have low acid ask your doc why you need to take PPI’s when you have low acid. If its high then you can justify taking the PPI’s to lower the acid. You can also test your PH of the stomach acid with litmus testers. Good luck.

    • Great question – as I’m a sufferer of barratts oesophagus. I started with acid reflux years ago after my mum left home so I mainly due to stress related issues and now I’m older and slightly overweight. I was never told if it was due to less acid or excess just told to keep taking omeprazole 1x20mg every day. To which I’m not taking and have been quite acidic lately – feel like I need to take another tablet now actually 🙁
      Not sure what to do for the best.

    • Eric if you have high stomach acid then indeed your doc may prescribe and you may need PPI’s. You need to find out what your stomach acid is high or low..

  11. Misinformation is rife on this website. Have you no shame?! The evidence that red meat causes cancer is far stronger than the evidence that PPI’s cause cancer, yet you voraciously reject the latter while embracing and promoting the latter.

    This site isn’t scientific at all, the author clearly starts with whatever position he believes/wants to be true on any given number of topics and then cherry picks, omits and misrepresents studies as it suits.

    • well if there is a correlation between red meat causing cancer and also PPI use….doesn’t that just show further how necessary it is to have enzymes working properly in digestive system?

    • Are you even clicking on all the scientific study links he has posted in these articles? There is an overwhelming amount of scientific evidence here and you can find so much more using google scholar yourself.

      Not to even mention how much sense it all makes if you have experienced some of these issues he talks about and researched them for yourself.

    • I have had atrophic gastritis twice the first time 10 years ago I also had campylobacter. I have been on omeprozale (Losec) for 10 years. I have just had a gastroscopy to be reveled I have erosive gastritis and atrophic gasritis. I am also B12 deficient. My GP said “Oh you have too much acid” my specialist said that gastritis and B12 deficiency point to too little acid. The biopsy came back with Reflux oesophagitis. They also removed 6 polyps. I asked my doctor for a gastrin test to prove his statement and I have received the results today and I have low stomach acid. I had been off PPI’s for several weeks when the test was done. I have stayed off the PPI’s. I am treating this with diet and am just going to start eating sauerkraut as this helps the stomach. I am starting to feel so much better. As my father died from oesphagael carcinoma I am concerned by this misconception. So Matt I clearly do not share your views on this. There are times when I have had to have zinc and folic acid supplements and my blood tests are pointing to borderline Iron deficiency. I cannot ignore the personal evidence.

      • I do not understand that the gastritis is a cause of your low stomach acid. Mostly gastritis is a cause of to much stomach acid or infection. Your low level of B12 can be a result of your gastritis. And if you have reflux oesaphagitis , this is mostly result of to much stomach acid. Here in Belgium in the university hospital they don’t treat low stomach acid or I your low stomach acid must be a result of another disease. Take attention that mostly to much stomach acid lead to problems and the biggest risk is damage the mucus lining of your stomach and esophagus which can lead to bleeding , wounds and even cancer!

        • Hi Rudi You are posting this on Chris Kresser’s website blog. Have you read the articles that he has written regarding stomach acid and causes for gastritis etc. Here is a piece for you information. It might be good for you to read these articles.
          “In this first article I will present evidence demonstrating that, contrary to popular belief, heartburn and GERD are caused by too little (not too much) stomach acid. In the second article I’ll explain exactly how low stomach acid causes heartburn, GERD and other digestive conditions. In the third article I’ll discuss the important roles stomach acid plays in maintaining health and preventing disease, and the danger long-term use of acid suppressing drugs presents. In the final article, I’ll present simple dietary and lifestyle changes that can eliminate heartburn and GERD once and for all.”

          My gastro said that gastritis and B12 are associated with low stomach acid not high stomach acid. I have had a gastrin test and I have low/normal stomach acid. Why would I take omeprazole when I was on it for 10 years and got gastritis and also oesphagusitis. I feel much better not taking it and I have had no pain or heartburn since getting off it. If the doctors can convince me that I need to lower the acid in my stomach even further then I will take the medication. The reason the acid is coming up and “burning” the oesphagus is due to LES sphinkter. I think the gastritis is due to taking methotrexate. I also had polyps removed at the same time. There are some doctors that say its too much acid some say not enough…. The medical profession can’t agree on this so we are not going to get it right in a discussion. Every person is different. If the acid in the stomach is high then maybe that person should be tested for Zollinger-Ellison syndrome. I will keep monitoring everything and will discuss with the specialist when I see him….

          • I had to comment here, because you mentioned you are taking Methotrexate, which my mother was put on for RA. It is a wicked drug in itself. Caused her blood sugar to go off, I had to test her sugar every day, and it also made her puffy all over. I am off Omeprazole again, but am taking 150 mg of Rantinidine, twice a day, even though I am drinking flax powder in water, and it helps, but not enough, not yet. And my belly is burning as I write this, because I put off taking my pill till just a bit ago. Ate my lunch, and boom! Burning. What are we to do, live on water and pablum?

            • Hi Julie
              Yes the methotrexate is dreadful stuff and I no longer take it. Even though I have gastritis and oesophagitis I don’t take anything. I control it with diet. Very bland and sometimes frustrating but absolutely worth it. Good luck I hope yuo get through the issues and become pain free.

      • Hi, is it like a nagging pain in the upper right part of the stomach? Does the middle of your stomach, just under the breasts bone feel tender- like? Does it pain? Does the burning get worst after a meal? And radiates into your back? Do you get chills, too? What about nausea? Sensitive to smells?
        I have all these. Trying to trace and connect symptoms.
        The doctor said that I have polyps, fatty liver and mild GERD.

      • I too like everyone else have been suffering from stomach problems after years on & off rennie. I have ended up with chest pains and was admitted for angina. Turned out I had a good heart and clear arteries but I have to had such a scare I packed up smoking cold turkey. Then the anxiety started cos I have to was sent home from hospital with statin and blood pressure meds. After 2 mths I have thought why am I taking these when my heart is falling off OK and after seeing the doc stopped taking them along with the omeprazole for the acid. For the first week I felt great then the acid started again. I went to the doctors and he suggested endoscopy after what I had been through I declined and he just gave me more omeprazole. However I soon realised I had stopped having acid but the bloating stomach pains and farting had now become an issue. I went back to the doctors and saw a nurse practitioner she stopped the omeprazole and put me on ranitidine a form of zantac so that she could take h. Pylori tests. She is very thorough and I expect to get results tomorrow. But omg what hell I have had on the zantac. Nausia diorhea pains burping bloating farting. I thought I would die this morning but after a glass of water. One exploding fart and burp I felt much better. I really hope I do have h. Pylori so I can can get on the food diet to cure myself & after hearing reports on this condition I thank you all for sharing because you have given me a boost today to fight on thank you all x Jane

    • Matt you have chosen to believe that red meat causes cancer. I have chosen to believe that PPI’s make my condition worse. Both those views could be rubbish who knows…. We will all believe or do what we think is best for us. Regardless. For the record I don’t red meat either. I also believe that wheat and dairy can cause issues with some people. Doesn’t mean every person that has it is going to get an intolerance. We are all different..

  12. Hi there I was diagnosed with barratts oesophagus in 2012 and told to have 20mg omeprazole every day. I was on them for a few years and started with IBS then pains around gallbladder / liver. I now don’t take them every day only when If I feel acid. My GP keeps advising me to take them every day but after reading articles like yours I’m unsure what to do for the best. Can you advise ?

  13. Chriss, I feel really grateful for these articles, I feel really relieved and helped by them…

    I feel really curious about the final article, since I am not sure what I should do…


    • Yes thanks Chris it’s all very interesting and has helped me make the choose to not take ppi,s even tho my doctor said there ok and told me to carry on.. personally I’m going to stick to no alcohol. Healthy diet, no fats and sugars ect. Since my last blog I’ve been diagnosed with polymyalgia and put on steroids to try to reset my immune system as it’s an autoimmune disease that I’m convinced was brought on by ppi,s.. ive been in severe pain for 3 months and never want to go thrue that again, ive no proof it was ppi but i wouldnt go back on them again and would advise anyone to only take them short term and change life style instead. Looking forward to last atricle

    • I have stopped using Prilosec and starting using essential oils from Doterra. I use the Digest Zen roller over my stomach area and chew the Digest Tabs. I am going to order the Digest Zen softgels next. I have been on Prilosec for years because I was suffering and nothing I tried worked. Thank-You so much for your articles and try essential oils!!! They work and are all natural and healthy!

  14. Chris, I can’t wait for your final article. Please make it soon. I am struggling with GERD ever since being diagnosed with SIBO. I eat only carrot, hamburgers, chicken. I take a digestive enzyme Similase Lipo and HCL. My GERD is getting worse causing me to need to increase my dose to 1944 mg. at each meal. I am not using any OTC or prescription drugs for the problem. I hope you have some advice on what I can do to get over this.

  15. Over the past year I had episodes of feeling fevered. I had body aches, (skin, muscles, bones…etc) and generalized fatigue. These episodes increased in frequency to the point where it was a daily event. I changed jobs (night shift ER nurse to 8 hour day shift nurse) thinking my body was just becoming run down. Depression was setting in as I felt more helpless, nothing was improving this horrible feeling. About a month ago I went to bed insanely early because I hurt so bad, I actually cried in frustration thinking I probably had acquired an autoimmune disorder or worse yet, a doctor would tell me I had “fibromyalgia”. Any nurse, especially an ER nurse, will tell you we don’t believe in this description of symptoms, it often accompanies very weak personalities, When I got up the next day, (a full night’s rest would always guarantee me a few hours of freedom from the pain) I started researching both of my medications, Atenolol and Zantac. I assumed if anything was the culprit it would be Atenolol as it was my newest drug. I found no correlation between my symptoms and the listed adverse effects of Atenolol. Then, I started researching Zantac, and thinking it couldn’t possibly be this medication, it’s an OTC, therefore safe. In one article, one tiny line in hundreds of paragraphs, I found the possible side effect of “myalgia”. This was all I needed to read, I immediately stopped taking Zantac and noticed in 2 days an immediate improvement of my symptoms. It has now been almost a month since I stopped taking Zantac, and I can say I’ve had approximately 98% resolution of all symptoms. I feel fantastic, and I am SO relieved that my case was resolved so swiftly. Today I found this article which so clearly explains why I was feeling SO poorly, like death was around the corner. This experience will give me new empathy for my patients with autoimmune disorders and undiagnosed diseases. Thank-you for offering this research, it has given me validation and a much clearer understanding of what was happening to my body.

    • Hi karen,
      I am also taking atenolol and zintac for last 2 years and around 3-4 months before i also started feeling tired with pain al over my body specially back and knee pain, is this might be due to zintac? Can i stop it without teplacing it with some other medicine?

      • Zantac, or Rantinidine, does not do that. It only reduces excess acid, it is not an acid blocker like Omeprazole. I would blame the Atenalol, which you must be taking for either blood pressure or heart, or both.

  16. I have a hiatal hernia and have experimented with omeprazole 20m pd for the past 5 years- my conclusion is thus:

    Long term use say over 30 days causes bloating and digestive problems- I simply can’t process my food when taking this stuff and overeat to compensate. I didn’t realise the damage this drug was causing me- we need stomach acid to break our food down and PPI are a lazy and crude method of intervention for acid reflux.

    For digestion I use vinegar cider, slippery elm, mastika and digestive enzymes and have to avoid lactose and other related foods, and without doubt PPIs screw up digestion if taken before any of the above. They’ve caused me intercostal muscle issues which have referred pain effects elsewhere in my torso and stomach swelling.

    I would only (if at all now) ever take PPI in short doses ( 3- 5 days) or before or after alcohol, which I have now stopped – so I am not planning on drinking alcohol or taking PPI for a couple of months and will watch the results.

    • PPI’s are bad for your health. Read the label. You should not take them for more than two weeks. Recent studies raise very serious issues: dementia and kidney failure are associated with people over 74 who take them. A forty percent increase over a five years period of dementia in seniors. I went back to H2 blockers and melatonin. check melatonin out as a solution. It works.

    • I was on a ppi for hiatus hernia and told to take it indefinitely . After 3 months I gradually developed chronic and debilitating pain in both shoulders both knees and both hips. Currently I’m being tested for autoimmune disease s including rheumatoid arthritis I’m convinced it’s due to the ppi, my doctor won’t have it but I’ve stopped taking them changed my diet and lifestyle and feel lots better with no gerd or heartburn so it can be done. I’ve still got severe joint pain but wished I never taken ppi in first place or just been aware of all the information that I’ve found on internet and taken them just to clear my ulcers which took just 3 weeks then stopped. Ppi are a quick easy fix so people can carry on eating to excess thers always a price to pay for this sort of treatment. Ditch the drug and chznge yo lifestyle. Tom m is an idiot.

      • I have exactly the same pain you described. I quit my protonix for a week and felt better. But then I could feel the acid in throat come back. You mentioned you replaced with other medications. What are the other meds that you take to protect your stomach and esophagus.

    • Hey Matt I am intrigued with your post regarding intercostal muscle issue caused as a result of prolonged ppi use. Can you possibly expand on the symptoms a bit for me. What exactly had you been experiencing?

      Thank you

      • The reason I ask is because I was on prevacid and losec for approximately 18 years before finally going off it. However I am now as well having intercostal issues as well

  17. Just so you all know, this is all garbage. Yeah stop taking anti acids so you can burn out the lining of your stomach and get ulcers and stomach bleeding. But hey, at lease you won’t get a virus..

    So unless you’re licking the pavement and making out with every person you meet, I’m 100% positive you’re fine to take your omeprazole. And the only real research shows that the drug shows increased risk of infection for elderly in hospitals. Reference? My pharmacist and my Doctor.

    And yes your stomach pH is suppose to be acidic, but your intestines have a very basic pH. You’re most likely feeling sick cause you’re not eating a balanced diet if you are experiencing nausea. And taking an anti acid can cause irritation cause again, yiu don’t have burning acid telling you your hungry.

    Please take care of your body and stop letting the risk of side effects control your life. Take your pills, feel better and live happier. Or don’t take them, live in misery and feel like garbage. I believe quality is way better than quantity. I’d rather live 60 great years than 90 just okay ones.

    • You’re an idiot! Stop spreading false information. The information in these articles share what many others studying this are finding. You’re a pharma pill pusher. You don’t even make sense in your comments.

    • “100% positive”, Tom M.??? Where is your sources to back up everything you’ve spotted off in your replies? Where’d you get your degree? There’s nothing wrong with people researching causes of GERD and side effects of drugs & making informed decisions themselves. Only a fool would take a drug without understanding the risk involved. I hope they put “Take your pills, feel better and live happier” on your tombstone when you die too young. Besides, I don’t think you payed attention the day they taught pH in chemistry class. Lol. So, go back under the pill-pushing rock you crawled out from under.

      • People, here in Europe. Ppi are the standard treatment for GERD.HCL is dangerous. It can even damage your stomach which can lead to cancer.I went due to GERD to a hospital in Ghent, Belgium, best university hospital in Belgium with top doctors. I told them that I did use hcl for GERD. Ok they say if you will damage your stomach and bowels go further with it. They say that h pylori loves to live in a high acid environment. So if you want to increase the risk with an increase of h pylori and cancer risk of your stomach go further with taking Hcl or pepsin supplememtation. Do you know that people can live without stomach? So stomach acid is just not needed. People don’t believe in to low acid stomach’s bullshit. I believe in doctors who continues have experience with GERD problems and these are gastro intestinal professional doctors.

    • Tom M each to his own. My doc told me the same as your doc. My specialist however had been in the job 30+ years and told me gastricit and B12 deficincy point to low stomach acid. So I had a stomach gastrin test done when I was not taking any PPIs or antacids. Came back low acid. I also gat gastritis and ulcerated stomach while on PPI’s. I have now come off them and feel heaps better and am enjoying life. If you are happy to take your PPI’s then maybe you really do need them as I am sure there are people out there that have high acid levels in their stomach. There is a place for PPI’s in society but not in my stomach thankyou. I would like to hear how you get on when you come off the PPI’s. If yuo don’t come off them it will be intersting to see what side effects you develope with time. There will come a time when your doctor will tell you to stop them as there is more information being made available as to the side effects imerging. All the best I hope all goes well for you Tom..

    • Well, Tom, aren’t you just a peach…lol. (sarcasm). I know personally that PPI’s and other acid blockers/reducers are not good for you…they don’t just lower acid, they influence and change body chemistry. I took zantac for 7 months and it has me caused awful muscle pain, joint pain, burning from head to toe and prostate issues. As a matter of fact, I just found out (from a blood test) that i carry a gene mutation MTHFR (which i also found out is pretty common) that makes it difficult for my body to convert and use B vitamins. This makes me susceptible to vitamin deficiencies and acid reducers are known to cause deficiencies by themselves so I can’t take them anymore. I am (with the help from a Naturopath) working on treating my GERD with natural remedies such as digestive enzymes, quality probiotics (not the cheap over the counter ones), slippery elm, DGL, ACV and changing my diet and lifestyle to eliminate my triggers. I think that having blind faith in anybody let alone any doctor is foolish. You need to advocate for yourself and ask questions and do research, and get copies of all of your blood tests etc. You are the best judge of your own health…if you suspect that a med is causing you discomfort or harm (especially if u didnt have it b4 taking it) then report that to your doc and politely yet firmly request that he/she assists you in either putting you on a different one or getting you off it if it’s not tx a serious condition….

