The Dangers of Proton Pump Inhibitors | Chris Kresser

The Dangers of Proton Pump Inhibitors

by Chris Kresser

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Prilosec Smart

Proton pump inhibitors rank among the top 10 prescribed classes of drugs and are commonly used to treat acid reflux, indigestion, and peptic ulcers. Although generally assumed to be safe, recent studies have shown that they have numerous side effects, from an altered gut environment and impaired nutrient absorption to an increased risk for cardiovascular events, kidney disease, and dementia.  

PPIs have become one of the most commonly prescribed classes of drugs in the industrialized world, despite increasingly frequent warnings by researchers about potential risks and complications.

A 2010 study found that of 946 patients receiving PPI therapy in a hospital setting, only 35 percent were prescribed PPIs for an appropriate upper GI diagnosis (1). In 2014, Americans filled more than 170 million prescriptions for acid blockers, falling only behind statins in total cost expenditure worldwide (2). PPIs are the most common of the acid blockers. They go by a variety of names but typically end in the suffix “-prazole” (omeprazole, pantoprazole, esomeprazole, etc.).

The purpose of this article is to provide an update to these earlier articles on heartburn and antacids, focusing on a number of scientific studies published in just the last few years. If you haven’t already, be sure to check out these previous blog posts.

The Many Roles of Proton Pumps in the Body

Before we get into the potential harmful effects associated with PPIs, it’s important to understand what they do in the body.

PPIs are inhibitors of proton pumps, specifically the proton/potassium pump of parietal cells in the stomach. The theory is that heartburn and GERD (gastroesophageal reflux disease) are caused by excess production of stomach acid by these cells, so inhibiting this proton pump will reduce the acidity of the stomach and prevent the burning sensation of acid reflux or the formation of peptic ulcers.

But proton pumps aren’t limited to the stomach; they are present in just about every cell in your body. All of your cells, with the exception of red blood cells, have mitochondria that allow your body to metabolize carbohydrates and fat to produce energy. They do this by pumping protons across the membrane to generate a source of electric potential that can be harnessed to form ATP, the body’s main storage form of energy. Without an efficient proton-pumping system, the body must rely on anaerobic systems for energy production, leading to rapid fatigue.

Proton pumps are also important in the transport of various substances in the body, as we will see in detail in later sections. And while proton pump inhibitors are designed to interact specifically with the hydrogen/potassium pump in parietal cells of the stomach, research suggests that they likely have nonspecific binding capabilities (3). In other words, their chemical structure enables them to bind to other proton pumps as well. Though PPIs don’t stay in the blood for very long, their binding to proton pumps is essentially irreversible—they will continue to inhibit the proton pump until the master antioxidant glutathione is able to facilitate dissociation (4).

PPIs can harm your heart, brain, kidneys, and gut. There are other alternatives.

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PPIs Alter the Gut

The composition of microbes that inhabit your gut is incredibly sensitive to changes in the local environment. pH, a measure of the acidity of an environment, is an important facet of gut health and a particularly potent regulator of microbial communities (5). PPI use reduces the amount of acid produced in the stomach, and ultimately the amount of stomach acid that reaches the gut. This causes a significant shift in the pH of the intestines.

Indeed, several recent studies have shown that PPI alters the gut microbiota by reducing its overall diversity (6,7). Opportunistic pathogens, including Enterococcus, Streptococcus, Staphylococcus, and E. coli, tended to be more prevalent in the guts of PPI users.

As stomach pH becomes less acidic, many ingested microorganisms that would normally be destroyed are able to make their way into the gut (8). Imhann and colleagues found that oral bacteria, such as the genus Rothia, were over-represented in the gut microbiota of PPI users (7). Those who used acid blockers also had an increased chance of acquiring Clostridium difficile, Campylobacter, Salmonella, Shigella, Listeria, and community-acquired pneumonia than those using other medications (9,10).

A 2013 study also found a significantly increased percentage of individuals with small intestinal bacterial overgrowth (SIBO) among PPI users (11). Together, these studies point to the vital importance of sufficient stomach acid for protecting against bacterial influx into the GI tract and maintaining an intestinal pH that supports GI health.

PPIs Impair Nutrient Absorption

Another consequence of long-term PPI use is impaired nutrient absorption, which I discussed extensively in a previous article. Stomach acid is essential for the absorption of many macro- and micronutrients. PPI users have been shown to have an increased risk of vitamin and mineral deficiencies, including vitamin B12, vitamin C, calcium, iron, and magnesium (12,13). Achlorhydria (a lack of stomach acid) and atrophic gastritis (stomach inflammation) allow for the overgrowth of bacteria, which compete with the host for consumption of micronutrients like vitamin B12 (14).

These micronutrients are particularly important for bone health. Studies have found an association between PPI use and total bone fractures in the elderly (15). While the association was modest, the findings were significant enough that the FDA felt it necessary to issue a news release in 2010 warning of the possible increased fracture risk (16). Since then, a more recent study has shown a similar association in young adult PPI users (17).

The effects of PPIs on bone health may be more nuanced than simply causing nutrient deficiency. Osteoclasts, the bone cells responsible for the resorption of calcium, also possess proton pumps, and their activity is thought to be directly affected by PPIs (18,19).

PPIs Increase the Risk of Cardiovascular Events

Several recent studies have also shed light on PPIs and the cardiovascular system. PPI users have been shown to have a significantly greater risk of heart attack than those on other antacid medication (20, 21). PPIs also reduce production of nitric oxide, a natural substance that promotes the dilation of blood vessels and improves blood flow (22).

PPIs may also damage blood vessel cells, as shown by a study published in May 2016. When researchers exposed cultured human blood vessel endothelial cells to esomeprazole, the cells seemed to age much more quickly, losing their ability to split into new cells. PPIs, which are designed to work especially well in acidic environments, seemed to inhibit an acidic compartment of the cell called the lysosome, which can be thought of as the cell’s “garbage disposal.” Without the ability to break down old proteins and other waste products of metabolism in lysosomes, “garbage” built up in the cells and inhibited their function (23).

PPIs Harm the Kidneys

The kidneys are also affected by PPIs. A study published in 2016 compared patients using PPIs to patients using H2 blockers, another common antacid drug. They showed that over the course of five years, those in the PPI group were 28 percent more likely to develop chronic kidney disease and 96 percent more likely to develop end-stage renal disease (24).

While the mechanism by which this occurs is unclear, we do know that proton pumps are present in the intercalated cells of the kidney. These proton pumps are responsible for moving protons into the urine, creating a gradient that allows for bicarbonate reabsorption into the blood (25). Bicarbonate is vitally important to maintaining proper blood pH.

PPIs Negatively Affect Cognitive Function

PPIs also impair cognitive function. A 2016 study found that regular PPI users had a 44 percent increased risk of dementia compared with those not using the drugs (26).

A different study published in 2015 that assessed cognitive function in PPI users versus controls found statistically significant impairment in visual memory, attention, executive function, and working and planning function among PPI users (27).

Several commonly prescribed PPIs, such as lansoprazole and omeprazole, have been reported to cross the blood-brain barrier. In mice, PPIs were observed to affect β- and γ-secretase enzymes, resulting in increased levels of amyloid β, a protein fragment that forms the plaques characteristic of Alzheimer’s disease (28).

Furthermore, communication between brain cells requires the action of proton pumps. Simplistically, neuron cells contain small vesicles, or pockets, of neurotransmitters. When a neuron is stimulated, the vesicle releases these neurotransmitters into the synaptic space, where they can then interact with receptors on other nearby neurons, transmitting the signal down the line. The neurotransmitters must then be taken back up by the neuron so that they can be released again in response to the next stimulus. The energy required for this reuptake process is driven by proton pumps (29). If PPIs bind to these proton pumps, cognitive abilities would certainly be impaired.

PPI Withdrawal Can Lead to Rebound Reflux

Your body is acutely sensitive changes in your physiology and is constantly trying to maintain a stable equilibrium, often termed homeostasis. In the case of PPIs, when it senses reduced stomach acid production, your body produces the hormone gastrin to try to compensate. Gastrin normally stimulates gastric (stomach) acid production.

Excess gastrin has in turn been shown to lead to an expansion of enterochromaffin-like cells (ECLs) (30). ECLs are found in the mucosa of the stomach in close proximity to parietal cells. A greater number of ECLs results in a greater amount of ECL hormones released that can interact with parietal cells. Parietal cells, as you may recall, are the cells responsible for stomach acid production via proton pumps. These parietal cells undergo hypertrophy, or an expansion in the size of each cell (31).

Larger parietal cells have more proton pumps and can produce larger amounts of stomach acid. This is termed “rebound hypersecretion,” or an overproduction of stomach acid after taking PPIs (32). This is why getting off PPI therapy is so difficult, because long-term use fundamentally changes the physiology of stomach cells. It also points to yet another instance where simply treating the symptoms of a condition fails to recognize and treat the underlying root cause.

Luckily, parietal cells are constantly undergoing renewal, with an average lifespan of only 54 days (33). So just because you took PPIs does not necessarily mean you are destined to rebound hypersecretion forever, as after a few months your stomach cells should have largely turned over. However, the repair mechanisms after PPI discontinuation have not been widely studied, and it is entirely possible that there are lasting effects.

Alternatives to PPIs

Collectively, these and many other studies suggest that PPIs are not as safe as they are made out to be. Frankly, it’s bordering on criminal that the FDA continues to allow these drugs to be prescribed as frequently as they are, and for durations of years or even decades in some cases, given the overwhelmingly large body of evidence documenting the potential harms associated with long-term PPI use.

If you’re convinced you should avoid PPIs, there are some alternatives (see my previous article for a more detailed discussion of these). Always consult with your medical practitioner before discontinuing the use of PPIs and be sure to reduce your dose gradually to avoid any withdrawal symptoms.

  1. Eat a low-carb Paleo diet
    Malabsorption of carbohydrates can lead to bacterial overgrowth, resulting in the bloating and increased abdominal pressure that drives acid reflux.
  2. Resolve low stomach acid and treat bacterial overgrowth
    Contrary to conventional wisdom, acid reflux is often due to too little stomach acid, which results in bacterial overgrowth.

Now I’d like to hear from you. Have you taken PPIs? Did you know about the long-term dangers? Did you notice improvement in your acid reflux by switching to a Paleo diet or reducing your carbohydrate intake? Share your experience in the comments section!


Join the conversation

  1. Thought to have reflux, our daughter at the age of almost 7 was prescribed 15 mg Previcid per day for 3 months. A few days shy of this duration I stopped giving it to her because she seemed to be getting worse throughout. The same day I put her on probiotics (not even knowing at the time what a good idea this was.) Of course, it was 2 more years of torture before we found out that we were all gluten intolerant and her problem turned out to be too little acid instead of too much acid! Now that I have read that line in this article: “Though PPIs don’t stay in the blood for very long, their binding to the proton pumps is essentially irreversible –they will continue to inhibit the proton pump until the master antioxidant glutithione is able to facilitate dissociation,” I need to know what affect this may still have on her now years later at the age of 16. As we have all been stringently gluten free for almost 7 years and had good natural supplements along with a strict anti-inflammatory diet in the beginning months to heal our digestive systems, I would like to know whether you think our daughter could be having adverse affects even now due to the Previcid.

  2. Anyone taking these drugs should look for an alternative urgently

    My husband had a massive ulcer burst in 2012 – He was prescribed Omaprezole

    From a happy go lucky, comical, nothing ever got to him type of person, he changed to having severe paranoia and horrible thoughts, so bad that for a whole year he wouldn’t leave the house and we couldn’t leave him on his own.

    I watched him almost cry in pain with leg pain and back pain, stomach polyps , rashes etc. He went for tests but at no time did his GP suggest that he should stop taking Omaprezole to check whether these could be the cause

    He was not monitored by his GP. On the few occasions I managed to stop him taking them, he went back on them because the acid reflux was so bad. Little did we know that the Omaprezole was very likely making it worse.

    He raised the question of the Omaprezole with his GP on a couple of occasions but was told to continue taking them.

    He is no longer here due to paranoid thoughts going around his head and he took his own life.

    We had no reason to believe these pills could cause such bad effects but having read more and more into it, the comments various people have made whilst taking these pills, has made me realise that the effects on him over the last 6 years have been down to these killer pills.

    I knew him well – I had lived with him for 32 years before these horrible events started happening and could not believe what was happening to him.

    Although I tried and tried to get him off them, I now have to live with the regret of not doing more research on these killer pills than I did and not taking them away, making him look for alternatives . If I had, he would still be here.

    So anyone who is taking them, please seek an alternative urgently.