  18. Wow! I have heard some of this before and have tried to get off of my Prilosoc. Of course, the “withdrawal” symptoms were unbearable, so I started taking them. Now I’ve read that these symptoms can take several weeks to several months before disappearing. Yikes! Wish all doctors were aware of this and stayed away from PPIs. No one ever told me I would become dependent on them and that taking them was actually harming me instead of helping.

    I have taken my last Prilosec. Hopefully, eating many small meals during the day will help with the acid reflux symptoms. But it sounds like it is going to be a long 3 months.

    • I am currently weaning off 20 mg of omeprazole. I started by cutting back 1/4 of the granules out of the capsule, then 1/2 out, and this week am down to leaving only 1/4 of the granules in the capsule. Stopping suddenly only brings on rebound, as your stomach over-produces acid to make up for what has been repressed. Doing it gradually like this, I have had no problems so far.

    • Don’t drop your anti acid because you read a bunch of “what ifs.” If you have constant stomach acid, you will burn out your stomach lining and once it’s gone it is gone. Don’t go to the hospital for stomach ulcers and bleeding because you read something on the internet and someone who probably never had this issue, wrote a lot of garbage saying it’s bad. And cutting cold turkey from anything is extremely harmful. Don’t be a slave to “what might happen.”

      • You should stay off boards like this one. Your comments are utter BS and what is helping to keep people dependent on drugs.

  19. So I started taking Prilosec almost 3 months ago when I was having weird chest pains from acid reflux right before I quit smoking. Shortly after I quit smoking my acid reflux intensified and my dr said I should take the 40mg for 3 months to help with a ulcer she thought I may have. My regular dr did a blood test a month later and did not show any sign of a ulcer. Now that I have 2 weeks later I have been going threw the weirdest things. I have developed super tight and sore leg muscles, feeling a bit foggy now and forget words or stumble sometimes when I am talking, could these be from the Prilosec possibly or could is be from when quit smoking still? This crap scares me. I am a fairly healthy person don’t drink or do drugs quit smoking over 3 months ago and still out of it from that but for the most part healthy

  20. In my opinion, as someone who has taken both acid reducers and PPI’s for about 20 odd years, they need to have rehab centers for us. Anyone who has tried to stop taking these drugs after taking them for so many years, almost always go back to them, because you are in a word, MISERABLE! I want to stop, and have tried. I have tried enzymes, vinegar, you name it, but I feel so rotten, I go back to the pill. I do only take 20 mg once a day, and my vitamin levels are fine.

    • Why are you acting like this is some type of addicting narcotic? Yeah you’re miserable cause over production of stomach acid is dangerous and can cause stomach bleeding. You’re blowing this out of proportion and people reading your post are going to get the wrong impression. And vinegar is acidic… Maybe take a chemistry course? You want to fix an acidic stomach, have a basic pH diet and no processed sugars. But most importantly, use your brain and stop getting info from a blog on the internet on life decisions….

        • Ray
          I think you should read and gain information before you accuse people who take the time to contribute to this site of being trolls, idiots, whatever. In fact, the person expressing concern about PPI’s is echoing the opinion of doctors writing for the Journal of the American Medical Association and its Neurology publication plus doctors in many other venues: based on a recent study showing a strong association between use of PPI’s and dementia and kidney disease. The doctors advise that PPI’s be used very cautiously. This cure may be worse than the disease.

        • People must understand when they whean of there medications. Off coarse symptoms returns. They forgot how bad they were before. That’s the reason why you take medicine. Yes? PPI are bad ? Who said that? If you look to people who takes medicine for high blood pressure. These medicines can also cause dementia and kidney disease. Of coarse many people take medicines and forgot what they need to do, change there lifestyle. Eath healthier, go outside moving, etc. of coarse if the professional doctors give you a medicine who can help you, in these case PPI, but you changed your lifestyle of course you can get many other diseases which not came from using PPI but from your lifestyle you didn’t change. You can see it as if you have continuous back pain by not doing enough excersises of not sitting well. Your doctor can prescribe to go to a chiropractor. But if you not change your lifestyle. The chiropractor cannot do more, even you will be more and more in pain. That’s the same for using a PPI and all other medications. When you try hcl and pepsin instead of PPI ok it will be maybe better. But the risk of stomach bleeding and damage will become greater. Why? You did’t change your lifestyle. Here in Belgium , best university hospital UZ Ghent, the gastro MD says you can use hcl and pepsin instead of PPI but take in mind that risk of stomach bleeding and ulcers, which are linked to great risk of stomach cancer will increase.

      • Tom Raw ACV is the only vinegar that is actually alkaline-forming to the body. All other vinegars (white, balsamic, red wine, etc) are acid-forming. It is important to mention people with acid reflux issues should take only raw ACV (with the mother)

        • Everyone should read Anthony Williams medical medium book. He recommends not taking ACV, as like you said its vinegar, he does say it’s the safest vinegar to use rather than White and regular vinegar. He also recommends not to have fermented foods either (as they aren’t living) – interesting as I’ve tried both fermented and ACV and my body has shown me it’s not the way forward, For the last few days I have been drinking celery juice on an empty stomach first thing in the morning. It apparently boosts the HCL levels in your stomach which is mainly the main cause of acid reflux. That celery helps digestion of other foods throughout the day. The celery contains sodium and certain minerals, I have been having it now for 4 days and feel amazing. I’ll keep you informed of my progress.

          • Hayley so pleased to hear you have found something that your body can heal with. We are all different. I have just started on taking Bentonite Clay and so far so good. I also eat salads with added celery everyday so maybe there is something in the celery.. Who knows. Look forward to hearing your progress report.

    • You are so right! I stopped cold turkey after an endoscopy that showed polyps in my upper stomach caused by too little acid allowing for bacterial growth. But it felt like a cat fight in my stomach and they were clawing to get out! So what did I do? Doubled my PPI dose and doubled my zantac dose for a few days just to be able to function. There have to be published guidelines at least to teach us to wean off without suffering and the knowledge on what to do next.

  21. Hi chris,
    Thank you so much for these articles. They are very informative and interesting. I am a 28 year old woman, healthy (in my opinion , for the most part), non smoking , non drinking fairly healthy eating habits (oatmeal, yogurts, fruits for breakfast, veggies usually for lunch and a non gluten grain for lunch, sometimes protein and veggies for dinner etc .) I have been sick for the last two months, with a very uncomfortable cough, clear mucus, and asthma which I thought was a virus, (my X-rays showed no bronchitis, or pneumonia, etc), no bacterial infections, etc. I finally went to a doctor who diagnosed me with GERD. I was prescribed two medicines, but before taking, I will try your method of eating the right foods, not eating many carbohydrateS etc, restarting in a sense. I don’t eat bread/pasta regularly , though I have been in Italy the last month and a half and have eaten way more than normal. Anyways, there is one medicine that is not an acid suppressant , and I am curious about your opinion- though I don’t know if you will answer! It is called Neo Bianacid. It’s apparently “natural” , and helps create a mucous membrane barrier in the stomach and asophagus, to protect from stomachs acid irritation. I’m wondering if you know anything about this or if you have thoughts about it – their website says this about it, among other things:

    Poliprotect synergistic molecular complex of polysaccharides (molecular weight > 20,000 Da) and minerals (Limestone and Nahcolite) with mucoadhesive properties.

    Physiological mucus is, essentially, composed of mucin and bicarbonate.

    Anyways, I would love to hear your opinion! Thank you

    • I have lpr it seems burning in the throat but got bad side effects from lpr. I Stopped PPI now but the burning is bad. I bought neo bianacid and this morning I woke up with some burning had breakfast and took one for the first time and it seems to relieve the burn in the throat/upper chest. I will combine this with gaviscon advance and hopefully this will work and make life more bearable than it is for me at the momeny

      • Congratulations on getting off PPI’s. How did you learn about neobianacid? The only place I could find it is on ebay.
        You might also be interested in using melatonin which is not the same chemistry but also protects the mucus membranes in your digestive tract. It soothes these areas. Also, it allows the body to do what it is supposed to do including using acid to aid in digestive processes. I have had great success with melatonin, bit I want to try bianacid during the day time. Gaviscon advance is great. Good luck

  22. Hi. I have been taking Prilosec for 2 years and after reading about the long term effects I stopped cold turkey. Now I’m having bad acid indigestion and heartburn. Few questions:
    1) Am I at risk if I stop now of developing any of the horrible things above?
    2) Will this pass eventually as I build up my stomach again to handle the acid?
    3) Will Aloe Vera Juice help? Any other recommendations?

    Im 47 yrd old male, very fit, and eat well.

    • You’re extremely ignorant and that’s nice to know there are people who read this stuff on the internet and then go “cold turkey.” Use your brain… If you have acid problems go to your doctor(the guy who went to 10 years of schooling to help you) and listen to him. Unless your licking the pavement and kissing strangers daily, you’re fine to take an anti acid to help you.

    • Agree Tom. People read something on the Internet and what they do , they believe it immediately. Follow : cold turkey and symptoms return and why they forget immediately that they were better and become anxious of long term side effect which nor even proven, They don’t realize that other medicines who people takes for example high blood pressure, diabetic, kidney disease,etc if they stop this medicine symptoms become back and maybe worsened. Why because they were good when they take them.

  23. Chris: what are are your thoughts on the latest research reported in JAMA on the association between PPI’s and kidney disease and dementia? I was negative to begin with about taking PPI’s and I am determined to get off of them. I just saw on You Tube a specialist from UCLA gastro center talking about Barrett’s. It was interesting to me that an all doctor audience posed questions about PPI. He says there is no evidence that they prevent cancer and his guess is that they don’t. One hypothesis is: the reflux may not be acid, but something else. So there is no point in using PPI’s.
    Thanks for your good work.

  24. Where is the last article that is supposed to help me with all the issues you just raised in all the other articles?

  25. I’ve been on Prevacid for several years and I don’t think they do a lick of good. Years ago I started getting acid reflux on a daily basis. I went to the doctor and he wrote me a script. It was that easy, like handing out candy to a kid. Basically, it’s like putting a band aid on the problem. Nobody cared to investigate why I felt like I did. It angers me that doctors don’t warn you of the possible side effects. I’m tired of being another statistic and I’m determined to get my life back. I’ve been doing a lot of research about acid reflux. I’ve read that it’s actually you don’t have enough acid, it just mimics acid reflux. I’m ready for a change but need some solid info to get me kick started. I need advice on getting off ppi’s. I’ve heard you can suffer acid rebound quitting these types of medications. What would be the most effective way to quit ppi’s? I don’t care how long it takes, just as long as I can get off them in the end. I want to do it with as little pain as possible but I realize everyone reacts differently. I’m not even going to waste my time asking my doctor because I’ll get the run around. That’s why I’m here. I have finally found a group on the same level thinking as me. I need to get off these ppi’s and if someone can elaborate on a plan I’d be grateful. I want to get off these so I can try HCL with pepsin and just maybe, get my life back.

  26. My daughter has been on reflux medicine for about 10-15 years and has just been diagnosed with stomach cancer. She has horrible GERD and so do almost everyone in our family, some worse than others. Why are the big pharm companies warning us of this and fixing the problem. They told her she could get cancer if she did not take these drugs. Now her 5 year old has been on them since birth and actually throws up in her mouth. They are small girls and do not eat a lot. Now my daughter is having 60%of her stomach removed at 34 and we are waiting to see if the lesions on her liver are cancerous or benign to determine if she has to have chemo. I feel this is the ultimate money maker for the medical field. She has to deal with ally his and has a 1 and 5 year old child and a full time teaching job.. I am mad as hell about this and these doctors trying to push pharmaceuticals and not use our insurance snd fix our problems. This is nothing short of murder. And the ultimate scam to make the big bucks. I no longer respect the pharm companies, the health ins cos nor the doctors. Legal murder and a slow torturous death.

  27. I had heartburn, inflammation all over my body,asthma,diarrhea,all kinds of issues.I was diagnosed with food sensitivities. I was taking Prilosec, and started having heart arrythmia. I quit the Prilosec and started taking HCI with pepsin and betain before meals and,and,incredibly, all my issues seem to be going away. I now think I had too little stomach acid. The food sensitivities were actually the result of not digesting my food. It wasn’t that I was sensitive to the foods, it was that I couldn’t digest them. I feel like a new man. Workouts at the gym have gotten TOO EASY!!!! No more heartburn. No more inflammation.No more asthma.

    • I just want to point out to both Chris and yourself that while SOME cases of heartburn certainly CAN be caused by chronic low stomach acid levels, more often than not, that is absolutely NOT the case, and making a blanket statement like that is both factually incorrect and socially irresponsible.

      Now look, I hate PPIs as much as anyone, as I took them at high doses for several years and am now suffering the consequences (osteoporosis and chrohn’s disease, and that’s just the tip of the iceberg), but as someone who underwent a very successful surgery for GERD (Linx device), I feel obligated to point out that studies have IRREFUTABLY shown that the majority of GERD cases are the result of deterioration of the LES (lower esophageal sphincter), which is what keeps the contents of your stomach from splashing up into the esophagus.

      Advising people to take betaine HCL and digestive enzymes will only cause further esophageal damage to someone with LES dysfunction (which again, applies to the VAST MAJORITY of GERD sufferers), so while I’m glad that has worked for you and a select group of others, the truth of the matter is that it’s terrible advice for most people.

      • Friends:
        Please note that gastritis and GERD can be acidic and alkaline. Antiacids and PPIs are prescription drugs given by MDs and they ” work ” in either case. The way to go is to learn how to determine the acidity/alkalinity of the gastric disorder. Both cases can be present in the same person under different circumstances, however 98/100 times is insufficient gastric acid in the stomack the cause of the disorder. By design and nature of the digestive process, the valve that connects the esophagus and the stomack is only closed when the specific amount of gastric acid is present, amd that is the only way to close the valve. Consider the cause of acidic gastritis and GERD the only alternative is supplement hcl and then, only then the valve closes and the stomack releases the contents into the small intestine and signals the pancreas to proceed with the digestive process. Consider the gastritis/GERD to be alkaline, again you supplement hcl to neutralize the alkalinity of the stomack contents, in case of GERD to return to the stomack or to close the valve and to be released into the small intestine. In the case of alkalinity you have to supplement until you feel releafed, with deep knowledge I have to tell you that is how mature works and there is nothing we can do to change it. In cases when the valve in been managed with surgery, the process could ne alterated, but in 100/100 of the cases the procedure is a failure. The only way to reverse this unwanted result is to reeducate your digetive process very, very, very slowly until the valve is back to its nature. Most of the cases it reverses, do not give up, just be patient and become an investigator of your own boby and how it works, at the end you will be surprided,proud and free of medical malpractices. Alkaline gastritis/GERD, however rare is much more damaging than acid gas/Gerd, much more by far and I beg you to take action as soon as possible. The answer is very simple, add hcl until you feel relief, never before. Antiacids and PPIs are extremely dangerous because of the rebound effects they produce and the vicious circle they create. Believe it or not, the two most damaging drugs to human kind are Antacids and PPIs and statin drugs. Almost, if not all deses are because of those two poisons. If taking a high dose of antiacids/ PPIs reliefs your disorders is only and only because your body feels extreme pressure to let the the food in process to return and enter into the small intestine bypassing the stomack as the last resort in order to save your life of going into a alkaline coma. Hcl is the first line of deffense for the inmmune system, not enough of it, using antiacids and PPIs is an invitation to disaster and any pathogen causing any desease is free to destroy your health. It is a classical case of suicide.
        Please be proactive and take care of yourself, given the case that the medical system is not.
        Best wishes for you…….

        • Friends: Just for the benefit of the doubt ,I strongly suggest you google Dr Wallack, Dr Glidden, Dr Mercola, Dr Michael Greger, Dr Jon Barron,,,Dr Wilson, Dr Eric,,Dr Chris Kresser, as always impecable right.

  28. Does anyone have information about the long term use of antacids to remedy GERD and having your sense of taste and smell totally change? I’ve read in only one place that liquid antacid can change taste but can’t find more info. Doctors are prescribing more antacids and the smell/taste changes are really difficult to deal with and I’m suspecting it’s related.

    • Nel:
      I too have had changes in my taste after taking omeprezole, Zantac and now lansoprazole. Zantac did not control my acid reflux. But I don’t understand why I have lost my taste buds. I can’t taste most bland foods and it is so upsetting. My dr said he has never heard of this side effect and said I should live with it because not taking the lansoprazole would do more damage to my esophagus. Can anyone help?

      • Nel,
        Proton pump inhibitors decrease your bodies ability to absorb minerals and vitamins. One of them being zinc. Signs of a zinc deficiency include altered or loss of taste and smell. You can supplement with zinc, but do so cautiously, you don’t want to take too much at once.

  29. i have gerd and would like to know info. Also just quit Omeprazole after only taking for 2 weeks. Having alot of burping and worse symptoms of bloating, cramping, and acid indigestion. I was afraid to keep taking the PPI.

  30. I’m a 29 year old female and I started experiencing sudden heartburn after eating that seems to persistent for even a day or two after and been going on for two weeks now. After reading this, I wonder what the alternative explanation for heartburn could be if it’s not low stomach acid, because I’ve tried apple cider vinegar in the past (the Bragg’s kind with the mother) and had horrible heartburn after. It seems if it was low stomach acid, then this remedy should improve heartburn not increase it?

    • Melissa, start by taking PepZin GI 2-4 times a day between meals. If that does not help, you will have to try taking Zantac 150 one time before bed.

      If that’s not sufficient, shift to Zantac 150 every 12 hours, which is the standard dosage.

      I made a website about helping with gastritis, after stumbling into a lot of misinformation on the Internet:


      Apple Cider Vinegar is often recommended by naturopaths who want to believe the problem is low-acid, but in majority of cases this simply isn’t true, and ACV just makes things worse.

    • At your age, the most common cause is STRESS or/and eating too late in the night -unless you are addicted to spicy food.

      Stress will cause stomach pain, acid reflex, eventually ulcer.
      So any remedy to stop the acid are just temp without treating underling cause..

      You can try this

      There are different levels of GERB/heartburn
      If you have mild acid reflex(heart burn), flatulence, but no diahhrea, and little pain take this -your tongue must have some white coating or swollen:
      Xiang Sha Yang Wei Wan

      if you have acid reflex & diarrhea & pain -take this with meal.
      Ban Xia Xie Xin Wan Remedy will also treat pylori…

      These has been use probably a dozen centuries for sure,

      Xanac is not the answer…will make the problem worst.

  31. I have been taking Prilosec for over 3 years. I’m a female in my mid 30s and know I need to get off of this drug asap. I don’t know how and my doctors can’t or won’t help… I couldn’t find the final article in this series. Where is this published? Any additional resources recommended where I can help myself to get off of Prilosec? Greatly appreciate any help/comments!

    • I was able to wean of simply by adding a lot of fermented food. Quality farmers market saurkraut, kombucha tea from a health food store, and kefir. I even drink pickle juice if I need to. Go on a very low carb diet, stop eating sugar, and processed food, and load up on fermented food. If that doesn’t work read about adding HCL and pepsin into your diet. Also read up on how to slowly wean off of PPIS good luck!

  32. This is a very interesting read and about what I was looking for. I’ve been on Omeprazole for the past few months due to reflux causing coughing. Now, I never had excessive reflux issues, but it was bubbling up when I slept. Now, I decided to go off of it and try to treat the reflux with tums and fiber capsules, but the reflux is suddenly so much worse than it ever was before I started taking Omeprazole. I’m hoping the next installment in this series is doable, because I’d hate to have surgery for this. I’m only 26.

  33. I underwent surgery on the 29th of June to correct my refluax problem and I can unequivocally tell you that the PPIs I had taken for years was destroying my health. I am totally free of all reflux medicine and free of all symptoms associated with the reflux and massive hiatial hernia.

  34. Excellent series of articles. Absolutely loved it! Thanks for sharing this with the world. Just got a question for you: Doctors who claim acid reflux is due to excessive stomach acid, suggest to reduce intake of acidy food like tomatoes, onion, lemon, etc. Do you disagree with this statement? My understanding from your articles is that consuming these foods can actually be beneficial to increase stomach acidity and reduce or prevent acid reflux. I’d love to hear your thought.

  35. I was told to take Prilosec basically forever (due to peptic ulcers) two years later I read about how bad it was! I had lost so much weight and was always sick. I went back to my dr and he said I had taken it to long to safely get off, but I was determined. I have successfully gotten off for one year but it caused long term problems. I now am severely allergic to milk, coconut, and suppliment vitamin B’s.

    • I have been taking 40 mg of Nexium for almost 10 years now. I’ve hit my gallbladder out my appendix out and I still have diarrhea and then bouts of constipation. I had the H pylorie took the antibiotic and two months later it’s back again. Where is the next article about what to do about Gerd? I never did see it

  36. This is all so interesting to me. I had some issues with my bowels, so dr orders a colonoscopy. While drinking the prep, I was on my 10 dose (80ozs) I started throwing up blood, I stopped the cleansing process and went for procedure the next day, told dr what had happened and he also did and endoscopy. There was a small tear at the bottom of my esophagus, he also found a severe infestation of h pylori. I was put on 2 antibiotics and 2 pepto bismal tablets every 6 hours for 2 weeks. Had a 2 week follow up, at that time he put me on Zantac 2 a day. After a couple of weeks, I noticed it was making me feel horrible, a lot of discomfort when I take it! So I stopped taking it. It’s been 5 month’s and I feel like I did back before the procedure. I am run down, my give a damn is busted and I am hurting. I am supposed to go at the end of Aug for my 6 mt check up with my surgeon. Should I go ahead and make an earlier appt.? How do you find out your PH balance in your stomach?

  37. I now understand why I got so sick.
    Ultimately I am the idiot for taking Prilosec. A friend bought me Prilosec and fervently insisted that I take them for 2 weeks to “vastly improve my stomach and liver health that may have been damaged from my drinking habits.”
    I told her I have never had heartburn or acid reflux in my life, but sometimes loose bowel movements the day after drinking. She said it rehabilitates the damaged stomach and liver.

    Again, I’m the idiot.
    While going through the 2 week course of medication, i had lost appetite and energy. On the 14th day, after eating seafood I was completely floored with high fever, swollen lymph nodes and throat, and excruciating body aches. For nearly 3 days.

    Prilosec was the culprit. Or maybe my ignorance was.

    • If anyone reads this, can you tell me whether I may have done some serious damage by taking the 2 week Prilosec when I absolutely had no need?

      Will my stomach acid secretion level return to normal now that I have stopped taking them?

      What can I do now?

      • 2 weeks is reversible. Keep TUMS at hand, but try to use them sparingly, because excessive use can create kidney stones.

        You should be able to “land”. I find Russian food “tvorog”, also known as farmer’s cheese or quark… to be a good natural antacid.

    • I have been taking nexium for 10 years – 40 mg
      I cut back to 20 mg and had gurgling and could taste bitter taste. I think I am stuck taking it till I die. So it will be a vicious circle of h pylorie I fear..

  38. I’ve been taking Nexium for maybe 15 years .I am serving from some of the side what do I do for the GERD /ACID REFLUX? I would like to get off this medicine .Found info at lots of medicines.

  39. I have suffered from Silent Reflux for 20 plus years and have taken every PPI manufactured and it has been a night mare.

    Yesterday I had surgery performed to relieve the nightmare, I had a Laparoscopic Nissen Fundoplication procedure and I am real anxious to see how fast I see results and get of the PPIs.

    • I must have silent reflux too.) I’ve never heard that term) I had no idea I had herd and reflux because I rarely had heartburn.
      Let us know how you are doing ..

  40. Taking PPIs, in my case omeprazole and pantoprazole, was one of the worst things I’ve ever done. Omeprazole wasn’t that bad, but the pantoprazole my GI DOC prescribed me absolutely ruined me. The acid reflux got worse, I was constantly nauseous and couldn’t eat anything, causing me to lose almost 50 pounds in 2 months. I became so severely constipated and began having horrible cramps and bloody stools. My gastric motility decreased to almost nothing, so that food was sitting in my gut for upwards of 12 hours and I never felt hungry. If I ate food in the afternoon, I would wake up in the middle of the night, choking on the acid in my esophagus.
    It’s been 2.5 years since I stopped taking PPIs, and I’m still not fully recovered. I still feel nauseous constantly, and get full very fast. Most days I can only eat once, maybe twice on a good day. I’ve started taking digestive enzymes, betaine hcl, and am on a grain free diet. This has at the very least stopped the constipation, and the acid reflux is greatly improved.
    I recommend people be very cautious with PIPs. They are powerful, dangerous drugs, and and are often improperly precribed.

    • Try probiotics for constipation and better overall digestion. Chris writes all about probiotics and how they are relatively safe. Just make sure you have easy to digest prebiotics to feed the good bacteria like inulin. Also, look for probiotics that won’t cause excess gas and won’t make your symptoms worse.

  41. RE-PHRASE- I meant PPI AND Antacid use USED TO TREAT not caused by!
    The majority who take NSAIDS have no choice but to take them (including for RA), so therefore need a reliable way of dealing with the resulting (secondary) GERD. Is there a suitable solution for that? Antacids and especially PPIs merely make NSAIDS tolerable.

  42. It’s all very well to claim to deal with PPI Antacid use caused by GERD. But what about PPIs used in treatment for anti-inflammatory side effects? There is no way these drugs can be tolerated in an acid environment.

  43. To whomever can help me:
    I have taken OTC and prescription Omeprazole over the past 20 years. All doctors that I have seen (for different reasons) over the past 20 years tell me that its ok to take the drug and NO doctor will help me get off of the omeprazole! I have been developing different medical problems over the last 5 years. I have been diagnosed with IBS, I had a wrist fracture at age 50, I have had different stomach/bowel problems, and muscle/joint problems. I have gone to Gastro doctors and have had upper and lower scopes, I have gone to Ortho doctors and have had C/scans, MRI’s and ultrasounds. I have gone to GYN with problems, but she says it is in my intestines. I have “foggy brain” sometimes. There are so many more doctors and tests that I have gone through. I say the common in all of this is the PPI that I have taken for 20 years. NO doctor will help me ( I have gone to at least 10). I have run out of money. I am on only Disability Social Security now. What can I do. Please some one help me get off of the Prilosec/Omeprazole.

    • I don’t know if I’m surprised that doctors make it sound like taking omeprazole is safe for long periods of time. says you could develop B-12 deficiency after 3 years of prolong use. I never met a doctor who did the proper blood test or follow-ups as explained (and recommended) on the manufacturer’s website. Unfortunately, you have to do your own homework when it comes to medication.

    • Nadine, this is what you should do right now:

      1) Stop taking your PPI immediately and switch to Zantac. Zantac is older and less efficient, but a cleaner drug and safer for long-term use.

      Now the dosage is tricky. Standard Zantac dose is 150mg pill every 12 hours. But because PPIs are so strong, you may need to take Zantac 150 every 8 hours in order to prevent acid rebound. You will need to first try the standard dose, and watch carefully if there are hints of burning before the interval expires. The 8-hour scenario is LIKELY.

      Generic Zantac 150 (ranitidine 150) is sold on Amazon by Kirkland for very cheap.

      2) Start taking PepZin GI (zinc carnosine) – 1 capsule as you get up, 1 capsule right before bed, and 2 more capsules spread during the day between meals, but not immediately before or after them. Dr’s Best is a good brand.

      If you take a zinc supplement of some kind, then lower the dose to just 2 capsules.

      If you’re taking Sucralfate, stop. They’re competing for the same function – coating the stomach and healing it – but Sucralfate sucks at its job.

      3) Start taking sublingual methylcobalamin 5000mcg, which is a form of B12 you put under your tongue. You can buy it on Amazon. Jarrow brand is good. Kirkland (CostCo) brand is cheap.

      Traditional B12 tiny pills that you swallow, are useless. They are cheaply made and absorb poorly.

      4) For bowel/colon problems, buy broken-cell-wall Chlorella. Source Naturals is a good brand. Take 4 capsules after you wake up. Your poop will turn green, but its a cosmetic effect and it means its changing your bowel environment.

      Also consider trying the probiotic brand “Align” which has some clinical evidence of helping with IBS and such.

      5) Consider eating tvorog (farmer’s cheese/quark). Authentic forms can be found in Russian grocery stores. It’s a powerful antacid and probiotic. Unlike milk, it actually does good. Sprinkling sugar on it for edibility helps.


      Eventually if you get really stable and good, you may want to get off the Zantac. However, in my experience, this requires the method of liquid titration. None of the acid suppressing drugs can be “weaned off of” without EXTREMELY slow lowering of the dose. Cutting fractions of pill won’t do. It has to be more like, percentages. Hence… liquid titration.

      • I have been working on getting off the Omeprazole. I have been on the drug for about 16 years. I started lowing the dose on April 15, 2015. I am still not off completely, yet, but I am alot closer. I am keeping a diary of this journey. The 1st week (from 4/15 to 4/21), I started taking 1/2 every other day. The same for the 2nd week. The 3rd and 4th weeks, I went to 1/2 every day. On the 5th week, I cut it down even more and took 1/2 on the 1st, 2nd, and 3rd days of that week and then none on the 4th day. By that night, I had really bad GERD. I was so upset because I wanted so much to be better and then the GERD hit. I did do the same for the next 4 days and the GERD hit again real bad. Into the 6th week, I did the same for that next 4 days and the GERD was still bad. My sister had me try Super Enzymes with Papaya and I started taking them after each time I ate, even if it was a snack. Then into week 7 , I stayed with the 1/2 Omeprazole, on 3 days and off 1 day. . Now it is June 5 and I am in week 8. I have cut the Omeprazole down to taking 1/4 on 3 days and none on the 4th day. I still take (and maybe always will) the Enzymes, but that is ok. I feel much better then I did 8 weeks ago. I am sleeping better, my joints do not hurt as much, my belly area is going down a little in size, and I feel like getting out and going to the store now. I know I still have a ways to go, but I have been taking it slow and easy (its been over 2 months now and I still am not Omeprazole free, but I will be one of these days.) I am proud of my self for doing this. NO doctor would help me!! I am becoming Omeprazole free on my own!!

        • Hi Nadine,
          I was just wondering if you have done anything in particular to raise your stomsch acidity levels (besides weaning of PPI’s)? Of so, what has worked best?

          • Josh, the only other medication that I am taking is that once in a while I may take 2 TUMS, but that is only when I do not have the enzymes with me. I am getting some, but not very bad reflux. Its not even reflux,, but I am ready for it to turn into reflux, but it doesn’t. I am just staying with as long as I need to so I can be Omeprazole Free. I am so much better then I was 3 months ago!!

            • It’s been over a month since I posted about my experiences of coming off the PPI, Omephrazole. I was getting the GERD/Reflux so bad when I tried to go down to the 1/4 tablet (5 mg), that I ended up going back and staying with the 1/2 tablet (10 mg) daily. I also have been having some medical problems, unrelated to the coming off process.. Now, I am past those medical issues, so I am ready to restart the coming down process of the omephrazole. Today, I am starting the 1/2 and 1/4 every other day dose. (Today is Wednesday, so that means 1/4 tablet (5 mg), tomorrow, I will take 1/2 tablet (10 mg), then 1/4, then 1/2. I will continue this dose for a min. of 3 weeks. After that, I will dicrease to 1/4 every day for a min. of 3 weeks, then i will go to 1/4 every other day and so forth until I am off the omeprazole. This is my plan, but I know that plans could change. If the coming off is different, then I will write and tell my story. I WILL get off the PPI!! It will just be a matter of my time.

              • Shihonageth….
                THANK YOU!!!!
                I’m petrified but have to try. Ive been on omeprozole for 5 years. Now I have RA. I have to try to do as much as I can to get off this drug of the devil. I am so disillusioned by my doctor. She won’t even talk to me about it. When I tell her about my diet choices helping my RA she looks over her glasses at me like I’m crazy.
                I feel like I’m totally stuck on this drug forever. So sad.

                Nadine…. What an inspiration and thanks for the info. I am going to do it. Long haul but well worth it in the end. Thanks for sharing.

  44. A well meaning friend recommended that I drink the juice of a lemon every morning to lower the acidity of the body. Well, after a few weeks of that I developed acid reflux and have been having problems since. I stopped the lemon juice but I continue with problems. How do I go about raising the acid levels in my stomach again?

    • Your well-meaning friend gave you bad advice. I don’t think your problem is caused by low stomach acid, but by damage to stomach lining.

      You may still climb out of this without having to resort to acid suppressors. Start taking PepZin GI (zinc carnosine). You can buy it on Amazon.

      I am not a salesman, however I talk about this supplement everywhere. It is widely used in Japan to treat gastritis, but in America the doctors are CRIMINALLY oblivious to its healing effects, which were also clinically proven several times.


      I was curious about that myself, so I looked up a few articles. This one suggests that some bacteria are more apt to surviving the environment of the stomach. Some others suggest that dairy that contain “friendly” bacteria temporarily raise the pH of your stomach acid, making it possible for the bacteria to survive long enough to reach the intestines.
      This article suggests prebiotics, which instead helps the probiotics already in your gut to thrive.

  45. Thank God! Finally there is someone who knows what they’re talking about.

    Two months ago I would up in the hospital twice. At first I thought I was having a heart attack. The pain in the middle of my chest was unbearable. After all the testing and drugs given to me to relieve the pain they concluded that I have GERD.
    Over the last 15 years I have had episodes of heart burn and resorted to taking Tums to get relief. The MD at the hospital prescribed a PPI that I have been taking for 2 months now. It helps but it hasn’t cured the relapses of burning and dull annoying pain in the chest. So, now I’ll trash the meds and change my diet. Hopefully this will eventually cure this decease that is disrupting my health and quality of life.

    Thank you for this valuable information.


    • Me too! I ended up in the hospital and thought it was my heart and so did the doctor and paramedics. I was the one to push to see a G.I. and get the scopes to see what was really going on. after only 10 days on PPI Prilosec I was worse and found Chris’s website .. stopped taking it and the next day got HCL and took it first time yesterday and with the first dose I was better! I was like .. really? all these years and especially the last 6 months in misery ends with one dose of HCL? AMAZING!! Second dose at dinner was same .. no GERD! Bedtime a little but not too bad, natural antacid helped that. but is was just my first day. Today is the second day and breakfast was same .. HCL and food is doing fine and NO GERD! Finally someone who knows what the heck they are talking about! thank you for saving my life! Now to get off the synthroid that they thought my Thyroid was causing my throat feelings. Nope it was the GERD. I will be med free soon! I’ll recommend Chris’ website to everyone I know!!!

  46. It appears you have hit the nail on the head, I have had GERD for 30+ years. I was started on Prilosec in 1993, and about 2 years ago my whole life started falling apart. I started developing drug allergies and food allergies and was getting severe headaches. The headaches were caused from an allergy to the prilosec. I have since been chasing endless solutions to my problems, which up until now have pointed to candida overgrowth. After reading your article on GERD/Heartburn I feel you have found the answer to my catastrophic GI pain and digestive issues. I am overwhelmed with all of this and have begun by stopping all PPI’s. But am being instructed to take ranitidine to aid the repercussions of stopping the PPI’s. I feel this is counterproductive. I don’t know where or how to start the process of getti g my gut back to normal. Where do I start?