  3. For anyone taking these drugs, I urge you to find an alternative. I can’t go into detail but my husband was prescribed these 7 years ago. He changed from a happy go lucky jolly person to almost crying in pain with crippling arthritis, severe anxiety and psychotic thoughts. He should have been regularly more informed by his doctor but he wasn’t -when he asked whether they could be affecting him he was told to carry on taking them . His acid reflux was getting worse, he could hardly walk some days with the pains in his knees and back, the slightest problem caused him severe anxiety. He was a different person. He is no longer with me and nothing will ever convince me that if he had come off these killer drugs years ago, I would still have him here with me. It is criminal that these drugs are still being prescribe so I would urge anyone who is taking these to find an alternative without delay

  4. Hi, I was prescribed Pantoprazole 40mg for non-existent heartburn and without any physical examination by a nurse practitioner based on a hunch. After 21 days I stopped the meds on Feb.16 when I found out what this medication does and the potency of it. About 2 weeks after stopping the PPI I developed a terrible rash in my face that lastet until the end of March when I finaly saw some improvement.The rash looked like acne pimples but they were itchy at times and my cheeks were lightly swollen. My skin felt tight and it was slightly giving me a burning sensation. The rash also gave me a very painful infection on my lower eye lid, which also infected the skin direct under my eye.

      • Yes. Absolutely. I am also allergic to penicillin, which also gives me a rash in my face; although not as bad as PPI did. Through my research on German websites I found out that PPIs are not first processed in the stomach but in the small intestines. From there they go into the blood stream and then attach themselves on the proton pumps in the stomach to reduce acid production. The PPI studies were done on volunteers in a university in Norway and Denmark.

  5. Hi, I was diagnosed with GERD early this year. Before that have been treated for heart burns and H.pylori 8 times last years. I was put on Nexium 40mg everyday and now am feeling weak, headaches, diarrhea, i have had severe sore throat twice, persistent dry coughs at night in a span of two months since i started taking the medications. I have consulted the doctors on this but suggested i should continue taking the medication. I came across your article online kindly i need help. Thanks

  6. Hi, my nurse practitioner prescribed Pantoprazole magnesium 40mg because I was complaining about stomach pain, a horrible taste in my mouth and a chest cough. I was fighting the flu and I was coughing a lot. Luckily I only took this med 21 days when I found out what it does. I also researched articles about excess and low stomach acid and the symptoms were mostly all identical. I stopped taking the med as I could not get rid of my cough and constantly had to clear my throat. One day after I stopped the meds things slowly started to improve and after 4 days my cough was almost gone. I had no appetite while on the meds but this also drastically improved on the 4th day. My body is mostly alkaline so I found it odd that I would produce excess stomach acid. I now take 1 tbsp apple cider vinegar in a little water before bigger meals and digestive enzymes. I also watch what I eat and when I eat it. I start to feel much better after the meals. However, my digestive system still adjusts to get rid of the PPI meds and bring everything back into balance. Never again PPIs!

  7. I have weaned myself of PPI’s and cannot believe the difference in my health! I was so ill I believed I was slowly dying. Now that my gut is getting back to an acid environmet my gut can heal and all the nasties are being got rid of slowly but surely. I cannot tell you in a short post how my diet has improved and increased so getting nourished again and feeling so much healthier, putting on weight, sleeping better, more energy and even my emotional health is improving. I am on absolutely ZERO medications now – even off my bp meds now. (My bp was always sky high on ppi’s.) I am now working on building up my health again with natural supplements and of course very, very good delicious foods! OH I CAN EAT AGAIN!!!

    • Did you stop cold turkey? I have been on pips for six months and my knees hurt so bad I can hardly walk. I am down to one 20 mg per 48 hrs. My heartburn comes back at that time.

  8. I just started taking these this week and after reading this article and comments think I should stop . Felt nauseous and shaky all day .

    • Karen, if you start you will be in a vicious downward spiral and cycle and will think you cannot come off them. The reason being that when you try to stop it gets far far worse with rebound. Most people who try to stop fall into this trap and so just stay on them thinking they need them for life. There is loads of info out there on the dangers of ppis these days, Chris’s article being one of the most informative and easy to read. I also found stuff on youtube. I came off one granule (in capsule) at a time after trying umpteen times. I got that help from someone struggling with the same situation on youtube. None of the doctors I visited (and I visited many in desperation) was able to help me wean off ppi’s. ALL my help has come from the internet so you will not get the best advice from the allopathic world!

      • Karen silly people don’t tell you a cure, fresh cabbage and apple juice juice fresh ly made at home, red cabbage as well, kills stomach bugs and neutralises stomach acid on your rebound. Also take coconut oil a spoon morning afternoon evening as it’s a antibacterial and reduces inflammation

  9. Iv been Prescribed Esomeprazole for 15 years and have tried many times to stop taking them. The rebound is unbearable at times and I always have to go back to them for relief. Im currently trying to stop again after reducing my dose down to 20mg a day for a month I then switched to 20mg every 2 days for 3 weeks and now have just stopped taking them all together. Its very uncomfortable and rebound is unbearable at times, Iv nearly given in to it again but with the help of ranitidine and traditional antacids Im hopeful I will stay PPI free this time (although it is very hard). I will say this, I stopped taking them for 3 months the last time I gave up and the Rebound although reduced was still terrible after this time, although that time I just went cold turkey. I cant believe how these drugs are prescribed so freely and can be bought over the counter and even in the supermarkets here in the UK. These drugs cause a serious dependency and as stated it is bordering on criminal that this is allowed to go on.

    • Scott see my reply to Karen re how I weaned off ppi’s after countless failures. I failed to mention I was already off all grains, sugars and dairy (plus any foods you may be very sensitive to) due to the fact they cause inflammation for me and therefore will not help the situation). Because PPI’s have caused such an imbalance of bad/good bacteria in the gut there is no way a traditional diet can be followed till at least the gut is healed. I actually had to do years of research for myself because there was just no help out there. (I live in South Africa). I also take supplements because PPI’s have made us deficient in so many, including magnesium, so important for peristaltis. HCL (I took it slowly!) is important too. I cant do vinegars currently so I dont do the Apple Cider Vinegar which many people do. You HAVE to find out your triggers and what is particular to your own case. There is no one size fits all unfortunately. I totally agree with you its criminal that doctors just dish out this stuff. In fact mine started in the UK when I went to a dr. for very painful back and she prescribed iboprufen. I told her I cant take it as it upsets my stomach. Her reply was “well then I cant help you”!!!! Stupid me in desperation decided to take a few – thats where my problems started – 2011 – and just managed to get off ppi’s a few months ago. Recently, over the Christmas period I went a little mad with the wrong foods and within a few days I started the same acid symptoms. I could very well have gone back to ppi’s thinking I cant live without them, or that it was rebound, but it is not, its the wrong foods. I am still in the process of healing my gut so cannot eat those foods that cause inflammation in me.

      • I weaned myself off ppi it took 9 months i opened the capsules and removed one tablet at a time.about every three weeks .iused gavascon on any bad days of reflux.know the doctors have meon zantac but. i ve been having kidney problems amnd other side effects

  10. Hello. Posted in July about getting off PPI. I was on them for about 6 days. Pretty sure they get rid of the lump in my throat feeling. So stopped taking those and started ACV but I still have the burps. It’s been about two months. I’m not sure how I can stop this. Some days it’s better than others. Also a diet change is probably not something I can do at the moment because I’m bordering on being underweight due to weight loss from my panic attacks. (refer to my post in July). I feel like I have no reflux just the burps or gas. And also my nose is stuffy a lot of the times especially at night. Not sure if this is related. Would love to hear any advice to stop the burping.

    • What you are describing sounds like you were diagnosed with LARYNGOPHARYNGEAL REFLUX DISEASE (LPR).
      If that’s what it is, then you should NOT be drinking ACV or anything else that has a moderate to high acidic value that will continue to damage tissues in your throat caused by acid and pepsin that made it passed the upper esophageal valve.
      Please consult your ENT doctor about this to avoid further damage if this is what you have.

      • thanks for the heads up but no they didn’t really diagnose me with anything he just thought i had reflux. no tests were done. main things i’m still getting is feeling sick after eating and burping after drinking anything. the lump in the throat feeling is long gone, that only lasted shortly after a bad panic attack. i’m not sure what happened but my body hasn’t recovered from it I still burp after anything I digest and my heartbeat is very noticeable when laying down. I don’t feel like there’s any damage done to my throat I can still sing and talk as good as i used to but i don’t feel as good. i’m not sure what it is but it’s not healing.

        • and btw i’ve gained back all of my weight. it isn’t the worst thing in the world but it is a bi*** to deal with especially at night trying to sleep.

        • I had a lot of burping and also very noticeable heartbeat when resting. Turned out i had a 95% blockage of the LAD. Had a double bypass and both symptoms went away. Do you have any other symptoms like shortness of breath or chest pain of any level( mine wasnt bad at all)?

    • Sonic, sorry you HAVE to change your diet even if you are underweight. The stuffy nose is a sure sign you are eating something you should not be eating which means your gut cannot heal whilst you are eating the wrong foods. The most common triggers are grains, dairy (unfortunately) and sugars. I too lost loads of weight but I am putting on again now that I have managed to get off the ppi’s. My gut was in such bad shape I couldnt even eat raw veggies but I have been able to re introduce them recently – so my food choices are increasing as my gut is healing. You may even find that after staying off certain foods for some time ( NOT a few weeks, much longer!) you will no longer have sensitivities to certain foods. Diet change is imperative for healing of the gut. Sorry if that is bad news, I know I didnt want to hear it! Took me a long time to accept it!

      • Yeah i’m thinking of doing a fast where I only eat vegetable broth for a day on one of my off days. actually i’ve been feeling a bit better since i commented last. drinking more water is helping with the heartbeat thing at night. and the burping has gone down some.

  11. I’ve been taking Dexilent for several years now. But recently have heard of the negative effects from taking it. While on vacation I was so busy I stopped taking it. When we got home I started up again and the acid reflux was bad! I felt like it was worse after taking it. So I just stopped using it. Now I feel like I have constant heartburn. Any suggestions as to what I should do? Should I go back on the Dexilent and slowly go off? Or should I just stay off? Should I take probiotics for my stomach flora? Are there any alternatives that I can use to calm down the reflux?

    • Go back on the PPI. Then, slowly wean yourself off by taking it every other day and then every third day. Then I would go on one of the H2 blockers like Zantac.

    • I weaned off exactly like Jeff said but not everyone can do it that way. If it doesn’t work, take the Zantac the days you don’t take the PPI. You can also check out something called Enterade, which I’m drinking now twice a day and they give it to patients with cancer because their stomachs get all messed up because of the chemotherapy. In my case my doctor recommended it because of my gastritis. It has aminoacids but what I don’t like is that each bottle has about 230 mg of sodium. It’s about $5 per bottle and you can only buy it online. For now I’m getting it for free from my doctor.

  12. I very concerned about my 86yr old Mother in Law. She has been taking Lanzaprozol for many years over the last 18 months she has become very tired all the time she can sleep most of the day away. She says she has no energy. In recent months I have noticed a deterioration in her short term memory. She is also very pale. She does suffer from depression and although on antidepressants they don’t seem to be helping her.
    I realise that she isn’t getting any younger but in 18 months she has gone from being mobile, independent, and mentally aware to a very old old lady who shuffles about in her dressing gown all day. Could taking PPI’s be causing any or all of these symptoms?

    • Have them check her B12 levels! I took Prilosec for years and now have Pernicious Anemia (B12 deficiency) and had many of the same symptoms.

    • Ive been taking Prilosec 22yrs but in the past few yrs have become allaergic to dairy and gluten and have gallbladder polyps and fatty liver, I want to stop the Losec (UK) but everytime I taper I get this rebound acid reflux, probably cause of hiatal hernia which would keep the LES weak, I do keep trying to taper every so often and got down to almost zero but after a few weeks weird swallowing problems like a piece of bread felt like I’d just swallowed a brick got me back onto 20mg of Losec, have to lose weight and try again.

  13. I have been on Prevacid for GERD due to a hiatal hernia (found via scope) for 15 years. At some point, maybe ten years ago, when it was available OTC and my insurance would no longer pay for it, I realized the 15mg dose was all I needed. I have been feeling generally good and it has controlled my acid reflux very well. However, these recent studies have terrified me, and I am now trying to come off them. My doctor told me to taper off by taking one tablet every two days, then every three days. I did that, and have now been off them for almost a week, and this is my worst day by far. I have been taking 150mg Zantac up to twice a day to try to calm the acid, and started ACV this morning, but the acid reflux, nausea and cramping is bad. I don’t want to give up though, but don’t know how long these symptoms will last. I’m thinking of taking the Zantac 150mg morning and night just to get through the next few weeks (54 days or whatever I need to), since I figure it’s better than being on the Prevacid (have read these are much safer), and then I’ll try tapering off the Zantac. My diet is much better than it was when I started this med, so I was hoping I’d be spared this, but here we are.