  47. I can tell you all that if you stop the medicine your heartburn / reflux will go through the roof. I believe the reason for this is that your stomach is constantly trying to produce the acid cells that the medicine is killing so when you quit the drug you have an extra abundance of acid. However with time it gets much better. I have had a lot of the issues discussed int this article. I have had reactions to shellfish because of it’s bacteria content and my stomachs low acid content. I have had stomach infections. I have asthma. I have quit the meds and will never go back to them. The solution is to eat healthy and exercise. I am however, afraid to go to the doctor to find out if any cancers are present because I took meds for 20 years and I am only in my early 40’s. I would like to know how the recovery process of the stomach once one quits taking the medicine. Will the body heal itself?

    • Melissa, you are the first person I’ve seen who has taken the acid blockers as long as I have. My last Prilosec was this past August. Like you, I’ve been through the gauntlet. It’s not over, but it seems to be getting better. I haven’t had the asthma or stomach infections you’ve seen, however.

      Like you, I wonder what permanent damage has been caused by my use of Prilosec for such a long time. In my case, I am wondering whether inability to absorb essential nutrients for so long has caused issues, particularly with joint problems. I had plantar fasciitis in one foot for years which suddenly vanished within a month of stopping the Prilosec. I have developed (evidently) trigger finger in both thumbs. Although that is better now, it is still a source of much pain.

      Lord knows what we’ve had done to us by these meds and our lack of information about them.

      • How did you guys get off of Prilosec?!? I have been taking this for over 20 yrs as well and cannot find a reliable way to even slowly quit. Please help. Thanks.
        Glad you are doing better.

        • Hi, Dave.

          You are one of the few I’m seen who have taken Prilosec as long as I have taken it.

          I’d love to be able to give you a step-by-step, sure-fire way to stop Prilosec. I’m not sure such a thing exists.

          In my case, I used a gradual reduction in dosage over a period of around six weeks. I took my last Prilosec this past August. In retrospect, rather than tapering off the dosage over a span of six weeks, I now wish I’d chosen to taper over a period of at least six months – perhaps even longer.

          I’d be here all day if I related all the problems that have arisen due to ceasing this medication. From massive stomach acid problems to nearly critical bowel issues, it has been a tremendous battle. I am constrained by time, however my bottom line advice is to extend the time that you gradually back off from this drug.

          Perhaps when I get more time, I can get back on the forum and go into further detail.

          • I have been on Omeprozole for just shy of 1 year. Dr insist I take it because of the risk I run of inhaling the acid into a newly transplanted lung. Any and all advice in weaning off this drug would be very much appreciated. Have been discussing with my Dr and they said fine- try Zantac…. Which sounds terrible also. I have a homeopathic remedy- but they don’t want me to use it…. ” in case” it interferes with all the other mess I am on. 🙁

            • Zantac is not terrible. Look into clinical research and documentation – it’s a pretty clean drug.

              Pepcid is cleaner overall, but in my experience its effect burns out faster at equipotent dosages, and FDA issued a warning about its impact on the kidneys.

              There’s also Axid (nizatidine?) which is sold in some countries OTC, which is supposed to be the best and latest of that sort of medication, but in America we are stuck with Zantac, which is, frankly, good enough.

    • I can tell you that it didn’t go through the roof! The last day I took Prilosec I had the worst heartburn of my life. Next day found Chris’ website. next day bought HCL .. next day took it with Lunch .. AMAZING! NO GERD! Eat right? of course but even if you don’t HCL will help most people just like Chris says! He truly is a life saver! and a money saver as I have limited insurance and have been paying the doctors visits myself .. over $1000 later I was worse off for it! Like the saying goes “you do not have health issues for lack of taking _________” (enter any drug you like). Natural is always the best way to go, to bad most people don’t believe that.

      • I just started on Prilosec 40 mg. caps.for a hiatal hernia. HCL is Hydrochloric Acid, right? Anyone know what kind of HCL, etc.? Thank you.

        • Lynea, I have a hiatal hernia w/ something Dr. calls thin esophagus . So both together causes my Gerd , I’m on Protonix . going on 2 years and started with joint pain, bloating , gas . The thing is I was only having heartburn , now I have all this crap !
          I’d love to get of it, but are you afraid ? Why I am is if I have another health problem arise , my Dr. will blame me for stopping it !! I sure would like to try that HCL too , I’m so torn 🙁

          • Diana, I have stopped the Prilosec after only eight days on 400 mg. per day. Now I take Zantac twice a day as someone here recommended. What is a “thin esophagus”? As for telling the doc we’ve gone off something, that doesn’t usually cause me any problems–mainly because my doc is very open to my own use of meds.

            The bad aching in my stomach is back, depending on time of day and what I eat.
            Not as bad as it has been before changing my diet and eating more, smaller meals that I try to eat slowly.

            I am scared, too. But it’s the hiatal hernia that has me scared. How long have you had it? Are you seeing a gastroenterologist for it? How old are you? I am 69 1/2. Never had stomach problems before a year of severe pollen allergies seemed to make my stomach hurt based on the amount of mucus I was swallowing. I wonder how common that is?

            • Lynea, I’m really not sure how long I had my hernia , but they found it 3 years ago. I never knew It until I started having stomach aches and chest pain. No I was never sent to a gastroentologist . Gave me a scope down my throat and sent me home with Protonix . I only have Medicaid so my Dr. won’t send me to specialist unless , she can’t figure out what’s wrong or tries different pills.
              What they mean by thin esophagus that having acid reflux for so long before I was treated , it burnt away the inside . It had gotten so bad I was vomiting and couldn’t keep anything down. Oh I have had and do have a list of health problems. Had my gallblatter out too was full of stones.
              I’m only 55 I had one Dr. tell me my body isn’t in any in any better shape then a 70 year old !! That was a great thing to know .
              That’s why I’m scared to about trying to get off the Protonix , if my Gerd gets worse I just couldn’t take it .. I really wish I had some answers for you. I do wish you luck to figure things out 🙂

  48. I’ve been ailing from GI issues for about 3-4 years. It began with about 2 years of burping/belching all the time. Especially after I ate. Eventually just drinking a glass of water would cause a half an hour of bloating and belching. This eventually got worse about 1.5 years ago when on top of the bloating I had acid reflux from whatever I ate or drank. I got this under control with prilosec and took it for about 4-5 months. I tried coming off of it and after a few weeks the heartburn was back with a vengeance and I had a new symptom. Ectopic beats happening a lot, especially at night. I’ve had the odd ectopic beat over the years but I’d have one then they would dissapear for months. Now it was one all the time every night and the only thing that gave relief was burping. So I went back on the prilosec, however the ectopic beats are still coming and now when I eat and drink I can feel the food just sitting in my stomach. My digestion feels really slow. I had an ECG and everything was good. My GP is scheduling a 24 hour monitor but told me that the beats are benign and once they find out where they are coming from I can have an ablation to fix the issue since the beats are causing me sleep issues. I’m just wondering if my stomach is really the culprit here and is causing the beats. Or could this be just a coincidence. The doctor also said all my symptoms could be real but also psychosomatic and due to my anxiety. Has anyone had this issue and found a cure? I’m going crazy these days. The doc says my magnesium levels are okay but I wonder if that’s the case. I eat hardly any magnesium related foods. I eat pretty bad most of the time.

  49. Hi Chris,
    you make a great case that too little acid is the cause. Please remember that part 3 said:
    “but I’ve seen several patients in my practice on a very low carbohydrate diet that still experience heartburn, which improves upon restoring proper stomach acid secretion (which we’ll cover in a future article in this series).”

    Looking forward to learning how to restore proper acid secretion.
    Kelly T

  50. So far ( or I just haven’t read yet) about the author’s concerns for the cancers produced by the acidic secretions of herd on the esophagus etc. Are anti acid meds worth the risk for these sx, considering u r risking cancer without them? Also the articles don’t emphasize all the people who have to take anti inflammatory meds , which also cause heartburn. Thanks for your future responses.

  51. I wish I would of known this information years ago. I am 19 years old and have developed an enormous amount of health issues in the past year that has completely taken over my life. The doctors had me on the highest strength of an anti-acid medication for 5-6 years just because I had minor heartburn. In fact I even asked about the dosage being right for me after reading online that high of a dose was for ones with ulcers, but my doctor assured me it would not make a difference. I have gotten off the medication around 6 months ago with the advice coming from a homeopathic doctor. We were desperate of finding answers. I have been working with him and several other doctors for months now and it has seemed to be a never ending journey and has become an my absolute biggest nightmare that ruined my once enjoyable and healthy life. So my question is… Are there certain things someone should do after getting off an anti acid? I have already made many changes, taking pro-biotics being one, other vitamin supplements and trying to take a dose of apple cider vinegar daily assuming that would help get the acid back in my stomach. Another homeopathic doctor suggested a high dose of phosphorous being something to use so I have recently started that. I cannot explain how much anger and sadness stirs up in me after reading this article. Doctors are the ones who made me sick in the first place just to be told we don’t know whats wrong with you and pretty much saying you will probably have this for the rest of your life so just learn to deal with it. I am in the process of trying everything I can do to heal my body but the damage done may be irreversible. Please let me know if people have any suggestions/what the best way of knowing your maintaining a good level of acid in your stomach.

    • i can tell you exactly what happened to me. if i had not found out about BETAINE HYDROCHOLRIDE . i would now be dead…yes, dead. after all the antacids my stomach was producing no acid at all. so ? nothing was digesting. lost 30 pounds in one month… WAS INFORMED AT THAT TIME BY A DIFFERENT DOCTOR ( A NATUROPATH _ I NEEDED TO SUPPLEMENT ACID….juiced only for a month while adding the HCL. little by little i could tolerate food. learned exactly how much to take for what.. for a regular meal i was taking** 5 ** 650 mg caps of HCI. OMG ! it worked . i was also taking about 75 other vitamins, minerals, and pre-digested protein to get my nutrition back to normal…3 months and i knew i was going to live. i was 75 years old at that time.. i am now 83. love waking up., raising 2 kids. do all my own housework and clean my own carpets. just learned about MSM. an awesome pain killer and it is working also… watch a lot of DR MERCOLA ON YOUTUBE. I USE ZERO ANTACIDS NOW. proton pumps totally rehabed. they are what produces acids in the stomach.. good luck to all and hope you are as blessed as i am now. no meds at all. BLOOD PRESSURE 112/72… only occasional pain pill and getting rid of that with the MSM. I COUNT MY BLESSINGS EVERY DAY FOR FINDING NATURAL CURES. THEY ARE OUT THERE. WATCH DR MERCOLA. JUST TYPE IN ** YOUTUBE AND DR MERCOLA AND ANTACIDS OR WHATEVER IT IS YOU NEED FIXED… YOU WILL LOVE

      • Eilnor, That’s wonderful news ! I enjoy a good story about someone taking charge of their health 🙂 Wish I had known what I do today for my parents health problems .
        At least I have the tools for a Happier- Healthier life and not suffer like they did with Quack ,Pill Pushing Dr’s !! Hope your still going strong ……

    • @ Kayla – I thought I was the only one experiencing all these problems this young!? I’m only 21 & have been taking PRILOSEC everyday since I was 15yrs old, I’m so ashamed of that & like you have suffered from SOOO many health problems these past couple years. I’ve tried quiting for like a week but it burns so bad after a while & end up giving in, I don’t know what to do anymore…..

  52. This is Amazing and pretty scary. I understand more now and appreciate the work you are doing. Thanks for all the information you are sharing. Now, please tell me what should i eat to increase my stomach acid?

  53. Hi I was wondering if u could tell me about another medicine that will help me with my heartburn and acid reflux I’ve been taking ranitidine or whatever and I’ve been,taking it for 2 months and starting a month ago I’ve been feeling sick like I have to vomit super nauseated and I’ve been having diarrhea as well

  54. I truly believe your articles. My husband died from stomach cancer in 1997 at 47 which was caused by taking Losec which is the brand name in Canada for Prilosec. He started with the acid reflux, put on Losec & within 9 mos. he was dead. I spent a lot of time in the hospital library reading the trials in which a lot of research trial rats died from stomach cancer. Thank you for putting it out there for all to finally know these acid inhibitors kill.

  55. I found out about a yr ago basically all u say and stopped all antacids I’ve been on nothing since…now my meds don’t absorb well at all in fact some of the time they will come out and not have dissolved in my body at all, I still get wicked heartburn I don’t know what to do to stop it I just suffer through it it’s not as often in fact I would say it only once or twice a month I can’t take any kind of Motrin anti-inflammatories or anything like that at all if I take one instant stomach gut rot like never felt but I’ve yet to find any kind of help not from doctors not from anyone I would love for someone to tell me if there is any help. I have suffered a massive injury in which they would normally give an anti-inflammatory but I, and no joke can’t take any it’s like I ate glass, so they put me on 4 5mg of a drugh called oxycodone, which is basically percoset without the Tylenol, now it worked fine but the manufacturers all are making all these apparently horrible narcotic drugs so called tamper proof, so I now swallow glass if I take even one, they used to be a powdery like pill, I mean if I left them in my bottle to long eventually the last ones would be smaller as they would kind if start to fall apart but now they r either like rubber or hard as a rock and I can’t digest them, drs want me to take an anti acid…they make it worse..I can’t find any help so not only do I have a giant gash in my actual butt muscle and my hip is jammed badly and tendinitis as well as many other horrible problems because of the stupid hip and butt, but I can’t take pain meds unless I want to end up throwing up or like I said feel like I ate glass and that’s really not worth it cuz they no longer work..I mean if it’s coming out of me it’s not even getting into me so taking nething to ease the pain is what? A big fat nothing, and nigh taking anything means I can’t walk or sit or stand or take care of my kids better than I am (for your information I do take care if my kids and I’m a good mom, in many ways a better mom than many even stuck) but I digress, how or is there even a way to fix or reverse the symptoms a. My dr thinks I have chrons disease. Yay…I heard in Europe that taking papaya can actually help and Overthere the doctors are actually perscribing things to help fix stomachs because they have discovered that when you are a teenager you produce more acid than any other age in your life so it is impossible for you to be overproducing acid as an adult so ant acids are not necessary so they’re getting it right why can’t USA get it right…I can’t figure out what they r giving to fix this though…I would love help

    • I’m not trying to say “Google it” but i am on my phone and it’s hard to type on the tiny keyboard. but please look up abdominal adhesions. I had them from my appendectomy. They were basically killing me and doctors didn’t believe that I could have them or that they would cause me so much pain. I couldn’t sleep. I couldn’t eat. I lost a ton of weight. I was in the worst pain of my life for over 2 years. I wanted to die. Food became the enemy. I had excruciating sharp pain every time I would eat or have food move through my gut. I would get into these nonstop vomiting cycles that would require ER trips. I was at the ER a lot. Doctors were telling me nothing was wrong with me because all the tests they ran came back negative and the ER is for sick people. You could count each and every rib up until my collar bones. I had to chase doctors around and convince THEM I had an adhesion. I finally got one doctor to listen. They cut me open and there was a big, thick adhesion that glued my gut to my hip bone, right where I had been pointing this whole time. After surgery, all the pain was gone. I did have pain from tight muscles from where they cut me but stretching and exercise is making it go away. My life is back, the pain is gone, I don’t want to die anymore, and I really do not trust doctors anymore. Doctors didn’t mention adhesions and then they didn’t believe it was adhesions. This is the short version. I can elaborate more later if you have any questions and I hope this helps. I wish I would have found out sooner.

      • I also forgot to mention that surgery can cause more adhesions so it can be a gamble. I know it may sound silly but there are types of massage and physical therapy you can get/do to stretch out any possible adhesions or scar tissue to possible avoid more surgery. I did some and it really helped. The massage is Mayan massage or the place I went to, is a physical therapy place called Clear passages.

      • I would try Castol oil packs to break up adhesions, before undergoing surgery. After my abdominal hysterectomy I used them and successfully got rid of hip thigh pain. I’m going back to using them again as I feel lumps and pain under my ribs. It didn’t ‘to take long before I knew it was working. It’s messy a little bit time consuming, but I prefer the natural way to good health.

    • Tina –

      You are not alone in noticing an alarming trend of non-absorption of other medications after the cessation of PPI usage.

      While I don’t have the other issues you mention, I am in the position of stopping the PPI drug Prilosec after around 20 years of use. (Sadly, prescribed to “prevent stomach damage” from the use of some rather stout pain meds which I took for around five years. NOT due to an acid problem, which, of course, I now have in spades!) My last Prilosec was over four months ago and I am seeing a real problem with non-absorption of my thyroid medication. I have Hashimoto’s – an autoimmunity problem wherein my immune system attacks my thyroid gland. This condition requires me to take large doses of thyroid hormone replacement drugs.

      After years of no problem with the absorption of these drugs, suddenly my thyroid lab numbers are literally off the charts – as if I am not taking my meds at all. Clearly, the cessation of the PPI is related to the non-absorption of certain meds, as I have changed NOTHING else, with the exception of the use of over-the-counter antacids (see below). The non-absorption issue directly mirrors the cessation of the PPI drugs, and this is clear when looking at my last few blood labs.

      Right now, I have no answer for the problem, nor do I know whether this non-absorption issue will mitigate over time. Note that in my case, I discovered that my use of common over-the-counter antacid meds (Tums, Rolaids, etc.) was in direct conflict with my thyroid meds. I had been using these to help alleviate the wicked PPI withdrawal issues. I still use them, but rarely now and keep a “buffer time” of around four hours between the use of the antacids and my thyroid meds. I also use the H2 antagonist (H2 blocker) Zantac. This should avoid the conflict that I see with the standard antacids due to the calcium content. Nevertheless, even with the avoidance of antacids alongside my thyroid meds, I still am seeing a huge non-absorption issue. My lab numbers are still off the charts, and I really do mean “off the charts;” my numbers are not even listed in the scale my endocrinologist uses.

      Unfortunately, it seems that doctors here in the USA are quite uninformed regarding the PPI withdrawal issues. Even my endocrinologist – usually very informed – is not even close to being up-to-speed with this. My primary MD is similarly clueless. Much of our doctors’ information is provided by the PPI manufacturers themselves; and these corporations have massive financial incentives to seemingly promote obfuscation in regard to PPI withdrawal – if not outright ignoring the problem.

      If I am able to see a trend regarding non-absorption, I will post that information here. Be aware that this PPI withdrawal is a very slow process and it may be months and months before I have anything concrete to report. If I have nothing positive, I may not post at all.

      • Hi,
        H2-antagonists (Zantac) block production of stomach acid. So, really, you are still achieving a high pH in your stomach, just using a different mechanism from proton pump inhibition. Not to mention, you are consuming calcium-rich antacids on top of maintaining a more neutral pH in your stomach. To reiterate, you should not really be having an PPI withdrawls since you are still keeping your stomach acid levels low with the H2-antagonist.
        Hope you feel better soon.

    • Please be careful to diagnose yourself with heartburn. I thought that is what I had so I ignored it. After a few weeks I got dizzy, was sweating terribly, started passing blood from stools( this is gross: but I mean gushing) also, vomiting blood.
      This “almost” started without warning. I could not walk and ended up almost dying within a matter of hours. Had to be put in Critical Care, given transfusions of 9 units of blood (there are only 10 in your body). You know your body and if you think something is not right, get to a Doctor!

  56. Geezuz…thanks alot for this depressing article….Now im leary of taking my zantac for my stomach/intestines… You make it clear to us that are taking it, what exactly it does to our body, and with all this you said its all bad….but you offer no solutions to us in distress, if we do stop these antiacids.. Now what? go natural alternatives? geez. this is difficult everyday.

  57. HI! I always take antacids whenever I experience reflux or acidity and if suffer with lot of stomach aches or different from reflux symptoms I then would take protonpump inhibitor for one week without asking a doctor. I don’t know why I always experience it eventhough I follow my doctor’s dos and donts..I am 17 when I diagnosed with hiatal hernia after an endoscopy and my doctor said it was inborn in my case, and know i’m 18. What would you advice to me sir?.. now I have acnes on my back and some on my face.. And im underweight.

  58. hi! thanks for the infos.. I always take antacid whenever I experience reflux or acidity. and if I suffer from it with lot of stomach aches I then would take protonpump inhibitor for one week without asking a doctor. I don’t know why I always feel it even though I follow my gastrologist do’s and don’t’s, especially because I was diagnosed with hiatal hernia after an endoscopy and It was inborn he said.

  59. If you stop Prilosec after long term use, will some of these issues go away? RA or Leaky Gut, things of that sort?

  60. After 12 years of taking Prevacid, I decided to try and get off it. All previous attempts hard failed as the moment I went cold turkey it became completely unbearable. I moved to a lower over the counter dose about 3 months ago. Initially this was tough, but then all seemed OK again. I thin thought I could and should make the move to stop completely. I can report that after 5 weeks of no prevacid I am struggling. I am taking the natural products people are mentioning all over the web. Nothing is helping. This article that Chris wrote really seems to make sense. I guess it is time to go to the doctor again. I’m sure he will suggest that I get back on the PPI’s. Really would like to try out taking more acid. Maybe I’ll see if that is an option. I’ll report back.

    • It took me three months after going off PPIs cold turkey for the rebound heartburn to settle down to a bearable level. The entire time I was taking many supplements. Over time it got better and better. It is now almost three years later. I still don’t always know when heartburn will strike but for the most part I have it under control with healthy eating and good supplements. You can do this!

  61. I have been on ranitidine for over 3 years, my so called doctor, who I rarely use, suggested ranitodine, saying it had minimal side effects. Like you said, it never goes away. Whenever, I do not use 2x’s/day the acid comes back. I am down to 75 mg each time, but feel like I am destroying my stomach acid. Is this as bad as the name brands? Does it erode acid in the stomach just like Zantac and other popular antiacids?

  62. Hi, Chris,
    I got really sick last September and have seen some progress but still remain undiagnosed and symptomatic. One doctor has diagnosed me with Meniere’s. I had been on Lipitor 20 mg for about 8 years straight and had been on Omeprazole 20 mg for about 2 years straight for acid reflux, doctor’s orders. However my reflex was getting worse so I was switched to Dexilant at 60 mg for about 6 months and then Nexium at 80 mg for about 2 months. After getting extremely sick, since doctor’s could not figure out what was wrong with me, I quit both drugs. I developed severe difficulty breathing, post nasal drip, tinnitus, dizziness, anxiety, extreme fatigue, head and ear pressure, tingling in my hands and feet, and blurred vision. I read after stopping these two drugs that taking both of them together can increase their effect. Doctor never told me that, probably never knew. Anyway, I have been off them for awhile. I was found to be vitamin d deficient. I was wondering how long it takes to be off PPIs before the nutrient absorption goes back to normal and if there’s anything I can do to help it along the way, especially for us people who have been on them for years. Anyway advise you can give would be much appreciated. I sure would like to get better, assuming these drugs have anything to do with my problems..

    • Ok start with sunlight and a good vitimin pack. Diet is the bigest part of stomic issues eat lean meat fish chicken and vegtibles u need too eat blain and stay away from alchol.

  63. Hi Chris
    thank you for the informationon GERD. I believe you are correct, I have suffered dramatically with GERD ond and off for 5 years. Weight loss and smaller meals have helped but through books regarding Paleo instruction I was education that the acid level is too low not too high! Wow! I am an RN and work with GI doctors everyday and they will never tell you this – would you be so kind and to tell me what you would suggest for the acid supplements – where to ge them and how they should be used.

    thanks so much

  64. I am looking for the final article – I couldn’t find it. Help, please.
    “In the next and final article of the series, I will present a plan for getting rid of heartburn and GERD once and for all without drugs.”

  65. The reason you have a significant weight gain is because the drug is working and you have started eating again – you’re gobbling food up now.

    Get some self control. This PPI bashing is DANGEROUS.

    • No, Tom. What is dangerous is the massive marketing of PPI drugs by the pharmaceutical industry without the WARNINGS which should accompany this marketing. This entire class of drugs was promoted as virtually “risk free” for well over a decade, when in fact nothing could be further from the truth. Ask anyone who has attempted to cease using PPI drugs just how “risk free” they are.

  66. I just read all the articles about GERD & am shocked that I’ve probably been prescribed medication which worsens the issue I it’s called Omeprazole here in the UK. I’ve been taken this for 2 months & have noticed significant weight gain in that time. I’m heartened to see that there is a way to do this without the need for medication. It is a horrible condition & I will be looking into alternatives / low carb diet more seriously

  67. The acid produced by the disturbances being a targeted individual affected my voice and they put me on prolecec. After reading your article, I have the tools to quit. The “relief” never came regardless, and being a former paramedic, the only thing that really helped was to drink half a bottle of mylanta and get drunk. Your article proves that drugs never help in all cases. I still think my issues came presently as a normal defence mech of the body. When we get upset, we produce acid. Removal of the sorce is better than any med.

  68. I know of a woman whose sphincter is always open she has scarring in her throat from acid reflux, she cannot lay down and everything she eats (which is only honey chicken bananas ow) causes her to have pain bloating and reflux as well as head pressure. She is on Nexium and prilosec 🙁 What in the world can she do? She has tried a few natural herbs to help but her reactions are so severe as well as Nausea Chris, we are very scared for her. Any info to help her START a new diet without symptoms? Any idea HOW to wean off these pharmas that are lowing her acid even further? She still has severe reflux

  69. Hey Chris,
    Good article. I have had severe heartburn and acid reflux since I was pregnant with my son at age 18. I have always had severe allergies. At 19 I was diagnosed with asthma. I will be 42 soon. Over the years, I have seen numerous doctors, had countless endoscopies, overnight PH monitoring, testing on the muscles in my esophagus and finally had a nissen fundoplication in 2010. I woke up from the surgery with a mouth full of acid reflux and knew that it was a failure. I have been on Nexium, Prilosec, Prevacid, Xantac, etc., etc., etc. for ages. I now take 40 mg every morning of the generic Prilosec since my insurance won’t cover a more expensive drug. I take my medicine faithfully and it does prevent heartburn but not the acid reflux. I ALWAYS have a mouth full of acid and can literally taste my last meal for hours after I have eaten. People cannot even have a conversation with me because they can smell the food on my breath. At my last endoscopy last year my doctor said that stomach tissue has started to grow in my esophagus and I have Barrett’s. I have been to the top doctors in my big city. Each one just ripped another prescription off of their pad and said there was nothing else to be done. I am at a total loss as to what to do. Any advice would be appreciated! Thank you!

    • Well all i can tell you is have a strick diet nothing but blain meat anf complex carbs oatmeal brown rice fish chicken. Raw fruits vegtables i know it sucks but it is all in the food and vitmins take s good multi vitimin pack and exercise daily with eating small blain meals for teo months and it will heal i promiss you. Im on ppi right now only because i wont cut back on my drinking and my diet is not consistsnt

  70. What is the connection with gerd and a increase pulse and bp? My wife was in the hospital for two days ….with no help.
    After your fantastic article I believe the low acid in stomach is the cause.
    Last night she ate pizza and within an hour 115 pulse and she felt like garbage. She has been belching a lot over the past couple months and it is worse now. Is there a connection to stress and
    Aggravating this too?

    Thank you.

  71. I just realized that my 17 year old daughter loves pasta which has a lot of carbs. Could that be causing bacterial overgrowth?

  72. Why does a person have low levels of stomach acid in the first place and what can you do to increase the levels? I am looking forward to future articles. My 17 year old daughter has GERD and is on 20 mg of prilosec 2 times a day. I want to get her off of the medicine as soon as possible and find an alternative. She is a singer and the reflex irritates her throat and prevents her from singing so for now I have no choice but to leave her on the medicine.

  73. Hi There Chris,
    Does you know why your stomach start to produce less HCL acid in the first place?,sorry if you have touched on it already I may have missed it.

  74. Hi, my name is Nada. I don’t know where to start with my story.

    It all started about 2 years go when I got something like a stomach flu. It could have been something else, I’m not sure. I just remember having these crazy symptoms like pain, not being able to go to the bathroom for a few days, and then took laxatives which did not even work, and then if I recall correctly I had really bad diarrhea. When I did go to the bathroom after that I had dark pebble like stool (sorry for the graphics) I had no idea what was going on went to the doctor who did nothing except tell me it was from stress. The stool was tested and turned out “normal”. I took peoples advice and ate yogurt, drank soda, ate soft foods. Which was probably a bad idea.
    It all changed from that time. I was having indigestion, sorry if this is too graphic but there was always undigested food in my stool, and they tested a sample of it which turned out normal…. My stomach used to hurt when I ate and so I decided to eliminate certain foods from my diet to see what was causing the discomfort. So I cut out dairy and bread. Sort of went vegan. I did that for a week, and I had so much energy, and no more gas, bloating, and my stomach making weird noises. I found out that my symptoms were occuring whenever I ate dairy! So I stopped eating dairy from then on. I also used to get nauseous almost always.
    Thats when I started going form doctor to doctor again. First my primary care doctor, then a specialist, then moved and went to another specialist, and was prescribed several medicines to “try.” I had an endoscopy and colonoscopy done, which is kind of good so that I can assure myself I’m on the safe side and don’t have something going on that I should know about. The results turned out normal, except that I had a little inflammation and acid reflux. I was put on the PPI “Pantoprazole” (40 mg) for about 3-4 months.
    Then after a long process, when I started getting very fatigued), and was almost misdiagnosed with Fibromyalgia, I found out I was very deficient in Vitamin D. This is when I started increasing my intake of calcium and Viatmin D through Soymilk and things like that. I was also put on a high does of viamin d.
    Now, I’m having alot of neurological problems, and might need to have an EMG done, which I’m dreading. I dont trust most doctors anymore… its really starting to feel like everything they do is for money. They just want to treat your symptoms, not cure the underlying cause.
    I’m only 19 years old….
    My stomach symptoms havent went away, now I’m not sure if I have low stomach acid or if its something like Candida…. since I have had recurring yeast infections. See, I’m not a doctor and its hard for me to diagnose myself. (Even though I was the one who found out about my vitamin deficiency through lots of research!) its their job! and its sad the way they are handling it. I simply dont have the time to be online finding a cure for myself being a full time college student. But my health is important so I guess I have to make the time. It just sucks because its one thing after another. I’m so glad I came across this article because it opens up so many different explanations and opportunities for a variety of treatment methods. If you read all of that, thank you so much. I’m just hoping someone will read this and be able to point in in some direction….. I dont think ill ever take antacids again. I might just start trying different remedies that restore stomach/gut health. I cant take pepsin because I cant have pork, and so I might find another betaine hcl brand and try that…again, not even sure if i have low acid…. and im pretty sure i dont have alot of good bacteria in my stomach…. but the things chris mentioned in the article, like those fermented recipes, i dont think id be able to get those. Would probiotics be good enough?
    It wouldnt be the worst thing ever to not eat dairy for the rest of my life though it does become a hassle. Especially since I know I wasnt born like this. I hope i get to the bottom of this soon. And good luck to anyone going through their own battle!

    • What about using a CPTG essential oil? Oregano oil is supposed to be a powerful antibiotic. Lavender, wild orange, & peppermint are supposed to be tummy tamers. What about licorice dgl? Even melatonin for a short while may help.

      • Hi Lisa great advice natural is for me the best way.
        I personally just started on Lily of the desert Aloe Vera Juice for what they claim I have.My daily routine is now this HCP 70 (Probiotic),Omega Essential fish oil, Vegegreen,and Phytoberry smoothies been taking this for years : ) just pumping it all up to get rid of the damage the PPI”s did to me.And I know deep inside this is what triggered the burning I am now feeling.

  75. I am successfully using 2 teaspoons of apple cider vinegar with 4 ounces of warm water and a squirt of honey twice daily to help with acid reflux. After the first 2 weeks, it has been as successful as antacids. Besides, there are numerous health benefits to apple cider vinegar! It’s worth a try and inexpensive too.

  76. I have gerds because I have a hernia, I was on antacid meds only as a preventative so stomach acid doesn’t damage my esophagus, I discovered it wasn’t good to stay on the meds permanently. so I went off, but now I am having some symptoms that show me damage is being done to my esophagus. How do I stop that without taking the meds?

  77. Hey i got prescribed PPIs and took them for months and had no relief and ended up having a endoscopy from the top and bottom and they found atrophic gastritis but didnt know why it was happening. I now read your article and it all makes sense.. my acid was surpressed for far too long..
    i dont take the PPIs anymore but i am also not fully healed. My main problem now is that anything i eat i get allergic type reactions.. coughing mucus, nasal burning and congestion, red teary eyes etc.. allergy meds dont do anything. I think the food is going into my stomach and there is still not much acid there to properly break down the food and i end up getting these reactions.

    Please tell me what to do and how to correct this situation and go back to normal.. please! i am so desperate at this point. No doctor can help as they dont know whats wrong.. and if u can believe it they are trying to get me to take MORE PPIs again!

    i hope u can get back to me or email me..


    • Try drinking a small amount of coca cola and if you need to cough something out from doing this it is a good thing to be rid of it. It always helps to neutralize AND give me the necessary acid BOTH.

  78. Hi Chris,
    What would recommend for someone who has hiatal hernia? Without Prilosec I pretty much get heartburn from anything I eat.
    I’ve been taking it for almost 7 years now and just recently came to the conclusion that it maybe the cause of my abdominal pain for the last three years and other symptoms you mention in a lesser degree.
    If I don’t take the pill I risk esophagus cancer and if I do I risk stomach cancer. A no win situation….
    Any advice would be greatly appreciated.

    • I took Gaviscon, only thing that cleared the hiatal hernia pain. It completely went away and that was a long time ago. this is what the doctor told me to take. gaviscon.

    • I recently, through a routine, endoscopy, discovered that
      I had h. pylori, and 2 bleeding ulcers. I was treated with
      2 antibiotics + 6 pepto bismol chewable tablets tablets
      daily, plus 40 mg of nexium for a 10 day regiment. after
      a month I was rescheduled for a repeat endoscopy, with
      an ultrasound. biopsies were taken to insure the eradication
      of the h. pylori infection, and a potentially , cancerous stromal tumor. I haven’t received results to date. my symptoms seem to parallel a low acid
      stomach. what probiotic supplement and diet should I be adhering to, to alleviate my situation ???

  79. How about Pantoprazole? I was on 40mg of that for about 3 months. I regret every single pill I took. I’m sick of doctors always prescribing medicine that provides temporary relief yet causes long term health issues, which are often worse than you start out with. I’m really losing my trust in doctors. I feel like I’m right back where I started after I stopped taking it! Would you say 3-4 months is enough to cause harm as well and lower stomach acid?