    Has anyone gone through this and succeeded? I’m feeling pretty hopeless right now. Don’t know how I’m going to get through the workday feeling so nauseated and with the acid burning up to my ears. I forgot what that felt like – when the acid was so bad you could feel it in your ears.

    • Aaron I know how you feel mate, I think the proton pumps awakening and the acid rebound could last up to 90days, what I did when I reduced (prilosec 20mg 22yrs) was take out a few beads in the capsule (10%) then 50% and down to zero and anticipated the burn so I took DGL at night, slippery elm chamomile, aloe vera, flax seeds in hot water, silicon solution etc but it didnt do much, the burn still came and problems swallowing was the alert that I needed to go back onto prilosec, I need to try again soon.
      With Hiatal Hernia I realise i have to lose weight, my ideal weight is 73kg but Ive been around 105kg mark for 20yrs and so possibly shedding that weight will help the hernia to go down, so possibly in your case weightloss may help if you are overweight or have a big belly as this may push up on the LES. also I put an apple or ball on the LES area and roll it down (hurts a bit) and massage the hernia area down, try to do all the hernia healthy things like avoid lifting heavy objects, avoid constipation (straining), cardio is better than weights cause of the straining effect, although targetting the abs may be a great idea (yoga, light ab work), good posture all day, wearing braces as opposed to belt etc. Keep in touch let me know how you get on, I will do my next taper soon.

  14. I had been taking PPIs for about for 5 years. Was finally able to get off them in Feb 2016. Since then I have been taking MVI, magensium, calcium, b12. I was feeling good for a little while but for the past year or so, I have been struggling with some brain fog as well as muscle/joint stiffness/weakness. I was wondering if anyone on this board had some thoughts. Could it be that the chronic PPI use has altered the way my GI processes wheat and that I am now gluten sensitive?

      • Rhodiola in the beginning of the day for your brain. And Ashwagandha at night. Muscle joint weakness – perhaps not enough amino acids? I love Dr. Axe’s collagen powder, that helped. (Seemed I had more energy) Plus going to the gym more often helped. If not enough time, more walking seems to help along with standing still and doing side punches (keeps my back more stretched out!)

    • Hi, I can’t say weather the cause of your symptoms are the ppi’s but what you are describing to me sounds like gluten sensitivity. Have you triend cutting gluten from your diet? I have the exact same symptoms when I eat gluten. You will notice a difference within a few days of cutting the gluten; that is to say if the gluten is what’s causing it.

  15. I’ve been taking omeprazole for 20 years to control reflux after a PDT cure for Barrett’s esophagus in 1997.

    I experience the all of the lower GI side effects on a rolling basis. Recently the side effects seem more chronic.
    I have been concerned about the long term side effects of PPI’s and feel like i have no alternatives. I have an appointment on 7-13-17 with a GI doctor and found your site while preparing for the appointment.

    • Good luck. I used mastic gum and Raw Manuka Honey along with periodic pickle juice to help me get off of Prilosec. The mastic and manuka honey were used to help kill any H. Pylori that may be overgrown in my stomach (and the honey is soothing to me as well) and the pickle juice helped when I had heartburn. I tried the ACV but just couldn’t get past the taste – I do use it in salad dressing though.

    • My story is similar to James’. I tried not taking omeprazole but the reflux is horrible. I also have Barrett’s and hiatal hernia. Is there surgery for this?

    • James I’m onway to a GP this Thursday to try and convince him that after 23 years on Lansoprazole (for Barrett’s which hase not progressed) I have B12 (and whatever else) deficiency. In the last 7 or 8 years I have gone downhill significantly healthwise physically and mentally.
      Over the years I would also crack the 15mg capsules and empty out either half or one third’ish to try and ween myself off them but the mere thought of going back down the Barrett’s path again scared me into staying on them.
      At this point in my life now (I’m only 49) I really need to give myself a full MOT and get off PPI’s and manage what time I have left (hopefully many decades lol) a lot better; the B12 absence has taken it’s toll on my mind, my skeleton, my digestion and my general well being.
      Enough is enough!!!

    • I also have barrettes esophagus been taking PPIs since they first came out 20+. The pamphlet was about the size of a index card Everything I heard I have been saying for years I’ve had wrist fractures knee fractures I’ll be working and just feel like a slug instantly I get confused It all makes sense

  16. Don’t know if this thread is still open but I’ve been taking Omeprazole for about six days due to some minor symptoms (lump in the throat feeling and frequent burping). Other than that no other real symptoms. (I’m 23) Here’s the thing I only recently got these symptoms after a few panic attacks and major anxiety. I normally don’t have digestive issues. I’m still getting the frequent burping and some feeling of mucas in my throat but it has subsided some. I want to get off PPI because I don’t think I have any real issues. What would you guys recommend? Do I even need to taper off or can I just quit suddenly.

    • I would recommend you get off them immediately. You haven’t been on them long enough to really feel and withdrawal symptoms. You can take try an all natural product like Braggs raw and unfliltered apple cider vinegar and see if that works first. If not, try an over the counter remedy and see how you respond to that. Your ultimate goal is to not take prescription drugs, especially for symptoms.

      Good luck

      • Thanks for the quick response. Yes. I didn’t take my dose (delayed release 20mg) this morning and plan to quit cold unless I get some reflux in which I will taper off. Today my throat is feeling better. No mucas stuck in back of throat feeling today. I’m still getting the burps. It happens after I get up from sitting down or from drinking water. This is pretty much my only symptom right now aside from nasal congestion from time to time. In your opinion you don’t think this is serious right? Only thing I worry about is if acid were to get to my voice box or something like that. I don’t think I’ve been tasting acid in my throat though. Just normal morning breath upon waking.

        • In no way am I qualified to tell you what you should and shouldn’t do. Sometimes we need to take medication(S), but this one in particular I feel as though it should be for short term use only. My journey on these meds started off wonderful but after prolonged use (11 yrs), I really started to feel the effects. I decided to wean myself off them safely without the Dr.’S consent and have successfully done so by cutting the dosage down over 6 months and I’ve now lost 35lbs and feel like a new woman. I still need to lose 30 more in order to be at my optimal weight. I now use over the counter meds to get me thru the day along with natural products and know that eventually I will be free of those as well.

          • Thanks and happy you’re doing better. Been taking the braggs acv for about 4 days + some cocunut oil. Still burping that’s pretty much my only symptom right now aside from a slight cough from time to time. Maybe I should try alkaline water. But I’m pretty sure it’ll probably pass. Definitely not getting any heartburn or pains though I feel pretty great aside from burping after every drink lol

        • A tablespoon of ACV in a glass of water helps heartburn, or you could take basic digest enzymes with each meal. Both have helped me tremendously. I wish I’d known about them when I first came off 2 yrs of Prevacid. I suffered for months until my body adjusted to the paleo diet.

  17. I didn’t know about the dangers and it makes me so angry. I waited a year to see a GI doctor and he told me to lose weight and raise my bed. Guess what, my acid reflux is worse not better. I’m having to once again, self diagnose and medicate myself. I am going to start dosing myself with apple cider vinegar and baking soda. What choice do I have? I have been on PPI’s for over a year and fear for my health. I am getting so fed up with doctors. What’s the point? I should only go to ask for medical tests and just treat my own symptoms.

  18. I just wanted to thank everyone on here. I have received more valuable information than any doctor has provided in 15 years. As many of you are doing, I have been ppi addicted for well over 15 years. My doctor said that I would be on it for life. The doctor who does my upper gi scope has said that I am not a candidate for the plication surgery so I have been trying to find an alternative.
    First, I have a hernia that causes a very odd pain when eating certain items like spicy or dry foods. I start to hiccup and need water to chug to almost force it back into place. Second, I wake up quite often asperating almost as soon as I fall asleep. I never know when this will happen but I often spend entire nights watching tv because my throat and lungs are full of acid. It seems like my personal hell when this happens. Third, I have recently found myself to be lactose intolerant. This is causing all sorts of other uncomfortable issues.
    After reading through article and all of your responses, I went straight to the store and bought magnesium along with b6/b12. I have been taking one each per day with a multi vitamin for about 12 days. I am happy to say that the aspirations went away. I even tested this with eating late, eating chocolate, salty chips and dip. After that normal course of food, I would asperate and spend the next two days feeling like I had the flu. Surprisingly, I had zero issues! I have cut the Nexium in half and plan to ween myself off as soon as this bottle runs out. I am getting heartburn in the evening, but tums or Zantac cures it quickly and it’s based on my choices of food so I think that I can limit that too!
    Overall, I am soooo thankful to find this information
    I am now thinking that the ppi drugs have been counter productive. They have been increasing the bacteria in my stomach and decreasing the absorption of vitamins, causing further issues such as the spasm of my throat, resulting in aspirations when my body relaxes.
    The doctors that I have seen for years are a joke. Not once have any of them asked to check my chemistry. They just keep pushing pills. I urge all of you with these issues to try these vitamins. Although, it has only been less than two weeks, I really have a new outlook on life. Just maybe I can retire someday with my wife rather than dying of throat or lung cancer!!!

    • Dealing with all the problems of GERD. DExalent most powerful ppi told dr about my resevations after 7 years . they act like I was accusing them of murder. each person body chem. different. how many are pot smokers? possible link not reconized?

    • Marc thats a great story how you doing now? Im ging to by the mag/b6/b12 what are doses of these vits? Yeah the lung thing I get when I wean off cause acid comes up the throat and creeps into the lungs and irritates them of course.

  19. So glad to read an article on this topic. Since October of last year I have been on Nexium. A few months later my gastro doc switched me to 40mg protonix twice a day. I have to say the fatigue, headaches, cloudy head, irritability, and worse the heart palpitations (scared the life out of me) have made me really reticent to continue.

    I have quit the protonix and the palpitation, fatigue, rebound reflux among other issues have presented in last few days. How long do these issues persist? I have been trying to drop from two protonix and two Zantac a day to just one Zantac at most a day over the last 6 weeks. Am I trying to get off of them too fast? I have done most tests and no real gastro issues noted and cardio wise all is great. They guess it’s “moderate redux” but not certain. The cure seems to do more damage than the disease. Thanks to all who posted, you give me hope to get back to some form of normalcy!

    • I have gastritis and esophagitis. I was taking 15 mg of Prevacid at night. I was taking Omeprazole before. I was taking these pills for about 3 years. They made my health worse. I think they are what caused my malabsorption of nutrients. I had low vitamin D, B12 and iodine. And I was very low on Vitamin C, my doctors couldn’t believe it. It’s almost impossible to be low on Vitamin C in the USA. I also have multiple symptoms of other things. I told my gastroenterologist that I wanted to get off the Prevacid and he told me to take it every other day for two weeks, and then every third day for two weeks and then quit. I thought that was kind of fast but I did it anyway. I’ve been off of it for about a month now and I’m ok. If I don’t feel well I take something similar to Tums. I also have Zantac just in case but don’t want to take it because even though it’s not as bad as the Prevacid, it is still bad for me.
      A doctor told me to take something new called Enterade that was made by the place who made Gatorade, the University of Florida. This is supposed to be for people with cancer, (which I don’t have) so they can eat (since radiation and chemotherapy makes them not want to eat). This Enterade is made up of aminoacids that will restore your gut, etc. So my doctor told me to drink it for my gastritis. I have to drink one in the morning and one at night. I think it’s helping. It’s very expensive. ABout $5.00 a bottle if you buy less than 12 and $4.00 something if you buy more than 12. My doctor is giving them to me for free for now. I recommend you give it a try for now. At least try it for 2 weeks and see if it helps you.

  20. Im trying to get off the PPI “Solox” that i have been on for over 10+years since i was at least 18 years old. I have been using Apple cider and 1/2 tablespoon of Baking Soda in alkaline water twice a day and it has helped but some days are hard. I have reduced meat to only at night and eat sugar/grain free. I use coconut oil etc in cooking and a green smoothie i make. i supplement magnesium, probiotics, zinc, b12 injection every few months and few other things. Hoping for some improvements over the next few months. I also stopped alcohol a month ago. coffee is still a trigger but i have 1 cup per day in the morning… might have to kick that. after reading this article i know i suffer from some issues i see above, my cardio / muscle energy output has suffered over the last year – cramps, energy lows, dizziness or vertigo all the time. hopefully improvements happen im only 29

  21. I have been taking first Tecta and then Omeprazole for about 3 years, and in the last few months have suffered from anxiety, heart palpitations, dizziness and increasing mental fog. I have had a colonoscopy (two small polyps removed), endoscopy (discovery of a small hiatal hernia and two polyps that the gastroenterologist said were caused by the PPIs), as well as cardiac ultrasound, Holter monitor and cardiac stress test under the care of a cardiologist, showing no heart issues at all. So basically, I’m a healthy 64 year old. Interestingly, my current and previous family physicians, the gastroenterologist, the cardiologist and an ENT I saw two years ago about the lump in my throat caused by acid reflux ALL told me there was no problem taking PPIs long term. So over the last couple of months I have reduced my PPI dosage to 20 mg every two or three days, and 10 days ago stopped altogether. I used 150 mg Zantac once every day or two. However, I have a raspy voice and sore throat, which I know is caused by the rebound acid. Will this go away? I am leery of taking apple cider vinegar, as it seems counterintuitive to me, but will it help with the throat issue?