    • I’m with you on that one but what are we to do.Sadly unlike you I had not one symptom of any problems with my digestive until I started on the same pill you are taking!!!
      Now I can say I have digestive problems and am truly pissed at this.When they cant figure it out leave it alone.
      I truly believe they have to dispense a certain amount of drugs for there end year quota.As my Family ate lots of fatty foods when I was growing up and they all lived past 90 no pills like what they hand out now a days.

  80. Where is the last article as I need to learn how to get off this Nexium ASAP and preferably naturally.

    Help! And thanks for all the information!

  81. I’m 45 and I have been on dexilant 40mg for the last year and a half, before that I was on pantaloc and before that prilosec. During the Christmas holidays I fell ill to a gastric virus, to which latter on I got laryngitis and then bronchitis. Meanwhile there was always and excess burn in my throat. Last week I got the flu, and bronchitis came back again. I told my Doctor about the burn in my throat and that I believe my lung problem is from my acid reflux. He agreed and changed my meds again to pantoloc. The burning has not subsided my lungs don’t feel any better and when I ask my Doctor for an alternate solution he says I must stay on the PPI’s. Can anyone help I can’t go on like this any more.

  82. I have been on Prilosec 40mg for nearly four years no, the past two months have been a living nightmare for my stomach and GERD. It seems I have had more issues taking this poison Prilosec then I did before I started. I have often suggest to my GI doctor that low acid levels could be causing my problems, but he won’t hear any of that… His response, you would feel a lot worse if you didn’t take it. I am so glad I found this article, and I’m changing doctors before he kills me.

    • Hi to all

      Jason I am going through the same thing. It all started when I was rushed to the hospital they drew blood and said my pancreas enzymes had elevated to 5,000 ask how much I drank(alcohol) told them I was a non drinker.So they called it idiopathic and said chances are it will never happen again…three weeks later back in ER this time with 7,000 enzymes.So they were baffled! So next best thing when they don’t know the cause yep anti depressants and PPI’s both to which made me quite sick.Quick the anti depression pills and continued on PPI’s.Told both my family and specialist Dr that I was getting a burning sensation that I never had before and white tongue they told me not to worry about it basically I need these pills.
      I was then tested and was told by phone that I had Barrett’s of the esophagus (no cancer) and so this is why I should be on PPI’s and anti-depression pills!!! I said it is quite funny that since I have been on a very strict diet 15 grams of fat per day and taking 80mg PPI’s a day I have never before experience burning or nausea like I do now HELL I use to love red pepper rings I don’t dare eat them now. But what scares me is that they imbed that I will develop cancer if I stop the PPI’s.So whats a person to do continue on medication that causes you pain and symptoms I never had before or chance dying of cancer?
      I read this someplace and it is so true>The pharmaceutical industry does not create cures,they create CUSTOMERS! And whats worse is that in the long run the customer who takes these drugs must recover twice,once from the disease and once from the medication”< William Osler M.D.
      Anyways I feel for you and anyone else that feel they are not being heard.Also Chris GREAT site but like many others am wondering as to where the rest of you article is?

  83. I have been on PPIs off and on (more on than off) for about 20 years. When first prescribed this “wonder” drug I was working in a fast paced news environment. My doctor thought that perhaps I had pylori; however, this was not the case. After five years I thought I would like to get off them. My family doctor said that I could try, but he found that most patients usually were back on them within six months. And true to his projection, I was back on them within six months. At this time (probably around 1995) there was not much information as to the long-term damage that might occur. Although I have severe reflux, chronic rhinitis, and severe nausea (my primary complaint) the numerous endoscopies and colonoscopies the only problem that shows up is severe diverticulosis, but have not had any episodes of diverticulitis. My gastroenterologist (who is very well known in research in his field) feels that perhaps I am just “one of those sensitive stomachs”. I have been on 40 mg Nexium twice a day along with 10mg of domperidone ½ hour before meals and sometimes before bedtime. I eat extremely well—no fat, chicken, fish, lots of greens, veggies, fiber, water, fruits, minimal cheese, no pop, liquor, etc. etc. I am 68 years old now, 5’8” tall and weigh 133 lbs., so I am not overweight. Last year I had severe nausea that ended me up in the hospital several times. Something quirky with my stress test and the nausea and chest pain, prompted them to do an angiogram, which showed that my arteries are pretty well plaque free. I exercise daily. So . . . in November 2013 I decided that I must get off the Nexium. I read a report about a Brazilian doctor who did a study about getting the body to produce melatonin that would help with GERD. I started a very slow reduction of nexium in November—starting with the 40 mg; then 40 mg alternating with 20mg; then 20 mg for a week; then 20 mg alternating with 10 mg (cut a 20mg in half); then 10 mg for a week; alternate 10 mg with 0 mg; then 0 mg. All the while I have been taking Protexid with this, which is tryptophan, methionine, B12, B6 folic acid, betaine. In the beginning I took melatonin at night; however, in correspondence with the Brazilian doctor, he advised me to stop the melatonin as I was trying to get my body to produce melatonin on its own. Well, long story short, I was much better initially, but it seems that I still have the horrible nausea and it’s terribly debilitating and depressing. I never know how I’m going to feel so can’t make any plans to do anything in advance. I have tried ginger, Iberogast, gravol, but nothing seems to get this nausea to disappear. At one time my nausea was so severe I was prescribed Zofran; however, I try to get through with gravol. I have had blood work done, CAT scans, Uppper GI series, brain, neck and back MRIs, nerve testing, and see an ENT regularly. I meditate and exercise daily. I don’t know where to go from here. Could this just be a severe rebound effect since I have been on ppis for so long?

    • Non Ulcer Functional Dyspepsia is what I was dx with when my only complaint was a burning, sour stomach, nauseous feeling in my gut. I had the ultrasounds on galbladder, pancreas, stomach, liver. Nothing. I had an endoscopy which showed a “boring stomach.” Gastro doc prescribed 10 mg desipramine. It’s an older tricyclic anti-depressant. Guess what? No more functional dyspepsia. That was in 09. I might have a day of FD once or twice a year, but that’s it. 4 years ago I developed “silent reflux” / LPR, so that’s what I’m dealing with now. :/

  84. was wondering, that if “acidity” is more often due to lack of enough stomach acid, then why taking a antacid helps, in the short term.

  85. This past summer I was diagnosed with H pylori for the second time in my life. It was eradicated with a double course of antibiotics. I was then told to eat Greek yogurt for approximately 2 months in order to put good bacteria back into my stomach. Soon afterwards my gallbladder went out and I had to have it removed. About the beginning of this last December I noticed that I started having very bad heartburn and acid reflux. About a week ago I went to the doctor with it and found it I was not having h.pylori again and was diagnosed with acid reflux. I was placed on Nexium 40 milligrams delayed release. After a weeks course of this I found that it was wearing off after half a day so they doubled the dosage. After reading this article I am highly skeptical and very concerned! I want to know what I need to do in order to get my stomach back in good shape so that I don’t have to worry about things going very wrong. I’m worried, scared and in a lot of pain in Atlanta all at the same time! Please help.

  86. Hi
    I came across this site through searching up side effects of omeprazole as i wake up every morning with feeling sick.i also haveanxiety and low mood and now i am it the meds.i had an ulcer 2years ago and had helicobactor..severe weight loss also not much of an appitite either….should i stop the meds…i want my life back

  87. My husband was diagnosed with Barret’s 3 or 4 years ago, had 2 ulcers and large hiatus hernia. He was put on 60mg Lansoprosol. July 2012 he was scoped again and they said everything was much improved see again 3 years. Last month he went to give blood and was found to have very low hemoglobin. They did an endoscopy as with his recent history thought he might have a bleeding ulcer, nothing found, now they have booked colonoscopy for Dec 30 to check for bowel cancer when it seems to us that the high dose PPIs are quite likely to be the cause. The last endoscopy also said he had developed multiple fundic gland polyps PPIs induced. Would welcome your advice.
    (He has halved the dose to 30mg on his own and apart from burping a bit more has not had any reflux pain.)

  88. Dear Dr. Kresser,
    Your article is wonderful. My situation is such that I suffer from GERD. I have been taking Raperprazole since 2011, switched to Tecta 3 months ago and now Zantac so that I can check for Hpylori again [I tested + [2 years ago] and was treated.
    My GERD has worsened. It burns my throat with a bad gas [like a valve has a tiny puncture hol;d and gas is release] and little liquid oozing out. I will be going to see my gastroenterologist [ASA I get an apt} whom I first visited I Dec 2011. I then did a test with a camera [not through my throat] , did a barium test and all was well.
    I am also overweight [157lbs as of Sept 18,2013] and have lost 5.5 lbs in 2 months through work outs Curves 3 to 4 times a week. I need to loose 15% of my body wt.
    This GERD is bothering me tremendously and I require help. Can you please respond? I am in Canada and was wondering if I could even call to discuss? Please advise.
    Thank you kindly.

  89. Amazing articles – really eye-opening. I’m not sure if I have GERD. I burp but it’s food that comes up – not acid but solid food. I don’t get heartburn, but I burp for hours after eating ANYthing – bread, fish, vegetables, whatever. I’ve had this for years and have taken all sorts of medications – Nexium and other acid-reducing drugs, and most recently Ranitidine. The only thing these drugs did was leave me with a B-12 deficiency which I’m been correctly with a vitamin supplement. I’m not obese – I’m like 5′ 8″ and 145 pounds – and I work out several times a week. I’m almost 30 and I worry about the damage all this ‘burping’ is doing to me. I think I’ll try the pre-biotic and pro-biotic combination that you suggested in another article. If that doesn’t work, endoscopy here I come? Any other suggestions would be much appreciated!



  90. Hi Chris,

    I am suffering from heart burn as a result of acid reflux, and was tested positive for H Pylori. I had always thought that an increase in stomach acid leads to reflux but it just didn’t make sense, since the bacteria would not survive in a high acidic environment. So, I started reading stuff and came across your excellent article, and I agree that “low acid –> increased bacteria –> further reduction of acid –> increased gas/bloating –> IAS –> acid reflux”.

    I am now taking antibiotics to kill the bacteria, so hopefully once the bacteria is gone it should lead to an increased production of the stomach acid leading which would hopefully reduce gas/bloating –> reduction in acid reflux.

    What do you think?

  91. For many, acid blockers and antacids can be harmful or counterproductive, but these medicines do have a place. I’ve struggled with IBD for some time and have progressively gotten worse. I’ve tried all the natural solutions and resisted following the advice of my GI. One of the suggestions I’ve resisted most vehemently is the use of acid blockers, largely because so many speak so strongly against it. But then I got to the point where my gut was so inflamed from top to bottom, any food at all hurt and made me ill, I finally succomed to trying an otc acid blocker. I woke this morning with no stomach pain or nausea for the first time in maybe a year.

    So again, this medicine has it’s place, and for some who truly need it, not taking can result in perforation and other issues. Do your homework, read the actual studies (not summaries found on the internet), and do what’s best for you.

    • I agree with you. I have gastritis and inflamation in my bowels from so much worry/stress,… I tried staying away from the PPI’s just because of all the negative i read about them. But after so much troublesome gas/burping and bloating, i finally had to try the zantac. My stomach feels calm, and no nausea. Now im taking digestive enzymes and b-12 under the tongue.

  92. I’ve been diagnosed 2 month ago with GERD and gastritis. I took 1 month PPI and saw some slight improvement, but I stopped because I’m definitely not planning to be on PPI for the rest of my life, I’m 32 years old. But actually what is impressing me the most is that low acid can increase Stomach Cancer Risks. Unfortunately I’ve just lost my mother in law last week because of Gastric Cancer, and most of the alternative cures we read, think that one of the reason of it is an acid environment, suggesting to have an alkaline body and to use baking soda, so exactly the opposite. Whats the truth?

  93. I’m not sure if anyone can help with this or not but thought it worth a try?

    My doctor put me on omeprazole 2wks ago to see if it would help with pains I keep getting in my stomach and I also had slight reflux. For the first 10days I thought they were fab, they didn’t fix the pain in my stomach but they put a ststop to the indigestion I was having. 3 days ago though my mouth became all red and inflamed with red lump where the tonsils are (I’ve had mine out) and also little red spots on the roof of my mouth and red sore type ulcers under my tongue. I also have a horrible metal taste/sensation in my mouth too. The reason for my question is because this afternoon I ate half a slice of white toast and along with all this other stuff happening in my mouth my lips started to tingle and swell with clusters of raised red lumps on the inside of my lips. Could the omeprazole caused this and made me allergic to things as I’ve never had this before I it was only a small piece of toast.

    Any help would be greatly appreciated.


  94. Chris and team, this article is not linked to the final one in the series. You might want to edit to allow people to read forward. All other parts seem to have added a link to the next.
    > In the next and final article of the series, I will present a plan for getting rid of heartburn and GERD once and for all without drugs. (has no link)

    • I get your regular emails but do not have the final article with suggestions for getting rid of GERD without drugs.
      How do I get the link for that piece? Thank you very much for your good work.


  95. Hi Chris,

    My acupuncturist recommended I stop taking Aciphex, as part of my treatment. I found your articles invaluable in providing me with more information on the danger of low stomach acid and why GERD or acid reflux is not caused by too much acid.

    I was wondering if you could respond to Joe’s comment (or mine perhaps), mentioning a recent study that seems to show that PPI use doesn’t contribute to bacterial overgrowth (SIBO). (

    It’s okay if you don’t have an exact explanation, as you said, there is contradictory evidence. I didn’t read the whole study, just the summary. But perhaps the method used to measure bacterial overgrowth (breath), or the amount of time a person was on a PPI, or other factors played a part in their findings. What is your take? Thanks!

  96. After 9 years on Prevacid I am finally free of this drug. I had tried 4 times in the past to get off this drug but always ended up in the ER. Finally 2 months ago I went to see a naturopath. She started me on two digestive enzymes, one before a meal and one with a meal. In addition I get a B12 shot (PPI ‘s can deplete your body) and I also take a B12 bilingual supplement. I am so happy to be free of Prevacid. I don’t understand why the GI doctors,supposedly the experts, don’t recognize digestive enzymes!

  97. Hi Christopher
    I’ve been reading the above and fascinating articles on GERD and PPI’s and couldnot find your regime article in how to tackle GERD and the like without using PPI’s. Would you mind sending me a link as I’m desperate to get off these things….. Taking them for 5 years now.

    Many thanks and thank you for writing these articles

  98. Thank you! I have recently gone through a crazy cycle of IBS-Gerd episodes.i was popping Pepcid AC and Tums every day but then got so deperate, I decided to try Prilosec OTC as my doctor had originally prescribed. I took two doses which made me start to feel better however, I didn’t like the idea of being on medication every day and started doing a little research online. I found so many reasons NOT to take Prilisec and decided to try to find a natural alternative. I changed my diet which is already pretty good since i have Celiac Disease and am gluten free. I read about and tried “Natural EsophaGuard” which is made of orange peel extract and also tried apple cider venegar right from my cupboard. That combination gave me great results for the Gerd which in turn made me stop taking the antacids. My IBS was still acting up and I read about how antibiotics kill all the good bacteria. I had just been on antibiotics, so I took some probiotics to counter. Between not taking antacids and adding the probiotics, I now feel great and am pharmaceutical free. I Just happened to read your articles which confirms what I stumbled upon. I am outraged that doctors are free to write prescriptions that will eventually cause more harm than good without telling you the potentially dangerous side-effects. Mine never offered a natural remedy or advice on how to stop the disease in the first place. He heard my symptoms and immediately prescribed Prilosec. I am thankful to my husband who encouraged me to dig a little deeper. Luckily he cares.

  99. Hi there,

    I had a question for you. I have had stomach problems since I was a child. It started with chronic gas that was so bad, I would cry. Eventually I got gall stones, passed out and had to have my gall bladder removed. Now that I am in my late 20s I am starting to have lots of issues with GERD. It seems that my stomach is very very sensitive, especially for my age. I have not always had a great diet but for the past few years I have eaten better and better. Do you think my lack of gall bladder could be causing problems with GERD? Possibly because of a lack of necessary digestive enzymes, or something of that nature? I’m becoming frustrated since most healthy foods contain citrus, tomato, onion, curry, garlic, oil, and other things which I am struggling with. I am going to start taking HCL, and ACV seems to help, but I want to be able to eat some of these foods again. What do you think?

  100. Thank you for these interesting articles. I have a unique situation since taking Omeperzole in my early 30’s (I’m 37 now). I went to Ireland for vacation and within 6 months of coming back started having horrible stomach pains. I was diagnosed (without an endoscopy) with an ulcer for which I was prescribed Omeperzole and antibiotics. I did test positive for H pylori through a blood test. Later I learned that H Pylori is very prevelent in the Irish drinking water and that most people in Ireland have the bacteria.

    The ulcer never really did heal with the Omeperzole, it just got worse over the next few years. I was taking at least 2-3 pills a day for over 2 years. I started getting really bad ocular migraines twice a week and my legs were covered with eczema. I have had migraines due to food intolerances, but never more than twice a year. I also develeloped strangely enough, a bad case of pure OCD. I’ve been in CBT therapy for 2 years now with no real let up in the symptoms.

    After researching some of the ramifications of this drug I feel as though it’s ruined my life. I’ve cleaned up my diet and taken gluten out and started taking b12, high quality fish oil, expensive probiotics and magnesium supplements. The symptoms of the ulcer are pretty much gone, and the eczema is gone 2 years after I stopped taking the drug. I haven’t had a migraine in nearly a year which is great.

    Unfortunately I haven’t found anything to help the OCD. My doctor wants me to see a psychiatrist to get on some medication, but I’m terrified of the side effects (for obvious reasons). No one seems to believe me that this could be from the Omeperzole pills.

  101. Hi Chris,

    I like to sing and I have found increasingly that I cannot do so due to chronic throat irritation. I also often smell “smoke”. When I burp I sometimes feel burning. I have been paleo for quite some time now and consume very little carbs and little to no sugars. I don’t really get what most people describe as heartburn, but all my other symptoms seem to be tell-tales of GERD. After reading your article I want to try HCL supplementation. What is not clear from the article is how often to supplement. Once I find a comfortable does thats effective, how many times a day should I take it? Once? Every Meal? I can manage the former, but the latter could get expensive.


  102. Hey there!

    I am so grateful to have been turned on to your site by friend who has also spent many years trying to fix digestive/fatigue/issues. I just finished a 60 candida cleanse and about 3 weeks ago noticed a feeling like “something was stuck” in my throat…near my right tonsil it felt like. I thought it might be allergies (they have been crazy in CO right now) or tonsil stones. It then moved to the left side, which was off and slowly to the middle of the top of my throat. A Dr. prescribed me a steroid nasal spray to reduce inflammation she thought could be from allergies. That did nothing and then it moved deeper into my throat, near the top of my esophagus. It feels like there is a vitamin stuck in my throat and now I can feel it every time I breathe not just when I swallow. Dr. now prescribed me Omeprazole 2 times a day for 2 weeks thinking maybe it is stomach acid although I have no burning, no real heartburn or sore throat.

    I am at my wits end, and after reading this blog, worried about taking these pills and making matters worse. I am trying to get testing for leaky gut/food allergies so I can better pin point what is really going on in my digestive symptom. It seems so odd that I would develop something like this when eating so “cleanly” . The only other thing I noticed was I got a really bad case of hiccups the day before this all started. I had a bad case of food poisoning in NOvember and have noticed since that my diaphragm is rather spasmadic…ie: if I sometimes burp it will spasm three or 4 times…and hiccups seem more severe.

    could that cause a refulx issue? I have never had this in my life and the feeling like something is stuck in there is making me so miserable, let alone making so much effort to clean up my diet and only having a NEW issue to work with.

    any insight people have would be so GREATLY appreciated! Thank you!

    • I too have had this horrible feeling, for 2 months. Doc put me on 40mg Omeprazole, which went after 2 months, but now I feel nauseas(sp) all the time. But not as bad as the thraot thing. Cant come off Omeprazole though- any ideas for feeling sick? Thanks

  103. i have low/none acid in my stomach due to using 40mg dosage omeprazole i was told it was protecting my stomach. i was on 20mg but the dosage was raised 2/3 months ago and now keep suffering stomach bugs. i have now been told these have not protected me but have made me lose my stomach acid. how can i raise this back up again please as i now suffer with diahorria and can’t eat hardly anything. please help .

  104. I think the link between the acid-reducing drugs and the mood changes again point to gut health. The gut is where chemicals like dopamine and seratonin are produced. There is a definite gut-brain connection. If the gut flora gets out of balance, then it won’t be working properly and that will affect the chemical production which will in turn affect mood, sleep, attention span, learning ability, etc. The key is gut health! That means no antibiotics unless absolutely necessary, and healing the gut with probiotics and fermented foods.

  105. dear chris
    hope you can find time to reply. i live in the uk and have just found your blogs and find them very interesting. i am at my whits end with stomach problems. back in 2011 started with right side pain which went undiagnosed by my gp and hospital, i was put on 3 types of ppis increasing the dosage monthly to two a day i lost 3 stone in weight was off work for months. the first hospital diagnosed gastritis and diverticular disease, it wasn,t till april 2012 i collapsed at home with severe stomach pain i had the presence of mind to request the ambulance staff to takeme to another hospital where i was diagnosed as having a chronically inflamed gallbladder which had stones and sludge, at this point i couldn,t open my bowels and if i did the stols were clay coloured. since having the gallbladder removed i was putting on weight and feeling good, i had ever follow up test to check foe any remaining stones or sludge and everything normal, had lactulose hydrogen breath test and 24ph monitoring with swallow test all coming back normal.. until the first week in jan 13 when i have been experiencing acute pain under the sternum, vomiting and continuous nausea, i have a permanent foul taste continuously inmy mouth, all i can describe it as the taste you experience when licking an envelope, which is worse when i eat, my lips areburning and i also have a slimy feling in the mouth, with continuous air escaping from my throat which somtimes results in a belch. i was referred once again to the gastroenterologist, who has said i have non ulcer dyspepsia and prescribed 10mg of norotyptalyine. is this something i have to live with for the rest of my life as it is debilitating. i am awaiting hpylori test and was also checked for pancreas problems, a small incidental cyst found which was found to be benign and the hospital consider it not to be causing the problems. do you think i may have low stomach acid, just had some food and that slimyness has come back with the horrible taste. please advise if you can.
    l first

  106. Hi, I found this series of articles very interesting. But my issue is that I didn’t develop nightly indigestion (it wakes me up in the middle of the night) until I had been on a paleo/primal diet for three months. That said, do you suggest asking my MD to test for H. pylori or taking HCL? Thanks!

  107. After taking Prevacid for 7 years how can I safely stop it. I have tried several times in the past but rebound effect was so bad I ended up in the ER.

    • Try taking apple cider vinegar pills for a couple of weeks. Then reduce the Prevacid and see how you feel. Reduce the dosage slowly. If you can, 75% dose, then 50% dose, then 25% dose, then 0% dose. I’m not a doctor but this has helped myself and others.

  108. Dr. Kessler,

    I have read there is a simple way to determine whether you have too little or too much stomach acid. Try sipping a small amount of lemon juice, if this helps to rid one of heartburn then you have too little stomach acid but if the lemon juice makes your heartburn worse then you have too much stomach acid. I have done this myself and the lemon juice makes my heartburn MUCH worse! Apple cider vinegar also makes my symptoms worse.

    Can you give me any advice or thoughts…………… would be greatly appreciated!!!!!!!!!!!!!

    Thanks, Todd T.

  109. Hi Chris ,

    I’m not sure if you’ll have the time to reply to this message but I’ve been reading your articles for quite a while now and I’m in a tricky situation and would appreciate any advice you may be able to share.

    I’m a 20 year old male who has been diagnosed with H pylori and a stomach ulcer. On top of the burning from the stomach ulcer , daily acid reflux and heartburn I’ve also ended up 2 stone underweight , lacking multiple vitamins ( including b12 ) , have acne which wasn’t there before , multiple food allergies and daily joint pain.

    I’m guessing the symptoms that aren’t from the ulcer are caused by low stomach acid. This makes sense also because I was on PPI’s and antibiotics for many years before I became ill for an unrelated prostate problem. The antibiotics most likely killed off most of my friendly gut flora whilst the PPI’s lowered my stomach acid , both of these things made me susceptible to H pylori and it ended up taking a hold and of course as you’ve mentioned this too will cause low stomach acid.

    My problem with treating myself lies within the fact that I can’t do anything to raise my stomach acid because I’m suffering from the ulcers. I’ve tried HCL capsules but because of the ulcer and probable gastritis being caused by the H pylori it causes me terrible pain.

    I’m terrified of starting any antibiotics to combat the H pylori since I’ve read they can be practically useless and it was antibiotics in part that put me in this situation in the first place.

    Any ideas on something I could do ?.
    Thanks in advance.

  110. S. Beem, take another look–it’s not an ad. “Heartburn” is crossed out with “health.” It’s a joke that goes with the article. Take another look.

    Chris, I have suffered from laryngopharyngeal reflux for a while, but didn’t see anything about it mentioned in the series. It’s different than GERD in that the acid comes up into the throat, and the symptoms are very different (sensation of lump in the throat, post-nasal drip, etc.). Would you recommend the same protocol for it, or would you treat it differently? I’m interested in trying HCL supplements after reading all of this, but nervous if it will make it worse.

    • Chris – I am also interested to the answer to this question that Emily has posed. I also think I have the “Silent” reflux as I have the same lump in the throat symptoms and lots of post nasal drip. I’m curious to hear what your recommendations are for this.

      I had an episode last year (weeks of the lump in the throat feeling) and I did the very low carb diet (under 30g a day) for about a week and since then I have been symptom free. Well, up until a few weeks back, the lump has returned. 🙁 I think it’s because my “plant-based” vegetarian diet is pretty high carb and maybe I have low stomach acid? I also know that I do not chew my food very well – so I’ve started working on that – hoping it will give me some relief.

      Thanks again for the great blog.

      • I have the same question regarding laryngopharyngeal reflux and a hiatal hernia. Do you treat it the same way as GERD? I have not been taking any PPIs. I have been on a Paleo diet for 2 years and drink kombucha, eat sauerkraut almost every day. I do have occassional lapses with a cookie or two. Thanks.

  111. I just finshed reading “How your antacid drug is making you sick (part B)”. The gist of all the articles in the series being about how PPI’s cause, GERD/acid reflux and don’t cure it. Just to the right in the body of the article is an advertisment for Prilosec!!!! What in the eff is up with that?! Am I mistaken in my belief that these companies need your permission to advertise on your site? If so, then I apologize, but if I am not, shame on you!

    • Ha! I see this a lot on many sites. The site owner doesn’t control the ads. Google (or whoever places them) automatically places them wherever a similar subject is being written about or discussed. We should probably forgive the site owner, since they can’t control the ad content and need to make a little revenue on the site.

  112. This is such a fantastic site and it’s so sad that Chris Kressler has not taken the time to post to this blog and inform everyone that he has a podcast about the subject he promised to write about: How to get rid of GERD once and for all. It is very frustrating to me, and I’m sure to all of you, however, because he has such great insights I have decided to forgive him. : )) And for all of you here is the answer to your questions. Go to: I haven’t listened to it yet, but it appears to be the answers we all are seeking. In any case, it will take you to the newest part of his website and hopefully you can find what you need from there.

    And Chris — thanks for all of your help, but this column REALLY needs a follow up or a link to go to your new section on podcasts, etc. thanks so much though for enlightening me to all of this! I am going to try your suggestions of low-carb and low-fructose, as well as check out the Paleo diet. thanks again1

  113. I am having probs with my stomach growling as if I am hungry. This started a few months ago, and it seems to come and go, but lately is getting worse. Sometimes when I eat something it will ease up or stop, but sometimes it seems to get worse, so I eat something else. I do not have heartburn or GERD (I was diagnosed with that several yrs ago, took Nexium and later insurance switched me to Prevacid–which sometimes later I had severe anemia 2 times and I read about what I was taking for GERD could be the cause of that, so I quit taking). I belch loudly and several times after eating, get bloated sometimes, have excessive gas in the intestines, been diagnosed previously with IBS. My Dr put me on Prilosec and it didn’t help, gave me a prescription for some liquid to take, but insurance didn’t cover it and instead substituted Sucralfate 1GM tablets to take 1 before meals and at bedtime. They didn’t seem to do much either for my prob. What will stop my stomach from making all the gurgling, rumbling sounds and this gnawing feeling that I am hungry when I am not? I gained quite a few pounds over the winter from eating to stop the “hungry feeling”, and I have lost that weight…do not want to gain it back. PLEASE….I am desperate…ty.

  114. I started having problems with heartburn in college, and by the time I graduated I had begun struggling with severe heartburn that lasted up to three weeks and constant stomach pain. My insurance was about to run out and the doctor had ordered another series of expensive tests for me to try and figure out (for the third time in three years) exactly what was going on. All of these tests were the same tests that had already been done and found to be inconclusive. I decided to do something different and made some radical changes to my diet where I have eliminated processed foods and unnatural ingredients as much as possible. Since then, no problems unless I give in and cheat. The other day I had macaroni salad from the grocery store and within an hour I was doubled over in pain. But fresh whole wheat bread that is made without preservatives, or homemade wheat noodles do not cause any problems at all. My food is more expensive, but I eat less of it because it is more satisfying, I am pain and heartburn free and I’ve lost weight. And changing my diet is much cheaper than the doctor’s bills (even with insurance) would have been. This is a great article, very informative. I just thought I would share my experience in case it can be helpful to others.

    • Thank you very much for your sharing. Its helps a lot to us how to take care of our GERD. I’m contemplating of having a check up by a specialist, seems the symptoms persisted. Having been experienced severe stomach pain in 2009-2010 and the doctor prescribed me the Omeprazole (Prosec). Although it relieves me for a quite years, now its back with a vengeance since I didn’t go into diet. Every week I have experienced the pain.

  115. I’m also interested in learning more about what foods to eat and which ones to avoid. I’ve never been diagnosed with GERDS but I do find myself popping Tums nearly daily to treat heartburn. Thank you.

  116. How do I get to the final article of the above article? I did not see a highlighted area leading me there as I did on the other pages. I’m specifically looking for how to start testing for low stomach acid with HCL.

  117. You mention there is no proof of a link between ppi’s and anxiety or depression. I am a long-term sufferer of both gerd and anxiety, i was prescribed omeprazole (spelling?) and my anxiety spiked to the worst it had ever been, my doctor did not beleive in a link. I asked Dr Google, and found numerous people with the same complaint, and a number of doctors had attributed it to the prevention of absorbtion of b-vitamins.

  118. Hi Chris,
    I read for hours all your info & got to the end & can’t find the rest. Want to get off Nexium & relieve my horrible acid relux that is up to my ears now, even taking Nexium. Also have bloating & gas from just about everything I eat. Made raw organic veg. & fruit juice every day for 3 months with other only good foods, fresh veggies, cooked & raw , a little chicken & fish, ect. I drink Green Tea with honey & real ginger & then eat the Ginger every day. Tried apple cider vineager & honey twice a day alone for months before any food but ate during the day. Tried Aloe juice by itself before eating & also put aloe in a green food supplement smoothie to boost the immune system. (Gassy), Tried 2 T. olive oil & 2 T lemon juice, only once? I did these on different weeks to see what would work? Where is your answer to all your info to help us get off our meds & heal? Thank you.

  119. Hi Chris,
    It’s been almost 3 years that I’ve been using baking soda instead of toothpaste to brush my teeth, I brush my teeth 2 times a day along with my tongue using baking soda and I also use it as a deodorant.
    I’ve been recently experiencing GERD symptoms and I’m now wondering if it might be a long term side effect of using baking soda instead of toothpaste?
    I tested for h.Pylori around a year and a half ago (and sometime before that too), but the results were negative back then.
    If you think the symptoms are related to baking soda, any ideas on what I could use as a safe alternative to toothpaste? Can baking soda be also harmful in long term when used as a deodorant?

  120. Dear Chris, you allude to the fact that there is another article explaining how to get rid of acid reflux and GERD without using drugs. Are you still in the process of writing this article or is there a link to it that I am not seeing? All of this information has been very helpful, but that final piece would be really great. Let me know! And thanks for your time and knowledge.

    • I have also suffered from GERD for years and have been on PPIs for years. I have been on several, they work for awhile, then stop and I start having horrible symptoms again. I have even thought I was having heart pain or a heart attack at times as the pain radiates into my back, chest, etc. I have been checked by a cardiologist and have had tests run to rule out any heart issues, everything was fine.
      It is a horrible condition and I to would like to know if the final article has been written yet on how to get rid of GERD.
      Thanks for your help!!

  121. Your site is amazing!

    I have read this entire series, and I’m super impressed with it. I have a question though: I have been battling what my doctor has diagnosed as atopy (a.k.a. allergies with superpowers). I feel like I’m fighting a virus all the time with sinus infections, extreme fatigue, eczema, tinea versicolor, swollen glands, and brain fog. I’ve had a lot of serious thing ruled out, so my doc says I’m just hyper-allergic. He has me taking an antihistamine, nasal steroid, and I just finished a round of antibiotics. My naturopath says I’m hyper inflamed and that I need to fix my gut, so he has me taking 1 gram of fish oil, and a high potency probiotic (which includes FOS 100mg). Both have recommended I stay away from gluten, which I am doing about 90% of the time. Since I started the probiotic 2 months ago, I have had a sore throat and get occasional spasmy-type chest pains, which don’t really feel like heartburn because they come and go quickly (but my cholesterol is perfect with high HDL, and my EKG was normal). Is it possible that the FOS in the probiotic is causing GERD-like symptoms? I just assumed that this course of action wasn’t working for me, but maybe I’m taking the wrong probiotic?

  122. I am on aspirin therapy because I had a mini-stroke about 6 months ago. I have been told that I must take Nexium to protect my stomach from the aspirin. What is your take on this?

  123. Hi Chris,

    What is your take on this recent publication from a retrospective study of patients who have undergone GHBT finding that PPIs do not predispose to SIBO?

    The American Journal of Gastroenterology , (14 February 2012) | doi:10.1038/ajg.2012.4

    Proton Pump Inhibitor Therapy Use Does Not Predispose to Small Intestinal Bacterial Overgrowth

    Shiva K Ratuapli, Taylor G Ellington, Mary-Teresa O’Neill, Sarah B Umar, Lucinda A Harris, Amy E Foxx-Orenstein, George E Burdick, John K DiBaise, Brian E Lacy and Michael D Crowell

  124. Your treatment plan works! It takes a while. I was taking Pepcid Complete, which is only 10 mg famotidine and some calcium/magnesium antacids. It worked flawlessly the two days or so I had issues. Then Johnson and Johnson decided to take it off the market. I switched to (gasp) Prilosec. Took it two weeks, doc said, no no bad stuff, stop taking. Four months of rebound acid later, I am “fixed” I tried fermented dairy. I tried manuka honey. That made it worse. So did ACV. Finally, I tried the NOW brand of enzymes and it took a couple weeks but I took them religiously. I have a few issues now and then, for example, if I spend a lot of time weeding or gardening, or simply bend over, I will get some reflux, but it is tolerable and as soon as I stand up it goes away.