    • BTW, since stopping the PPI altogether, the mental fog has lifted, as have the anxiety and heart palpitations. I feel MUCH more alert.

      • All the side effects you mentioned above, I too experienced them all. I had halter monitors on a few times, heart ultra sound and stress tests. Results all came back normal. After 13 years of taking Nexium I can proudly say that I’m now Nexium free. I slowly (6months), have weened myself off them and now no longer experience the raspy voice, lump in my throat, that I was experiencing while weening myself off. Just changed my lifestyle somewhat and lost some of the extra weight I was carrying around for years too. Stay strong and keep up the good work, these PPI’S are not safe to take long term regardless of what the Dr’s say.


    • I know it sounds counter-intuitive to treat the problem with acid based of acid producing products but it works. There is lots of information on this site to explain why. I have weaned off Prilosec (took it for several years) and it has not been easy – but it can be done and this is the way to do it.

  22. Hi, I’ve been taking PPI’s 2-3 x per week for several years. My Father died of esophageal cancer and my two brothers and I all get heartburn regularly (all early 40’s).

    One of my brothers and I have been noticing muscle cramping, muscle failure, and weakness for no apparent reason. I am a runner and have logged miles my entire life – these days I can barely run a mile without leg pain, cramping, and joint pain. My brother also says that he is noticing muscle weakness and foot cramping.

    Anyone else have these symptoms? otherwise, we are all in excellent health. Not being able to run is making me crazy.

    • My opinion is the drug is mugging your magnesium, try adding a 250 mg a day. Also read Suzy Cohens Drug Mugger article. This drug mugs a lot of vitamins and minerals! Hope this helps.

    • It most definitely is the lack of magnesium. I was experiencing the same thing and after researching the problem, I started taking magnesium right away. After 6 months of mag now back in my body, the cramping has stopped!

    • I have been thinking that I’m getting pretty bad arthritis, since my foot has started feeling stiff and painful, but I’m guessing that was the pantoprazole too… I’ve been off the pantoprazole for 3 days (I took it first for almost 2 months, stopped for a month and then took it for another month). During this time of taking pantoprazole, I’ve had constant bloating, bad flatulance, and change in bm (I went from solid, nothing on the toilet paper my whole life, to watery, piecey stool sometimes, and the rest of the time, heavy, greasy stool). I think maybe it has created malabsorption issues? Also experienced abdominal cramping at times that got pretty bad and a more frequent urge to do a bm. Of course these symptoms worried me, so I went to see a gastroenterologist. He wanted to give me an endoscopy and a colonoscopy. I told him maybe I needed to be tested for h. pylori, as maybe this was the cause of my reflux issue, and he told me that I better hope that I have h.pylori because it protects against ulcers. Please, somebody tell me if I’m wrong, but I thought h. pylori causes ulcers? And stomach cancer? I knew this already, but didn’t say anything. I double checked when I got home, and found his information to be incorrect, just as I had thought. Anyways, he also told me that the pantoprazole was safe for long time use and to keep taking it. I cancelled both of the procedures and made an appointment with a different gastro, but of course, I have to wait for another month until my appointment. I’m wondering how long it takes for pantoprazole to completely leave the system, I’m already 50 percent less flatulent, zero bloating, and today is the first day I’m noticing less of a messy bm. I also feel less fatigued, which was another constant symptom. Also slightly out of breath, but not sure I can blame that on the pantoprazole or not? I have gained a little weight in the past year or so. My reflux at this point is slight, not sure if it will come back full force or not, but I want to find out if I have h.pylori and whether or not it could be too much stomach acid or too little. Wasn’t sure I should start doing apple cider vinegar or baking soda until I know which it is, right? Anyhow, I just wanted to share my experiences up until now, if it helps anyone, and ask for any relevant input, if anybody has any on the questions I have. Hope everybody gets well soon. Thanx

  23. I’ve been taking Prilosec since 2004. They work too well. I’ve been reading more and more information about the bad side effects of PPI’s. I’ve spoken to two doctors during my annual exam the last few years about getting off the PPI express. No encouragement at all. One doctor said “taking them is better than developing esophageal cancer.” I am slowing weaning myself off PPI’s, now down to taking them every other day. I’ve had to battle some with rebound re flux, so, I do the lemon juice/vinegar routine every morning. I should be completely free of PPI’s within the next two months. It is criminal the FDA has allowed a class of drug this powerful to available over the counter.

    • It is really criminal is right. Doctors and pharmasutical companies are all in it together and the more pills they prescribe, the more kick backs they get. I’m now down to 1/4 pill a day and should be off completely within a month or so too. Stay strong and keep up the good work!

      • Good for you! Have you had re-bound reflux? A little off topic but, STATINS. My total cholesterol is 159, LDL 100, HDL 51 triglycerides 89, and risk ratio of 2.5. My doctor wants me on statins! I couldn’t believe it. She kept talking about a “panel” who recommends “most” men 60 or over go on statins, whether or not they have a bad lipid panel, to “protect” the heart. Are these people crazy? I politely declined.

        • So far so good. Just a mild case here and there, nothing that a little Apple cider vinegar can’t cure. I’ve also been taking some magnesium and a hydrochloride supplement which helps tremendously. Stick to your guns and try and stay free of prescription drugs.

        • Don’t do it Jeff!!! I ached so badly that I could barely walk. My muscles felt like they were made of cement. I tried 5 different statins with the same result. I am currently taking Fenofibrate which is a super fiber prescription drug. I’ve been on it a few years and it seems to do the trick without the side effects.

    • Marc thats a great story how you doing now? Im ging to by the mag/b6/b12 what are doses of these vits? Yeah the lung thing I get when I wean off cause acid comes up the throat and creeps into the lungs and irritates them of course.

    • I had the same problem and have had great success with using a wedge pillow. I went off of the PPIs after taking them for several years. I was taking them because of my coughing but went off of them after reading of the many side effects. I rarely had heartburn but it is niw an ongoing problem and my stomach is now very sensitive which it never was before.

  24. Scott, thanks for all the good info. I would like to start taking betaine hcl but I don’t want to take pepsin because I am strict vegetarian. (Pepsin is made from some animal ingredients) I read somewhere the hcl can be taken with papain instead of pepsin for vegetarians. Could you be so kind to tell me if this would work as well. If not, is there something else I could take it with instead of pepsin? Thanks for your help!

  25. BTW, the drug was protonix. The diagnosis went from acid reflux to gastroenteritis in which they were not even fully confident of but it was never acid reflux in my opinion. THE PPI’s threw my digestive system all off balance. My VIT D counts are always low in the winter months <15 at times. On a daily supplement now.

    • Hi Ken,

      Try a good probiotic twice a day and just plan to stay on it. If you are like most people, you’ve been on at least one antibiotic course in your life. I’ve heard that the disastrous results of one single course is akin to completely clearing out a rainforest. Rainforests don’t regrow in a day. It’ll take years in many cases.

      Also consider prebiotics. It’s said that probiotics will simply die off if prebiotics are not there. Examples of food prebiotics would be onions (cooked or raw), potatoes cooked then refrigerated and eaten cold.

      I’ve found digestive enzymes helpful to speed up the stomach’s emptying time. Others would recommend Betaine Hcl which increases stomach acid, which would accomplish pretty much the same thing too. I’ve not tried that because I can’t swallow big capsules.

  26. I used PPI’s in 2014 for 90 days. I have battled GI issues for three years. (29 y/o) During usage, I had a few GI procedures(endoscopy),gastric emptying scan( barium swallow with egg), at least 3 chest x-ray’s and a CT:(. Originally, the issue was never GI related, it was anxiety but the doctor misdiagnosed that with Acid Reflux. I know the feeling of acid reflux, and that was the wrong diagnosis. The original symptom was palpitations and that was anxiety.

    After the PPI’s, still to this day I get lots of burping after meals and my stomach doesn’t feel to empty as quickly as before GI’s. I have to move around more to help digestive process or take digestive pro-biotics. My short-term memory and cognitive function has absolutely been affected from this, hard to remember recent things(things that happened in the past few months), B4 ppi’s, I have and still have foul smelling flatulence and most notably noticed after eating dairy.

    how do I repair my gut?

  27. I have been taking omeprazole for years! Possibly 10+ years. I’ve suffered declining health during this time and have seen multiple doctors. All have been aware of my GERD and all have given me the green light regarding this medication. I often raised concerns due to the 14-day warning on this medication but was told not to worry. Last week I came across your blog from 2010 and was so inspired I immediately stopped taking the Omeprazole (cold turkey) started on the Specific Carbohydrate Diet linked to the blog. So far no GERD. Thankful for your post!

  28. I have LPR and a paralyzed left vocal cord. Had the injections, which improved the symptoms for a few months. Next option is an implant if I choose to do so. I HAVE to be on a PPI. I have no protection otherwise. So, I take OTC Nexium 22.3 mg b.i.d. I have kidney function test and liver function tests every 3 months. Sometimes it’s not the quantity of your life, it’s the quality. Don’t know what else to do. I can’t afford to lose the other cord.

  29. Hi
    I suffer with burping, excess acid ad a pain in the middle f my breastbone that goes right to my back, almost like a tight band, its excrutiating. Ive had a clear endoscopy, clear Gall stone scan, no H pylori. I cant wear a bra Im so swollen. This episode has come from bending forward doing the Garden. Now cant even have a drink without burping sick up ( Sorry). The GP said Its Functional Dyspepsia in other words he dosnt know. I ve taken PPI`s and they dont work but he insists I try the again as he is clutching at straws. I have B12 Aneamia so it worries me that these can make it worse, so still in agony with no diagnosis and a very painful, swollen tummy.

    Please an ideas ?

    • you clearly need to talk to a different doctor. If yr GP practice is small you could try going to a hospital A+E dept that has a walk-in GP clinic- (best option is a hospital in a large city: idk where you are located but doctors in hospitals tend to be more up to date than GPs in provincial practices.) best of luck x

    • SEE A NATUROPATHIC DOCTOR OR A HOLISTIC NUTRITIONIST . DO NOT WORRY. THIS IS COMMONLY FIXED IN THE HOLISTIC WORLD .. it is usually because you have severe delayed food allergies .

    • As Chris stated, often it is a deficiency of stomach acid that causes the reflux. Basically, if you do not have enough stomach acid, than microbes live in stomach and create gas which flows upward and carries the acid with it.
      Have you tried supplementing with stomach acid (hydrochloric acid or HCl )?
      I used to have acid-reflux and heartburn after every meal. The supplements I took were all geared to increasing stomach acid, and increasing food digestion so I wasn’t supporting microbes in my stomach.
      I used to take a form of supplementary HCl by Nature’s Sunshine, “PDA” (which stands for Protein Digestive Aid – called this because basically without enough stomach acid you cant digest your protein). It is encapsulated so wouldn’t cause further irritation to already damaged upper GI tract. I was also taking Natures Sunshine’s “Food Enzymes” to help fully digest food in stomach and gut. These supplements helped quite a bit but adding digestive bitters before eating helped even more since the taste of bitters in mouth stimulates both acid and food enzymes being released.
      All of this helped but what finally changed my reflux was following some NES Health protocols. I no longer have reflux and am no longer using anything but the bitters which just seemed like a good idea to maximize my digestion.
      I am a Certified NES Health Practitioner and would happy to share more about it.

      • But if you have a Hiatal Hernia then putting more acid in means more acid solution to reflux especially if you combine this with a low carb diet and have no water/acid absorbing foods like bread and carbs.

    • I had taken meds with ppi for heartburn for over 10 years .
      I didn’t want to take and told Dr that it was making me sick. No one believed me until I was admitted to emergency .
      I had many testes done for different things that were happening and all came back negative . No one knew what was going on they thought I had cancer that would be the next step of testing.
      I was allergic to PPI in my heartburn meds.
      could of had heart attack . had anemia,Very low hemoglobin count shortness of breath weird sound in ear,allergies, and so on.
      It has been 5 months since im off the meds and im back to normal . I don’t have non of the stymptoms that I had before.
      Now Im on a gluten free diet and watch what I eat.
      Dr say im a rear case .. But im sure theres lot more people that are getting sick from ppi and maybe don’t know.
      Hope this helps.

      • I’m glad you’re doing better Rose. The Dr’s don’t tell you about the long term side effects and just write out scripts left right and centre. In fact, the Gastrointrologist looked me straight in the eye upon my asking him about any long term side effects and told me they we’re any and this medication would be safe for me to take for the rest of my life. Just told me to take some extra vitamin D and calcium.

    • Sounds like you have gastritis. I’m in same boat now for going on 7 months. I am in chronic pain everyday, I can’t wear a bra, I can’t sleep in my own bed because my stomach feels like it’s up in my chest, I can’t sit because it hurts too much in my stomach and back and I now how never pain from the unrelenting pain. I refuse PPIs, taking pain meds make me vomit and become very ill. It’s a no win situation. I have done everything naturally and with my diet to heal this chronic gastritis to no avail. I think one of the underlying causes is Hashimotos so I’m seeking out a holistic thyroid specialist. I’m absolutly exhausted by the pain. My heart goes out to you.

  30. QUESTION: Can anyone tell me how much vitamin B12/B6 was recommended to them? I am ordering the Bronson that was mentioned, which I believe is 1200mcg, but I am not sure how many or how often I should take them. I am 65 yo woman in pretty good health who wants to be more active. Taking a high dose of PPIs right now, but hoping to wean off of them. Thanks!

  31. So much good info here, and I could go on and on about taking PPIs at high doses for many years, but much has already been said. Just wanted to add a couple things…I did not see any suggestions regarding a hiatal hernia. I used to take DGL for stomach pain issues, but notice it doesnt work for pain related to the hernia. (My chiropractor thinks my stomach or diaphram get caught up under my rib cage, and I confess that is what it feels like when that particular symptom manifests. I tried an exercise for that–warm water, followed by dropping repeatedly on your heels to relax the muscle and drop the diaphram. It does seem to work when the pain is severe, but doesnt deal with related issues like GERD.

    I AM planning to follow Chris’ advice on getting off these high doses of omeprazole (40mg, 2 x a day) but wanted to let others know something important my research found. For many years I have had constipation, long before the stomach issues, and only a particular type where there does not seem to be enough moisture in the bowel. This type of constipation didnt respond well to most laxatives, with the exception of Miralax and Magnesium liquid laxatives. I must add that I drink significant amounts of water, so dehydration is not an issue. In 2012, when my husband was told he had high cholesterol, he researched intensively to find an alternative to statins, and found Chelated Magnesium–which also offered other health benefits.

    We both started on it immediately, 2x a day and it lowered his blood pressure substantially in 60 days, and the doctor signed off on his need for further medication. I immediately began having a normal elimination cycle, which i hadnt experienced in 15 years of so. When I miss a day of magnesium, I immediately have the same problem again. So, needless to say, I am a huge proponent of this supplement. And it is so much more convenient than a liquid version. I should add that I have taken magnesium in pill form many times over the years, and only this chelated version and the liquid laxative have had an effect.

    After reading all these comments, I am going to order B6/B12 in sublingual form as well, and see how that improves my health. I have severe back problems which improve with lots of exercise, but I fatigue much too easily. So, fingers crossed…Thanks all for your time sharing your experience. Now, on to the other two articles by Chris…

  32. was on Nexium for 15 yrs couldn’t quit due to rebound. Sept ’16 tried again -from 40 mg to 20 2 mos. then OTC Ranatadine 1 month gradually using baking soda and DGL…..Jan ’17 now only DGL and occassional baking soda throughout the day…..GOOD BYE NEXIUM! :)….( saves money too!)……had alot of withdrawl symptoms;- headaches, nausea, bitterness in mouth, hunger, dry mouth, skin rash, fever like symptoms….much better now 🙂

  33. Does anyone else have intolerance to Apple Cider Vinegar? If it is in anything I consume I will sneeze violently for hours and have flatulence for hours, also runny nose and watery eyes. I noticed this is the most often recommended but is there an alternative? Does Coconut oil work just as well & do the same thing?

  34. This information is really helpful. I had chest pain last August and it ended up being a 95% blockage in my right coronary artery which was fixed with a stent. Following that I was put on a platelet inhibitor (I have to take that for one year) a statin for high cholesterol, 81 mg aspirin and two BP meds–one a beta blocker (really small dose) and the other a calcium channel blocker. I also take calcium for my osteopenia and fish oil and coq10. Oh, and Enbrel (a biologic injection once a week) for psoriasis and psoriatic arthritis.
    When I was put in the meds for my heart, I was also told to take a PPI for one month–I guess to reduce stomach problems from the Plavix or the statin? I stopped the PPI after a month, but noticed stomach pain and a lot of pressure in my chest so doc told to restart the PPI for a month. Did that and since then I’ve had increasing pain and pressure in my chest. So much so that I thought I was having a heart attack two week s ago and ended up in the ER. A stress test showed negative for heart blockage and doctor told me to start up the PPI AGAIN! So, I’ve been taking it for almost two weeks and the pressure in my chest just keeps getting worse. Now that I have the info you’ve provided I’m concerned that the PPI is causing this problem. I would like to stop taking it and eat the kinds of food that are helpful in relieving or eliminating this pain. I’m sure my doctor is going to want to do an upper GI to see what’s going on, but I’m really afraid of swallowing that camera. I did it once years ago and it was horrible. Can you give me info on diet or natural remedies for my stomach/esophagus problems? Thanks!

  35. I cannot take PPIs
    I get hives and intolerable itching everywhere . The doc insisted I try twice ……I cannot take the PPIs.
    I have gastritis and esophagitis.
    I had stomach ulcers which are healed with zinc carbonate slippery elm alo marshmallow and DGL and so I ate cookies bread chocolate drank coffee everyday and had to have endoscopy to see what was going on because of the pain
    But the last endoscopy showed gastritis and esophagitis which has actually been almost as bad as the ulcers
    Awful pain under breastbone stabbing pain and then waves of pain , bone itself is very sore , lots of palpitations which I am convinced are caused by the acid which comes up my gullet into my mouth I can’t eat anything with white flour, eggs, chocolate, coffee is the worst I quit smoking.
    It’s hard living like this -the pain – I can’t eat , I bought Pine Nut Oil, I hope it works
    Any thing else I can try ?

    • Sorry to hear you’re having such an awful time. Have found that the following has been beneficial to me over the years:
      natural almonds settle an acid attack, chewing fresh spinach cabbage, and carrots. You might want to try taking 3-4 okra capsules per day – the mucilage it contains will supposedly help soothe the lining of the stomach and aid in it’s healing. Something to try!

  36. Hello loved reading your comments. About a month ago I got really upset as I lost a family pet. I think the stress triggered my symptoms!
    Lump in throat
    Pain crushing in my chest and back
    Thought it was heart ache….
    Then the link of fury teeth not able to get them clean. Realised I have silent reflux. Im on PPI for a month feel Better but still an irritated mouth and lumpy throat I’m wondering …
    is my throat and dry mouth called by PPI’s ???
    I’m managing my diet on PH5 and above foods. NO Chocklate and tomatoes as well. I’ve found an amazing book called the ACID WATCHERS DIET check it out. It’s all about managing your diet and stomach no tablets !! Off to the doctors in 3 hours today after reading all your wonderful posts i want off the PPI’s after only taking them for 4 weeks I should be able to get off them ok !?!! Keep going everyone I’ve found a slice of ginger in hot water is good to relax ajust the size of the slice of ginger for your taste buds xxx Esther

  37. I’ve been wondering if Helicobacter Pylori is in other areas of the digestive tract besides the stomach. It would make sense if it was found in the upper small intestine just past the stomach because that area has to be acidic due to the acidified stomach contents passing into it. H. Pylori lives in acidic environments without issue.

    I’ve also wondered if it has an actual positive function in the body. I know that it’s a pest in the stomach lining, but too much of any of even our good gut bugs in the wrong place can kill us. So, I went looking to see if H. Pylori is found in other places than the stomach and if it is useful.

    This article states that they tested for H. Pylori in the upper small intestine of several groups. In this testing, they found a correlation between people positive for H. Pylori infection and a reduction in enteritis. They hypothesized that there may be a synergistic effect with gut bacteria in the upper small intestine where H. Pylori may tend to lower the ph of that area.

    It’s a small study, and needs repeating to find anything. But with all the pressure to create a vaccine to eliminate H. Pylori, I can’t help but think that a vaccine is a wrong approach here. There usually is a reason that a symbiote exists with us.

  38. Hey all!!! I’ll soon be approaching one year since starting the process of life without PPi’s. Last March I began weaning myself off the evil drug and have been off acid suppressing drugs since May/June of 2016. It has been quite the journey. I’ve had some up’s and downs along the way but that is to be expected after taking PPI’s for a long time. ( about 11 yrs) I noticed different sensations that would bother me on a daily basis, generally for weeks. Eventually they would just go away one day. Even today, I still have things bother me but it’s nothing I can’t handle. It just takes time and is a process. I feel so much better without the PPi’s. Just remember, It takes time and we are all different in how fast we recover. I still occasionally get heartburn. If I don’t eat well I can expect some discomfort. Generally Tums will get me through and I’ll be alright. I’m always thinking ahead and trying new things to further me for the better. I have been taking Siberian Pine Nut Oil for about a week now. Not sure if it’s effective or not. They say 3 weeks of using it will give you benefits. Guess I’ll see… I’ve been reading about people taking vitamin b6/b12 tablets that dissolve under your tongue. How much does that help? I’m sure I could use some supplements after being on PPI’s for so long. Any recommendations of a brand to look into and where can I buy them? Any other supplements I should consider?

    • Hi James, when the heartburn hits, try a 1/2 – 1 teaspoon of liquid magnesium supplement. I’ve found that it quells my heartburn in about 15 minutes. And regular magnesium supplementation eliminates my GERD. I also use virgin coconut oil daily, but that kills gut bugs like H. Pylori. Coconut oil doesn’t deal with the esophageal sphincter spasming. Magnesium will. You need a balance of Vitamin D, Vitamin B12, and Magnesium/Calcium. Most of us get calcium from supplemented foods, but magnesium is not available. I use the liquid Magnesium Chloride supplement because it soaks in quick. I don’t know if I get as much benefit from the capsules with gel or powder forms, and I know I don’t get any benefit from solid tablets.

      • I should also mention that I mix that liquid magnesium with a small amount of water to suck it down. Then chase it with a pretty good slug or two of water to kill the taste. It is pretty vile tasting in concentrate. I haven’t yet found the right dilution strategy for it.

      • J Reeds, thanks for response and advice, I appreciate it. I’ll do some research and see what I can track down. Any recommendations of what brand to use? I’d like to find something I can go buy or possibly order from Amazon. I’m open to suggestions other than those places.
        I was taking coconut oil for awhile but got away from it. Right now I’m taking Siberian Pine But Oil. Heard it had good benefits just like Coconut Oil. This is what I’m taking now,
        I have also been taking Enzymedica Digestive Enzymes since quitting PPI’s. I think they have a huge benefit getting through all of this. They have a wide variety of great products. Anyways, again, thanks for the info. Let me know if you have any recommendations of the products you mentioned.

      • J Reeds, I have Hiatal Hernia and strating on a plan to reduce weight, BUT what can tighten that LES??? Please if you have any info I’ll look into it, it would make sense that calcium may tighten things and magnesium relaxes, so how does magnesium not relax the LES? Im going out to by it today, been on prilosec 22yrs and always try new tapering plans, one will work I suppose, could be this one, thanks mate.

  39. Hi everyone! I’m hoping someone can provide some incite. I’ve dealt with heartburn off and on since my teens (I’m now 31), though it would sometimes get better when I stopped drinking coffee.

    Last July I started experiencing terrible stomach burning and nausea. I finally had an endoscopy in December and was diagnosed with gastritis and reflux esophagitis, though both non-erosive and “mild”. In my twenties I drank alcohol quite often, took NSAIDs regularly, and right around the time this started happening I was experiencing a ton of stress.

    I haven’t had any NSAIDs, caffeine, or alcohol since July and I’ve begun meditation and doing yoga to help with stress. I’m even taking some time off work at the moment to focus on getting well.

    I’ve been taking a PPI (Pantoprazole) for about a month now. The doctor only wants me on it for 8 weeks and then we’re going to try tapering off. The esophagitis is still affecting me though. Last week I started eating a Paleo diet, though I’ve been mostly gluten free for some time now (now I’m entirely grain free).