    I had to get a blood draw for labs so had to fast after dinner until about 2 pm the next day. All I had was black coffee. No heartburn at all that day. That was so nice to discover, that coffee is not the issue, bending over is! Ate chili for dinner last night, no reflux. Ate leftover chili for lunch, no reflux. I did not try any of the other stuff, other than the enzymes. The stuff works! I cut back from 5 after every meal to 4.

  125. This is such a fantastic article. I recently had an endoscopy and was informed that I have erosions in my stomach but tested negative for H. Pilori. I don’t GERD symptoms in that I have no reflux problems, but do have constant gas pains and bloating. My doctor prescribed Protonix, which I’m very hesitant to take because of everything you’ve stated. Your article deals mostly with reflux problems but does the same reasoning apply to erosions? Is there any benefit to taking Protonix to allow the erosions to heal? Thanks so much!!!

    • I also have tested negative for H. Pylori infection and have a duodenal ulcer. I just started the Protonix because the dr. said that the ulcer will not heal without meds but i am very worried about going back on PPI. I was on Prilosec for months before the endoscopy showed the ulcer. I was wondering if Chris responded to this issue? If so, can you share the info?

      • A lot of the typical testing methods for h. pylori aren’t that accurate. I think DNA/PCR analysis should be done (via Metametrix) if there’s any question of h. pylori.

      • You couldn’t have said it better Alicia!!! It’s a sad state we live in. Least now we have info like Dr. Kresser’s site to make more informed decisions. I don’t know if children can suffer from low stomach acid, but I can tell you all, this article is dead on the spot. My Dd has suffered from IBS and GERD and SIBO FOR YEARS AND WE PUT HER ON THE FODMAP DIET, which focuses on reducing the highly fermentable carbs and sugars and this keeps her symptoms at bay with no meds. She also was getting sinus infections from the reflux going up into her sinuses at night. I believe a lot of PALEO sites may be starting to talk about FODMAPS, but if not and PALEo is not giving you full relief, go to Kate Scarlata’s blog on FODMAPS. This also looks at which sugars and fruits are least fermentable. Some people have a hard time digesting even soaked nuts, and she discusses which one may be most problematic. And yes, I could watch my Dd’s stomach bloat almost instantly from certain foods and sugars, and with the IAP, REFLUX,HICCUPS, and regurgitation and vomiting would set in. I always thought for years that the bloating was causing pressure on her diaphragm and LES.

  126. Chris,
    This is the best series of articles I have seen on GERD and I have emailed links to several friends. My reflux was so bad that many nights I sat on the couch to sleep as laying down was just not an option. About a month ago, I started on the Paleo diet because it just made so much sense to me, and within one week I was sleeping flat with no discomfort, bloating or gas after meals. I am a nurse, but my focus has always been on natural medicine so I resisted acid reducing medication, but was not getting good results with several natural remedies. Your articles made me understand why my paleo diet of no grains or legumes and not too much fruit worked so well. Thanks!

    • plaees send me your routine for the Paleo diet… the GERD and bloating after every meal ius killing me and the only solutuon i have is PPIs.

      pleaes send to my email/// [email protected]

      many thanks chris

  127. Chris,

    WOW! I was blown away by your article. I was up most of the night with heartburn and got online to search for answers. I take nexium 40 mg once a day and ranitidine at night. When my new insurance company cut my nexium from 2 a day to 1 a day I started taking prevacid as well. I still suffer every single day!
    Three years ago I was found to be gluten and dairy (casin) intolerant. I’m off all gluten and dairy. I feel so much better as far as that goes. About a year and a half ago I found out that I have laryngopharyngeal reflux (LPR), thus starting all the medication I’m now on. I also have asthma (however that started at age 10) and osteopina.
    Do you know if there is a connection between gluten intolerance, as wheat is one of the “gluten grains”, and GERD/LPR in connection with low stomach acid?
    One of my sister also has LPR and is on the same medication. Gluten intolerance runs in families and my family is pretty jacked up. Thanks for the information. I will soon start to get off all the life sucking meds., I’m on.

    • Katy I was told I had osteopenia too and then fibromyalgia. Turns out that acid reducers and proton inhibitors block absorption of important minerals like Magnesium and Calcuim and all the supplements and healthy eating were not helping because I couldn’t absorb nutrients. Soon as I stopped Ranitidine no more tight calves, plantar fasciitis . back pain or overall muscle pain. Magnesuim is responsible to for muscle recovery and relaxing muscles. I found out the back pain, bloating, and water gain along with restless legs were do to nefrititis, my kidneys were inflamed and could no longer process Ranatidine aka Zantac. Now I sleep on a long foam ramp from the Back Store and my reflux, laryngitis, sinus issues and asthma have calmed down and I wake up without muscle pain and those issues. Also be aware that any drugs in the NSAID family also increase gut permeability which is what researchers are finding out it the cause for the rise in gluten intolerance.

  128. Hi Chris,

    What if a person cannot start taking HCI or ACV or bitters due to too much acid, can I just low carb and slowly reduce the PPI and take yogurt and some licorice as well and lose weight of course and all the other lifestyle changes?


  129. Daniel,

    Thanks for the link.  I’ll check it out – sounds very interesting.

    I think we’re agreed that this is a complex issue with no clear conclusion.  Thanks for your comments!

  130. Excellent points.  It is a dilemma!
    The vit C, nitrite thing is complicated.  There was a very recent mechanistic study that in the presence of 10% fat (almost any meal), vit C actually produces more nitrites in conditions that simulate the stomach.  The idea was that vit C prevents nitrite formation but causes nitric oxide (NO) to be formed which dissolves in fat and then (I think because the NO is insulated from the water-soluble vit C) forms nitrosamines…  Perhaps vit E would help…
    In any case, it’s not clear how much nitrites are involved in the progression to gastric cancer.    This guys thesis is 2 years old but very itneresting.

  131. Daniel,

    The potential protective effect of PPIs needs to be weighed against the potentially neoplastic effect of insufficient stomach acid and bacterial overgrowth.

    From Effect of Proton Pump Inhibitors on Vitamins and Iron, published in the American Journal of Gastroenterology last year:

    “The ability of ascorbic acid to remove nitrite from gastric juice by converting it to nitric oxide is highly pH dependent.  In gastric juice of pH>4 (which is easily achieved by taking PPIs), the nitrite entering the stomach in swallowed saliva remains as nitrite and causes an increase in gastric juice concentration.

    The original Correa hypothesis of gastric cancer developing in patients with atrophic gastritis hypothesized a central role for the elevated gastric nitrite concentration.”

    This suggests a possible mechanism by which chronic hypochlorhydria could increase the risk of gastric cancer.

    There is also a known link between atrophic gastritis, in association with achlorydria or hypochlorydria, and cancer.  The risk increases with the severity of the problem and the length of time a person has it.  In one Danish study, people with the most severe atrophic gastritis had a four-to-sixfold increased risk of developing gastric cancer.  Perhaps most importantly in the context of this discussion, it took up to seventeen years after achlorhydria was diagnosed for cancer to develop.

    As you have pointed out, there’s no direct proof that PPIs increase cancer risk, and some evidence suggesting the opposite is true.  However, because it can take up to twenty years for cancer to develop, and widespread, chronic use of PPIs is a relatively new phenomenon, I don’t think we can safely conclude that PPIs do not increase cancer risk.

    I also think it’s important to pay attention to the physiological mechanisms involved and the circumstantial evidence, in the absence of direct clinical proof.  There is no doubt that acid suppression promotes bacterial overgrowth, and that bacterial overgrowth promotes production of carcinogenic nitrosamine compounds.  There is also no doubt that acid-suppressing drugs increase both the severity and progression of atrophic gastritis in people with H. pylori infection, and atrophic gastritis is a major risk factor for gastric carcinoma.

    One researcher commented on these risks in 1988, before PPI use became widespread:

    “Until information is available about the effects of powerful gastric secretory inhibitors on the proliferative indices and patterns of the human mucosa, the drugs must be categorized as too dangerous to use therapeutically, especially since the proposed benefits are minimal.”

    It’s certainly not a cut and dry issue, and there is much conflicting evidence.  Still, if there’s any way at all of controlling symptoms without PPI use I think that is the most prudent approach.  I realize this will not always be possible.

    • HELP – On July, 2014 I had an Upper Scan. Results are: LA Grade B Reflux, Esophagitis & Gastritis. I have been on Dexilant for 5 weeks and no change. My doctor just took me off Dexilant and prescribed Pepcid 20mg – 1 morning & evening. I get better for a week and then sick for a week. Worst feeling ever. Am I taking the wrong medicine / acid blockers?

  132. I think, in principal, controlling reflux should be superior than taking a PPI for cancer prevention in people with BE.  That said, if reflux is recalcitrant (e.g., on account of severe hiatal hernia), skipping the PPIs may be harmful.  Cancer progression in BE seems to be mediated by inflammation and associated oxidative damage.  Acid supression reduces certain markers of inflammation (but not others…) and may have a role in supressing ROS formation (and may have a role in causing ROs formation…).  The best evidence seems to be that the cancer progression rate used to be about 1% per year and now it is .5% per year.  It could just be measurment error, but acid suppression (at minimum) doesn’t seem to hurt (much) as progression to cancer among people with BE on long-term acid suppression is about 0.3% per year according to a 2006 UK study.  Turns out, antioxidants and nitrite scavengers, like vit C and vit E (and melatonin & NAC are promitting too) may do more to prevent cancer than PPIs, at least if the animal and limited human case report evidence is to be trusted.

  133. You’ve done a very solid review of the evidence.  I wish I had never taken PPIs but now I have Barrett’s esophagus, with the result that the conseqeunces of being wrong are greater than just a flare up of heartburn… There is not conclusive proof that PPIs prevent cancer in those with BE, but  most evidence suggests they so.  Thus, for people with BE, PPIs may not be elective.

    • Daniel,

      Thanks for making that point. I intended to include a section called “When to seek medical help” at the end of the last article, but forgot! I’ll do it in a couple of hours. What I would have said is that if there’s structural damage to the esophagus, surgery or medication may be necessary – as you have suggested.

      • Barrett’s Esophagus has been reversed, so there is an option to taking PPI’s. Daniel, it is worth at least looking into to reverse your BE and get off PPI’s.

  134. Hi Amy,

    I just published the article on treatment.  Hopefully that will answer your questions.  It can take a while for the bacterial overgrowth to rebalance.  Replacing stomach acid is very important, whether you do it with HCL (preferred), bitters, lemon juice, sauerkraut or apple cider vinegar.

    Some people find that they only need to take HCL for a short time, others continue to use it.  It varies person to person, and depends somewhat on how long they took acid suppressing drugs and the severity of their condition.

    • I was sadly diagnosed with appendix cancer last week after taking 4 years of Prilosec recommended by my Gastroneurologist for acid reflux . He said if I didn’t take it Barrett’s disease would be next , then esophical cancer after that . My surgery for my 15cm x 7cm appendix is tomorrow . I pray the cancer is intact in the appendix and hasn’t spread . The cat scan and MRI shows that the enormous mucocele is confined and nothing has leaked out . A foot of my colon is being removed along with a couple of limphnodes . After I recover from this I am moving on to the new acid reflux clinic in Texas where they can repair endiscopically my hiatal hernia at the section of stomach and Esophagus which will stop the reflux . A breakthrough for me as a reflux sufferer. I thank God every day for my good health and yours .

  135. Hi Chris,
    I have really  enjoyed your articles. I have been on a low carb diet for a long time and have seen great results but I am not completely symptom free yet. How long is this process generally? I have not taken HCL partly because I thought is this just another pill I will have to take forever, I do take probiotics.  Do you find that eventually people can stop taking HCL and not have symptoms return? I was on prilosec for seven years! I was also wondering do you find the other symptoms (asthma) that come with reflux go away once the relux is resolved?

  136. Well, I am pleased to report that after almost two weeks off PPI meds (Aciphex, after years of Nexium) I am mostly asymptomatic. A few flare-ups here and there but nothing like the disabling OMFG-kill-me-now pain I had years ago when I first went on Nexium. Thanks for the scientific ammo my brain needed to get off this stuff.
    I’m aware that it may take a long time for my gizzard to recover from the PPI onslaught.

    • Is Pepto Bismal an acid blocker? If so, what would you recommend for someone w/ lymphocytic colitis that hasn’t fou d remission on diet elimination and budesonide? I can reduce and often stop the diarrhea with Pepto & budesonide.

    • Prilosec caused food to sit in my stomach for so long that it seemed very delayed in digestion. Reflux was far worse. I went on an investigational med for HCV which required me to stop prilosec which would inhibit absorption by 50 %. My gerd pretty much went away. I still would get some heartburn but Ribavirin Also contributed to indigestion. This was far better then the reflux I was experiencing. I will never go back to prilosec or any other PPI. Food would stay in my stomach for 6-8 hours with little digestion to the point I would vomit it up so I could sleep at 1 or 2 AM.

      • I have been having the same symptoms… i was having back problems and front stomach pain as well.. no real acid re-flux or anything just pain.. after months of finding nothing.. i stopped Ibuprofen which helped my stomach pain. But was also sent to the GI doctor who immediately put me on Omeprazole DR 40mg once a day and scheduled a endoscopy. 2 weeks later had the endoscopy and he said he found a few small ulcers but couldn’t get his camera all the way down and i would have to come back for a stomach widening And also at the time doubled my dosage of Omeprazole. Now a few weeks later I have terrible re-flux, can’t eat without throwing it back up , nothing seems to digest.. i burp but throw up instead.. all this when i didn’t have any of this before I was sent to the GI doctor ???

      • Oh boy.. reflux if mild at nite I do this. Elevate my head withe 2 pillows. I drink about 6 sips of soy milk right before bed. Never eat after 5pm. That’s the worst.because I like snacking. Eat. Small meals during the day. All this is a royal nuisance but now I am use to it. I only took tums once in a while but they did nothing. I’m in a routine now and it works. I will not give up coffee in the am but make it less strong now and that’s not a problem now. Good luck!

    • Glad you have made it through getting off this stuff. I had worse pain for a few weeks after stopping omeprazole and now have gastritis back. Even after gastric blood tests that said low acid the doc and the new specialist have both said omeprazole. But I am not going to take it. I am having small meals but need to go smaller and small snacks. Cut right back on carbs as in bread etc. Still have root veges. No coffee I have green tea with ginger lemon and a tsp of honey. No red meat at the moment as that seems to cause an issue with me. Definitely salmon fish a small amount of chicken. Lots of salads vegetables no milk just almond milk on my own made nut and dries fruit cereal. I am mindful I have to watch the sugar content as I do eat apples and kiwi fruit when ripe. Its a long journey but I am determined to not be a cancer statistic like my dad was. All the best everyone hope you can all sort out what is good for you. It takes patience and time.. Cheers for now.

      • Can’t you all see there is a huge problem with this whole thing? The news is so good at making things worse than they are. Every drug, every single one, has a list of side effects as long as your arm. Blood pressure meds, pain meds, meds for high blood sugar, all have side effects of some kind. That doesn’t mean you don’t actually NEED to take them. I went back on 10 mg a day of omeprazole, because I was tired of feeling like crap on rantinidine. Some of you say now you have the acid coming up in your esophagous. This is very dangerous. THAT is what causes cancer. Eroding your tissue with acid. The doctors need to have a serious talk with each patient, and put to rest the fears many of us have taking a pill that helps us to be able to eat. I for one don’t WANT to give up my hot tea. I never was a coffee person, but not my tea. I don’t want to never eat even mild Mexican food, or Italian, because I know it will keep me up all night if I do. Even taking 10 mg, often I wake up in the morning with acidy feeling in my stomach, but I feared taking any more than that. But these forums I think often just fuel the fire for the fear and don’t really ADDRESS the issues. Many of you just seem to feel downright miserable, measuring every bite of food and having absolutely no pleasure because you are trying to stay off of this drug, which by the way is still sold over the counter to anyone who wants to take it.

        • Thank you for your opinion Julie everyone’s comments help in some way. It is up to each person what they want to do to heal their body. I know all about oesphagael cancer as my father died from it. If you are on only 10mg of omeprazole then you possibly want get the nasty side effects with that I was on 20 maintenance and got gastritis and oesphagusitis while taking it. I had been on 40 even up to 80mg over the 10 years I was on it. It doesn’t worry me not eating processed food or highly spiced food I eat fresh vegetables and low fat protein eggs brown rice and quinoa. Just for the record omeprazole caused me to not absorb vitamin B12 it also is found in the liver. It also causes kidney filtration rate to drop. Meaning CKD. I have had a gastrin blood test the results of which said I have low acid. Why would I take a pill that lowered it even further especially when I got gastritis and oesphagusitis while taking 20mg 2x a day on occasion. As I have said Julie it is a person choice and one size does not fit all. If the omeprazole helps you then thats fantastic keep it going. Omeprazole in the strength that we get on prescription in NZ is not sold here over the counter a much milder form is. The pharmacist does require that anyone wanting it fill out a questionaire and they are told thee side effects before they are allowed to buy it. It is still semi controlled in NZ. When you come off omeprazole Julie you may have worse symptoms than when you started I did which is why after 10 years I am not taking it. As I have said it is a personal decision and what suits one will not suit the other. Good luck I hope it all works out for you.

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