    My question is: has anybody else dealt with reflux esophagitis and been helped by a Paleo diet while still on PPIs? Were you able to wean off them? Can I get tested for SIBO while still being on PPIs? My naturopath wants to test for SIBO, but she said I need to be off the PPI for a week or so in order for the test to come back accurate. If anybody has an experience they can share, I’d appreciate it!

    • Julia, you have a smart doctor! Please keep that one. (My mom was put on a PPI that should only be used for a few weeks at most. And left on it for 18 years. We are weaning her off despite every doc who will tell them to keep on taking the PPI or “!! You’ll get cancer !!” and “nothing has been proven about negative effects.” [um, you shut off a major body function like stomach acid digestion and you think there will be no negative effects?] )

      Start keeping a food/reaction/sleep diary. You may have more food stressors (allergens) than you realize. Some may only be a problem under certain conditions. [I can eat chocolate. But only if I got enough sleep the night before and only if I have something more substantial in my stomach. Otherwise, it gives me heartburn. I never would have found that without a diary.]

      I talk about coconut oil a lot (and I do believe it is incredibly useful not just for keeping bacteria in check but also for Medium Chain Triglycerides (MCTs)). There are natural methods of keeping H. Pylori and other bad gut bugs in check. The typical modern diet would only eat about 20-40 foods. The human digestion system can handle hundreds. And in fact, there are several agents that reduce or eliminate H. Pylori from your gut. The worst insult in the modern diet is the added sugars. The second worst is the hydrogenated vegetable oils. Many food/spice/herb items will keep H. Pylori in check. Coconut oil is cheap and effective. (just don’t overdo it — work your way up to the 1-2 Tablespoons a day.)

      When I first went gluten-free (gf) and soda-pop free, I had a terrible time with sugar cravings. I’d eat gf pancakes and breads. Dairy was an irritant for a really long time. Rice flour is also an irritant for me.

      Reflux is happening because your esophageal sphincter is spasming. If you’ve had poor diet and nutrition issues for a long time, check your B12/B6 levels and magnesium levels. Muscles and valves in the body work on a calcium/magnesium balance –if one is missing, you have spasms or cramps or charlie horses. I found that I can’t really get much good from magnesium tablets. Either a gel form in a capsule (somewhat ok, Mg Threonate but I’ve heard that’s mainly for mg in the brain) or a liquid form swallowed (pico MgCl, amazing results but tastes vile; works everywhere in the body) work. When my magnesium levels normalized, I stopped having reflux myself (there are many causes, but this is a big one). Not only that, but my skin stopped cracking and drying in the winter and turned supple (!!), my constipation issues resolved, and I felt really good for the first time in a very long time.

      High stress levels deplete B12/B6 and magnesium because both are used to dissipate cortisol. (It’s way more complex than just that, but that’s a simple explanation.) I have found that a Paleo-style diet that is low in starches/sugars, high in green leafies and colorful veggies, moderate in grass-fed meats/fish and nuts/seeds, and pasture-raised eggs makes me feel awesome. And I started dropping weight like mad just by adding some leisurely walking with that diet. It’s actually not that hard to manage. I have one day per week where I let myself eat crappy food. It is very helpful for those impossible cravings because I put the food on my list and eat it on that day. And I find I crave crappy stuff less and less.

      SIBO testing should be done after the PPI is gone. Don’t stay on that stuff long –even 8 weeks seems long (I thought it was 14 days recommended) and could make tapering off harsh. For the acid reflux still occurring, get some DGL (degly{something something}ed licorice) tablets and chew them 20 min before a meal. Begin introducing virgin coconut oil daily, a teaspoon at a time so you don’t overdo it. It will kill SIBO too, so go slowly and increase to keep from vomiting. SIBO + coconut oil too quickly always leads to really unpleasant vomiting. If coconut oil makes you nauseous after you take it, make sure you take it with food and cut the amount back until you can tolerate it. I started with a teaspoon and increased it every few days until I reached a Tablespoon (3 teaspoons).

      If you have H. Pylori, you most likely have SIBO. If you take antibiotics, laxatives, or PPIs, you’ll end up with SIBO because all of those interrupt the gut bacteria. (It’s like noticing you have too many badgers and not enough deer in the woods so you burn down the woods and hope that when the trees grow back you’ll have more deer and trees and less badgers.) Healing your gut will heal your nutritional deficiencies because you’ll be able to digest food again.

      One last note, PPIs interfere with the vitamin Bs uptake into the body. Use sublingual B12/B6 (melt under the tongue) to get it into the bloodstream from the mucous membranes in your mouth. Taking tablet form vitamins is almost worthless with PPIs and/or SIBO.

      • J Reads,

        Thanks so much for your detailed response! Super helpful. 🙂

        The food diary idea is a good one. I was a bit hesitant because I have a history of disordered eating and I don’t want to start getting obsessive again. However, I think it would be good to get a general idea of how certain foods make me feel. Your personal example about chocolate is interesting. I experienced something like that with blueberries. Esophagitis was aggravated and I couldn’t figure out why until I realized I had eaten blueberries each time it started acting up. So no blueberries for me until it heals.

        To clarify, I had an endoscopy and was tested for H Pylori and the test was negative. I have reflux esophagitis (non-erosive). I’ve noticed acidic foods (apple cider vinegar as an ingredient in bone broth, for example) tend to bother me, as well as foods that have sharp edges like nuts. As a result I stick with nut butters (all natural, organic) and other foods that aren’t acidic or have sharp edges.

        I already eat quite a bit of coconut oil, so I’m glad I’m on the right track there.

        As far as magnesium and B12 go, I take epsom salt baths about 4 times a week for magnesium, and I take liquid B12 under the tongue. I’ll make sure to have my doctor check my levels.

        Thanks again for the response! Much appreciated.

        • Hi Julia, Epsom salt baths do contribute some magnesium supplementation, but if you have had high stress for a long time, it won’t be enough. I didn’t think magnesium supplementation was necessary since it didn’t do anything for me. Then I tried a liquid supplement and suddenly within a few days after I worked my way up to about 1 teaspoon 2x daily, changes happened. An eye twitch cleared, my skin got supple instead of dry and scaly, IBS-C just stopped being a problem, and the acid reflux just stopped too. It’s not that I’m taking that much. It’s about 600 mg MgCl, which at 12% Mg in that chemical means that I’m taking about 72 mg of Mg (with a daily requirement of 360 mg). But I’m taking it in a form that is working for my body. Delivery systems matter.

          I think it’s just enough to hit a tipping point for health. And when I stop supplementing, I suddenly have very dry skin and the IBS-C returns.

          • What liquid mg supplement are you taking? It’s not common to find a liquid mg supplement; I have tried Blue Ocean Minerals, maybe I should go give them a better shot. I was never very consistent. I have had tremendous success with Apple cider vinegar. TIA.

            • I don’t like to name brands (and I have no affiliation with any of the companies though from my posts in here you’d think I was paid by the Coconut Bureau 🙂 ). It’s a pico-ionic Magnesium Chloride version by Dr. Dean. (while her metal supplements are decent, I don’t quite believe in all of her medical stuff touted –like colon cleansing with bentonite clay which is a real red flag for me. That’s just dangerous and not doing what the customers think it’s doing.) Problem is that I take about 2 teaspoons daily and it’s pretty vile tasting. I haven’t found a good way to disguise that taste, so I began testing every capsule of either gel or powder. I already know tablets don’t work for me. Possibly because I’m celiac so I have digestion issues. I tend to do the green smoothie thing to get more benefit from veggies. I still haven’t found one that works as well as the pico-ionic liquid. I’m branching out to try other liquids now and seeing how far I have to dilute it to eliminate that taste.

      • J Reads thanks for your informative post, but Ive read that Fat weakens the LES amongst other things like chocolate, etc., also fat reduces transit time or time it takes for food to chug along, couple that with a low carb diet at least in my case speall trouble seeing as there are small amounts of carbs to soak up liquid/acids which creates a watery soup in the stomach which EASILY refluxes, whereas when I eat bread or potatoes the liquids get absorbed and there is less ‘soup’ to slosh aroung and reflux and less fat = faster transit so food+soup doesnt hang around to reflux, maybe your experiences are with those that didnt have a hiatal hernia, I have one and tried the low carb route many times, even keto (4 days) but couldnt stand the reflux even on meds, I’ll buy the mag/b6/b12 though today and see if I can start to taper (22yrs on prilosec)

  40. Cooked spinach works for me. A few years ago, I suddenly started having GERD, and the dr prescribed prilosec and to sleep propped up. I was confounded why this was suddenly happening as I had never had this problem before in 70+ years. I searched the Internet for natural solutions and when I read in a forum that spinach had helped someone, it clicked immediately. Normally, I eat spinach 4-6 times a week (a throw-back to my Popeye days), but there must have been a spinach drought because my local grocery store had been out of frozen spinach for several weeks. I live in NYC and immediately started calling around to markets to find out which had spinach and started eating spinach again. My GERD stopped immediately. I eat a lot of pickled foods, and from time to time, when I haven’t eaten spinach for a couple of days, I may wake up with a slight burning in my throat. I get up, cook a little frozen spinach in the microwave, eat it, go back to bed and no more burning. Hope this works for those of you suffering from GERD.

  41. I have been taking Add to dictionary + Domperidone for 2 years. Suddenly I started having thrush in the mouth and I was clueless. After some research I figured out that it is due to non stop intake of Rabeprazole.

    • Anil, virgin coconut oil helps kill yeasts and gram negative bacteria. To help prevent your thrush, stop taking the ‘azole and find a better method of dealing with the GERD or other problem. And try oil pulling with virgin coconut oil. The 15-20 min exposure to the virgin coconut oil should kill the yeasts as coconut oil’s lauric acid just destroys Candida. In the stomach, the coconut oil isn’t in there for as long or as concentrated a contact, so it takes regular applications (consumption) for the coconut oil to kill H. Pylori.

  42. My wife has been taking a medication called Altosec on prescrition for quite a few years for IBS. We just found out from another Dr that its having negative effect on calcium absorbtion and her bone density is headed one way if we dont find an alternative. Does anyone know of a good alternative PPI that doesnt contain Omeprazole – apparently that is the bad news ingredient that needs to be avoided

    • Apple cider vinegar, fresh squeezed lemon or baking soda in your water. The apple cider vinegar needs to contain “the mother”, a popular brand is Braggs however, Costco is carrying another brand; Vermont Valley…..or something like that. So I know there are alternatives to Braggs but make sure it has the mother in it!!

      • I will be starting this as I, too, was on pantropazole and the side effects were HORRIBLE. Took a while to dx why I was nauseous, dizzy, having heart palpitations and anxiety. I also lost 12 lbs. in less than two weeks. SICK, SICK, SICK from this PPI. I have heard about the apple cider vinegar and will definitely give it a try.

    • Mark, I looked up Altosec. It looks like it’s an injectable form of omeprazole with a dash of polyethylene glycol. IBS can be either the C (constipation) or D (diarrhea) forms. Two sides of the same coin, and they both hinge on the muscle contraction mechanism of magnesium/calcium. Too much calcium, and you end up not being able to move the waste along the intestine. Too much magnesium, and the waste dumps too quickly through the intestine. If you can find a Functional Medicine physician in your area, please get an appt.

      Getting off of the Altosec is going to be tough. You need to change your diet significantly to nutrient dense calories. IBS and Altosec means that the intestines and stomach are probably at a fraction of their healthy state nutrition absorption possibility. I would immediately begin making some small but very significant diet changes –bone broth soups, pasture raised eggs, a lot more fresh green veggies, cut out sugars/starches for a while. Please look into Paleo.

      If it’s IBS-C, try a liquid magnesium supplement of magnesium chloride (pico-ionic version works well for me), magnesium glycinate, or magnesium citrate. Stay far away from magnesium sulfate orally (epsom salts; Milk of Magnesia) because that is too brutal for a human system. You can increase magnesium slightly by bathing in epsom salts –20 min in a hot bath of epsom salts will help increase absorption without the diarrhea issues that mag sulfate usually causes.

      If it’s IBS-D, try a liquid calcium supplement in a form that can be absorbed easily by the body. I don’t like recommending brands, but I use a pico-ionic version that works really well on my mom. Calcium is added to a lot of foods, but without enough magnesium in the system, there are major absorption problems.

      If she’s having calcium leaching, she needs several basic things to help boost her absorption. Vitamin D3, I’d suggest 2000-5000 daily for a while to boost her levels. I’d also suggest that before you supplement try to get your doc to give her a 25-hydroxy D test to check her Vitamin D levels. They should be around 70, but definitely above 30 or she’s really low. B12 (1000 IU)/B6 (about 400 IU) /Folates sublingual tablets. Once again, see if you can get a B12 test before the supplementation. B12 should be above 450, but if she’s been on the PPI for a while, it’s likely going to be in that gray zone of 200-400. That’s dangerous to have B12 below 450 for long periods. Look up B12 deficiency to see what that looks like. B12 sublingual tablets because the PPI damages intrinsic factor in the stomach and interferes with normal digestive B12 absorption, so you have to do it through the mucous membranes straight into the blood stream –swallowed vitamin tablets are useless. B12 needs B6, Folates, and Vitamin D to work properly. And it’s one of the things that is depleted by stress (or lots of wild shellfish – but you have to be really overdoing it). If any of those were low, magnesium can’t be absorbed. With magnesium deficiency, you get esophageal spasms (acid reflux), constipation, can’t seat calcium in the bones and it ends up in the soft tissues of the arteries, etc. It’s used in so many things in the body, and magnesium tests are not reliable because if the body doesn’t have enough magnesium/calcium to run muscle contraction, it will break down bone matrix to get it because the heart is a muscle that has to work or the body doesn’t anymore. So, you may have mag in the blood, but that doesn’t prove it’s in the tissues.

      Likely your IBS was stress and diet and SIBO related. Lower stress, and you have a better outcome. This is quick and brief information –once again please look for a Functional Medicine doc in your area.

  43. I am a 70 year old female. I have GERD, gastritis, hiatal hernia and IBS. I have been on Dexilant for 6 years. I was originally put on it because Prilosec made me dizzy when I laid down. Two months ago I had a colonoscopy and endoscopy. Colon normal. There were 2 small polyps in my stomach that were removed and were non-cancerous. After all the press about proton pump inhibitors, I asked this new gastro Dr. (I moved across the country in 2014) about dangers and she just said stay on Dexilant. I often get stomach cramps after taking it. I never felt hungry and my stomach didn’t growl. My only clue to eat was back pain on my left side at waist. I rarely got any reflux due to the meds. A few years ago I stopped for 4 months but lived on Tums. I just stopped again 2 weeks ago. I couldn’t cut down because Dexilant is timed release. so I am taking a 150mg Zantac at bedtime. I am doing well. Each day gets better. I figure I can eventually reduce the Zantac. I take 400 mg of DGL before I eat. I suddenly have energy and my brain fog is greatly reduced. I have been struggling with depression ever since I had my 2 knee replacements – Aug 2014 and Aug 2015. The meds oxycodone and oxycontin made me hyper and stopping the caused depression. I take an antipdepressant – 25 mg of perphenazine/amitryptiline at night and levothyroxine – 25 mcg in the morning. I also started taking Vitamin B12, Vitamin D3 and magnesium plus a multiple vitamin. In just 2 weeks I feel amazingly normal with energy and my brain fog is getting less each day. I have been eating gluten free on and off for about 3 years and have reduced dairy to just yogurt. I don’t drink alcohol, coffee, soda or milk. I just drink water, herbal tea and almond milk. I avoid mint, juices, chocolate, heavy tomato sauces spicy foods. Any amount of gluten causes constipation with urinary incontinence. Also leg cramps and arthritic pain. I wonder if the PPI has anything to do with my loss of 4 inches in height the past 10 years. I have been diagnosed with osteopenia. I also have scoliosis. I am glad I found this website. I had a feeling that the PPI was a cause of my lack of energy and depression. I always wondered how a PPI could be just specific to the stomach. You explained it well. I did get some Bragg apple cider vinegar but have not taken it yet. Any suggestions?

    • Mix 1 Tbs Braggs, with half a lemon squeezed, 1/4 tsp Cinnamon, 1/4 tsp powdered ginger, a dash of cayenne pepper, 3 pkts Stevia Mix well, you will need to keep mixing as you drink. Drink 10 minutes before you eat your first meal. You will lose weight.

    • Carol, you are on your way. I would suggest that the B12 that you take be a B12 (1000 IU)/B6 (400 IU) sublingual supplement because that goes directly into the bloodstream without digestion issues. I think in your case the anti-depressants you are taking are low dose and likely decreasing your anxiety (and probably working on pain too). This is a good thing. The decrease in stress will make the depletion of B12 and magnesium less rapid. You may wish to try a liquid magnesium supplement because I’ve found that they absorb better in our damaged gut.

      Linda’s recipe helps in many ways, but if you can’t tolerate cayenne or another of the ingredients, leave it out. The Braggs is apple cider vinegar that has fermentation bacteria still in it. It’s good for the intestinal bacteria. The half lemon adds minerals and is a strong Vitamin C donor. The cinnamon decreases insulin need during a meal (great for diabetes too). The ginger has many healing elements, but one thing it does help with is pain. I’ve found it better than ibuprofen on pain relief (I took 1/2″ cube of raw ginger in a smoothie and the pain from a healing knee surgery muffled down for about 10 hours. It was like wrapping a blanket around a fire. Raw ginger is a tad strong for my stomach, though.) Cayenne pepper is a weight loss spice, though I’m not sure of the exact mechanism. The stevia is a low glycemic sweetener to get all that down because lemon juice and ACV are too strong without sweetening or dilution. Drinking all of that 10 min before a meal will take the edge off your hunger.

      • J Reads, thanks for your great posts, very informative.
        I wonder if you can sine a light on my predicament.
        Ive been on prilosec for 22yrs, suddenly became gluten/dairy intolerant 5 rs ago, I figured chronic low stomach acid = bad bacteria migrating to duodenum/small intestine + cause of low acid pancreatic enzymes not being sent to gut to break down food = leaky gut = CKK enzyme doesnt trigger gallbladder squeezing of old bile hence bile stasis (was diagnosed with cholesterolosis and fatty liver 3 yrs ago), was diagnosed with hiatal hernia about 10yrs ago via scope in China.
        So I figured loa carb wont work for me cause of my LES opening easily due to hernia, it doesnt seem massive maybe a small one but being overweight doesnt help and Im slimming down now (102kf from 115 two years ago – but plan to get to 75kg which is my ideal weight asap)
        My main concern has been the polyps in the gallbladder seeing as they can become malignant if they grow to >1cm and have to have regular check ups, I thought about intermittet fasting to deplete liver glycogen stores at I assume 16hrs and eat at 18-20hrs fasted so I get a few hrs of autophagy (self eating) so that those polyps would be cannibalised by my own body, but then read online about how low carb diet and fasting increases IGF1/HGH, you know were Im going with this right?
        I want to heal if possibly from these polyps and dont want growth hormones surging around but how do I get rid of these polyps, I hear mainly from two groups – vegan vs low carb, eggs are great for the liver cause they contain choline etc, but they are loaded with cholesterol so would be bad for my gallbladder situation, bone broth heals, no it contains Lead, carbs are good, no they turn into liver fat due to denovo lipogenesis, soooo confusing, Ive yoyo’ed between vegan and low carb and still dont know what to eat, my two concerns are GERD/Hiatal Hernia and Gallbladder polyps and I should say I have been taking prilosec and Paxil (seroxat) for 22yrs, so one affects the other, I read that Paxil relaxes the LES, Ive reduced that down to only 5mg from 20mg, but the PPI is tough one to taper, now will try the mag/b6/b12 but still not sure about diet seeing as I also want to avoid any growth of the polyps, no sure if I should start daily fasting again, I figured also that serrapeptase may work and took it in the fasting period and took digestive enzymes with my meals but heard that they shouldnt be taken together seeing as serrapeptase nullifies the digestive enzymes, I wonder if taken them far apart would avoid the conflict, I also take 8 apricot kernels, papaya and do coffee enemas as a natural anti cancer diet, also I have bee doing coffee enemas for 11yrs and wonder if these have damaged my gut, making it leaky, they are supposed to be good for clearing bile (seeing as I have Gilberts syndrome ), and ups Glutathione levels, I want to also stop those cause they are addictive but wonder if my body (liver) is used to them, I went in for Ultra sound a few yrs back and was diagnosed with gallbadder polyps and so stopped eggs, the enemas and 6 months later on next scan fatty liver appeared so I guessed the liver was used to the daily flush and clearing of old bile and became more stagnant than usual.
        I dont smoke or drink, my only vice is that I drink teas during the day with some honey/almond milk it revs my brain up to work or some almond milk and organic instant coffee, I think cause Ive reduced over the years my paxil dose my brain needs a drug to pick me up so I was wondering if Rhodiola or some herb I could take in the am instead of caffeine to give e that kick but not weaken my LES.
        Final point is that many that have depression/anxiety for which Ive taken Paxil. dont do well on low carb diet, I assume this is cause carbs = insulin hit = amino acids get sent to the body leaving Tryptophan to enter brain and affect Serotonin so how do I go low carb and keep serotonin high or normal/
        Sorry for the long post, Thanks for any idea you could give me.

        • It seems you may have multiple health problems going on, and the best person(s) to address them are doctors, with the added help of a nutritionist. IMO, asking for help on a comment board when you have so many health issues could be playing a dangerous game. I also noted your reference to coffee enemas. You may be interested in this:

          • Thankyou paula, but not sure whom to approach, some docs will have the vegan angle others more paleo type of thinking.
            Drs like Cresser, Axe etc suggest the paleo type route and Drs like Grieger, McDougall etc the vegan route and the opposite of no meat, low fat, carb type diet inculding potatoes, gluten free breads, veg and starchy veg.
            It doesnt make sense to add apple cider vinegar and HCI whilst severely reducing carbs (that absorb liquid/acid) and be default increasing fat which slows down the transition of food leaving the chances for food to reflux for longer – fat also weakens the LES so I dont get it.
            Bread, potatoes absorb acid which is bound to liquid, right? As soon as I try taking those absorbers of acid, reflux is worse and thats with PPI’s.
            Yes I think the coffee enemas may have contributed to my gut/leaky gut issues, but reading the posts on that site you sent didnt convince me, Ive been doing them 11 yrs and have more experience than those guys, but yeah I did lay off for a while and started again, will lay off again soon, hopefully for a few months.

    • All I do with Bragg’s, which I take for a variety of reasons, is one tablespoon ACV and 1 teaspoon honey in a glass of filtered or bottle spring water. I usually boil the kettle and put a splash of hot water in the glass with the honey and vinegar, stir, and they dissolve beautifully. Then add the cold water and drink! I have found that it goes down much easier as a cold or cool drink than as a hot one. I take this twice a day, morning and evening. Blessings!

    • I last posted on January 12. At that time I was about 2 weeks off of Dexilant (Dexlansoprazole). It is now 4 months later and I have stayed the course. At first I used Zantac 150 mg. at night and sometimes 75 mg twice a day. It did the trick. By 53 days I was feeling pretty good. It actually wasn’t that hard. I was on the PPI for 6 years. Now it has been about 3 weeks since I took a Zantac. I watch my diet (stay away from peppers and onions and peppermint) and eat gluten free. I only drink water and herbal tea. I have been off of caffeine for years. The main thing that triggers any reflux is bending since I have a hiatal hernia. I find a large glass of water does the trick. I realize now that PPI’s have been a boon for the drug industry. Without insurance and a rebate from the company my PPI would have cost me $300 a month. Drs. always tell patients that they have to stay on this drug for life. NOT SO! Sure there is an overproduction of acid when one stops but that lessens over time. I no longer feel short of breath and dizzy. I have cut my anti-depressant in half. I had my yearly wellness checkup this week and magnesium levels were normal. Life can be good without PPI’s. It just takes the courage to say no and take control of your life.

      • Hello Carol, I also have been on Paxil (Anti-depressant) and Omeprazole for 21yrs, I have been able to lower the Paxil dose from 20mg to 5mg and stuck on that dose, but Omeprazole 20mg find hard to stop, some say up your HCI and apple cider vinegar intake and this will shut the LES valve, this works for some but those with hiatus hernia it may not work, I have a sliding hiatus hernia and tried the HCI and ACV and ended up in hospital with a burnt esophagus. I did speak to a guy whos been on omeprazole for 18yrs and came off last year by switching to Lanzoprazole for a while and then coming off that which is easier than omeprazole, he switched to a vegan ow fat diet and says he won’t go back, so I m going to do this diet and switch to a H2 blocker next time I speak to my GP, what anti depressant are you on and how long have you been on it, may I ask|?

        • I am on amitriptyline/perphanazine. I have been on and off of it since 1982. A couple of full blown depressions but mostly been taking it in small amounts. 25/2mg three times a day is the therapuetic amount for a big depression. I had a total left knee replacement in 2014 and right in 2015. Both times the pain meds (narcotics) sent me into depression. However I didn’t need more than 1 pill a day. I now take 1/4 to 1/2 a pill each night. Very small dosage but I am sensitive to medications. My body remembers this med so it takes effect immediately. Amitriptyline is supposed to be very good for IBS which I also have. This is a very old tricyclic but it works for me. I stopped the PPI cold turkey. The Zantac worked along with DGL. I realize that the worst part is the rebound which is worse than the original reflux. I truly believe that the PPI’s continue the problem. In fact I often had more pain after taking the PPI. That pain is now gone. My symptoms were sore throat, and back pain at the waist which my GI doc said was a symptom of the hiatal hernia. What I really have to watch is bending over which triggers the back pain. Now I just drink a large glass of water to dilute any acid that travels up the esophagus. I think being off wheat is the main reason I am not having problems after eating. I have been gluten free by choice for several years and watch my diet very carefully – no onions, chocolate, acidic juices, peppermint, caffeine, etc. GF also has cured my constipation. I don’t even think about reflux anymore. I used to always carry Tums, Zantac, and take the PPI. It is so nice to really be free of all that pain and drama. Here is another person’s experience: A good book that I read several years ago is Wheat Belly by Dr. William Davis. Good luck.

          • Hi Carol,
            The Amytriptaline helps with nerve pain also, I know what you mean when you say the drug your body is used to to, the same with Paxil, there have been times when I taper too low and I can’t handle the stress, depression etc and when I up the dose it feels really good, my brain is used to it and works extremely well for me.
            What do you eat may I ask? Thanks for the link will check it later today, if you have anymore success stories show me please, thanks for your story cause Ive been trying to find someone like me, been on PPI’s and anti depressants for yrs and come off PPI’s successfully.
            For Hiatus Hernia if you add Fibre then you have less strain at stool and less chance of intra abdominal pressure pressing up against the hernia/LES, also losing weight will help and squatting makes passing stool easier or maybe using a small stool or baby chair to put your feet, lifting heavy things may not be good, also lie on your left side on an incline of 6 to 8 inches and not eat 3hrs before bedtime, I was thinking about taking magnesium at my last meal and then calcium citrate at bedtime with DGL, magnesium relaxes things and so would relax these valves like the pyloric valve and LES so food goes out of your stomach faster, then take calcium citrate at bedtime and calcium citrate may tighten the LES?
            How to get the buzz that you used to get from coffee or caffeine? I feel without coffee my brain stays in limbo and bored all day taking chamomile, almond milks but with coffee my brain wakes up and have loads of ideas and feels happier, is there a substitute that doesnt harm the stomach or gut?
            Maybe its just a question of getting the brain used to not having it, I like the feeling the Matcha tea gives but its caffeine again, unless I take L-Theanine which will do the same in the brain but worry cause Im taking the paxil, hmm.
            I also developed gut problems, maybe leaky or inflammed cause I started to be allergic to Gluten and dairy about 5yrs ago, and now get this ache in the duodenum and straight down to my small intestine area.
            I tried doing bone broths, eggs and meat and veg and felt sicky, the first night had nightsweats from hell, everytime |ve tried the first night I get these nightweats and I felt my body is rebelling, I told one young guy who trains athletes and is a paleo guy and he laughed he said oh these are meat sweats thats good, I checked online and found bone broths have Lead and heavy metals in them also meat causes an increase in gut inflammation that susceptible people will feel, so I wondered if I poisoned and inflamed my gut.
            Now Im juicing green drinks and veggies and friuts and want to do a juicefast to give my gut a rest, have maybe a cabbage broth seeing as it has glutamine and this can heal the gut, the problem is my wifes cooking then tempts me in the evenings to eat 🙁

            • Hi Gerald,

              Sorry it took me so long to answer. You comment has been sitting on my desk for weeks. What do I eat? Since being off of the PPI’s I actually feel hungry. While I took them I never had hunger pangs but only felt back pain (left side around waist) which told me it was past time to eat. I often forget when I am busy. I eat gluten free. Breakfast is either Cheerios, Chex, Granola (I make my own) oatmeal and Almond milk. Sometimes an egg or an English muffin GF. Lunch can be a salad, or some lunch meat, cheese, gf crackers. I also eat homemade guacamole and corn chips. Also fruit and cottage cheese. Yogurt is also one of my favorites. Dinner is gluten free pasta with gf tomato sauce (just enough to coat the pasta), gf meatballs, homemade mac & cheese with tuna or salmon, fish, veggies, potatoes, chicken, tacos, stir fry – there is a GF soy sauce called Tamari. There are also GF hot dogs. My favorite is to buy a whole chicken, quarter it and simmer it for an hour with some spices and eat it. I also make soup out of it. I eat walnuts and pecans. Food is pretty boring and now that I am retired and live alone I don’t really enjoy cooking that much. I don’t eat a lot. Overeating is really hard on the hernia and can cause a backup of acid. I just recently started drinking grape juice over crushed ice. It dilutes the acidity. I never got in the habit of drinking coffee. When I am out and feel a need for energy I drink Dr. Pepper. It is the only caffeine drink that doesn’t hurt my stomach. That and an occasional ginger ale are the only soft drinks. Living in AZ, I drink a lot of water. My weakness is ice cream. I make my own and then I know what is in it. I haven’t taken even a Zantac for months. Once in awhile, I take a Tums. I seemed to have finally found the answer to all that acid. One thing I do avoid is alcohol. Wine burns the esophagus. Onions are wicked. I use the dried flakes which I can tolerate. Things like chocolate and peppermint relax that muscle and cause reflux. I have even found a toothpaste without mint. Eating a lot of sugary things can also irritate my system. That bone broth diet sounded weird to me so I never tried it. My stomach used to be something that was always on my mind. Never left the house without carrying an antacid. Now I hardly ever think about it. It is so nice to be free of the PPI addiction.

              • Carol, sorry for the loooong delay in relying to you, not sure what happened, never got the prompt to say I got an answer.
                Just check these posts today, thinking about taking the zantac and b6/b12/mag sound like a good idea cause all my tapering attempts have failed so far, and losing weigh is now on the cards 😉
                How you doing now?

  44. I took pantoprazole (Protonix) for about 10 years. I started taking it to control some acid re-flux/heartburn. Once started, I found it difficult if not impossible to stop taking the medication, or so I thought. As of today, I have not taken the medication for about a month. Here’s how I did it: For about 2 months I would not take a pill once a week, then for another two months I would not take a pill twice a week (not consecutive days). Then I was able to take it every other day, and then every day and then every two days. After another month I stopped all together. I still occasionally get heartburn, but simply treat it with a carbonate (sodium bicarb, or tums, etc). I started losing weight and have more energy, plus I am happy knowing I did something good for myself.

    • I should also add that in the beginning I relied on Deglycyrrhizinated Licorice (DGL) for relief on the days that I didn’t take the PPI. I also changed over to eating more greens and vegetables and i drink lots of water ( 80 oz) daily. Last year I changed doctors. My new MD suggested I stop taking a PPI to avoid the adverse effects of long term use.

      • Paul,
        I found that drinking more water and eating more greens and reducing bread gives me more reflux cause there is nothing to absorb the acid that is bound in liquid, welldone by the way 😉

  45. I’ve been taking Nexium 40mg for 13yrs now and for the past 3 I’ve been experiencing severe heart palpations that come and go, which leads to bad headaches almost everyday. I’m now going to wean myself off these pills and hopefully this works. Wish me luck!!

    • Dawn, you likely are B12/B6 and magnesium deficient. Try a B12 (1000 IU)/B6 (400 IU) sublingual tablet because you can’t absorb tablet form B12 as Nexium damages your absorption of those vitamins in your stomach. Also get a magnesium supplement of either magnesium chloride, magnesium glycinate, or magnesium citrate. I’ve found liquid magnesium chloride works really well. Without the magnesium, your heart has difficulty in beating. I’ve covered that discussion in other posts here in this comments section.

      • J Reads,
        I get this weird thing happening, if I eat low carb and have a fish meal without carbs then I get palpitations, not sure if the fish coupled with morning coffee enemas do this, so whenever I have fish I need some rice or carb or I’ll get palpitations.
        Also I tried bone broths (chicken, lamb) and get left ear burning sensations and it is red only the cartilage area, this seems like relapsing polychondritis symptoms, so then I thought maybe Dr Grieger is right that bone broths contain Lead and are inflammatory or at least he says eating meat is, and noticed one lady cured herself of this condition by doing the McDonald diet. Its confusing indeed.

  46. I’ve been taking 40mg of Protonix (PPI inhibitor) for about 2 years, to treat a hiatal hernia and GERD.

    About 3 weeks ago I was diagnosed with Vitamin D deficiency and Vitamin B deficiency. I was having panic attacks, weakness in legs, headaches, “brain fog”, just wasn’t feeling like myself. I was prescribed a 50,000 mg “megadose” of Vitamin D to take 1x per week and a 2,000mg Vitamin B12 to take each day.

    4 days ago I was diagnosed with a kidney stone of 3mm, which I have yet to pass.

    It is rather obvious to me that the long term usage of PPIs caused the vitamin deficiency. I am thinking that the kidney stone was caused by taking the megadose of Vitamin D and not being able to absorb it properly. What do you guys think? Should I get off the Vitamin D supplements? Should I just ween off the PPIs and modify my diet (I’ve been watching my diet, but could be more strict if I knew exactly what to eat)? I have concerns about reflux bouncing back…Just looking for a plan and a light at the end of the tunnel. Thanks!

    • You’re probably getting too much polysorbate 80; which happens to contain polyethylene glycol, which contains ethylene glycol, metabolizes into oxalates and forms stones. To fight any reflux issues apple cider vinegar(Braggs) will help the reflux and help break down the stone.

    • OMG, this sounds so much like myself. The Dr’s thought my heart palpations were also panic attacks and they more certainly were not. I also had to be rushed to the ER a few months back with acute kidney pain. These PPI pills are worth all the side effects. I’ve decided to wean myself off, there are so many other problems that have occurred over the years and I had no clue it was a result of thes pills. I’m on my 3rd day and have split my dose in half and cut back on my food intake. Wish me luck!

      • Good luck Dawn!

        My doctor didn’t warn me of the potential side effects of long term PPI use. I’ve found that most doctors tend to only treat symptoms and it’s up to you to research and cure the root cause. It’s not all their fault though, the whole health care system is broken.

        I think true healing will occur once I am off the PPIs for a few months and my gut returns to a natural state. Until then I’ll be avoiding my triggers foods as well as overeating and late night binging, and exercising more regularly.

        • Thanks Ben. Update: it’s been a few weeks now and I’m doing fine on 1/2 a pill a day now with a reduced intake of food as well. I’ve lost a few pounds as a result and plan on eventually working my way down to 1/4 pill and then none!! I’ve been taking Braggs apple cider vinegar and I’m doing so much better. My goal is to be off these PPI’s by early summer.

          • Update: I’ve switched from PPIs (40mg, then stepped down to 20 mg for awhile) to ranitidine 300mg (taken before bed) and have been on this routine for about a month. So far, I’ve noticed a ton of improvement. I’ve been taking Braggs when I get a twinge of heartburn, but the step down to H2s has been a good move for me so far.

    • Ben, you need the Vitamin D. But add a magnesium supplement so that the calcium can be seated in the bone where it belongs and not in your arteries. Vitamin D and B12 deficiency leads to magnesium and calcium absorption problems. Also, you won’t be able to properly absorb B12 as a swallowed tablet. Your stomach is going to lack intrinsic factor due to the PPI use. Use a sublingual tablet — B12 (1000 IU)/B6 (400 IU). B12 needs B6 to function properly. Try a liquid magnesium supplement to help greater absorption –just do NOT use magnesium sulfate (epsom salts, Milk of Magnesia) internally. You can soak in a hot bath of them, but look for magnesium chloride or magnesium citrate or magnesium glycinate for better absorption.

      Mike is right about the P.E.G. causing kidney stones. So can magnesium deficiency. Also, soda pop is just the worst thing you can do to your body no matter if it is diet or regular. Just stop drinking that stuff if you do so.

  47. I was taking 20mg Omeprazole every day or so, for over 20 years.

    About six months ago, I switched to a low carb / high fat diet. I now find that I hardly ever need the Omeprazole – only when I drink beer, or eat white bread, which is now very infrequent.

  48. Hi everyone, I just did my colonoscopy and gastroscopy . The doctor diagnosed me with GERD, gastritis and duodenitis. I need advice on 1) He prescribed Dompenidine ( for bloating) and controloc 4 mg ( proton pump inhibitor) for gastritis. After reading the side effect of PPI, I decided not to take them. But what should I take to heal the erosion on my stomach lining. 2) now I understand why my dentist said my teeth showed signs or erosion – it is due to GERD. The acid reflux which also causes my malabsorption. He told me that my acid level is too high my stomach but I thought it is too low that causes reflux? I will know the biopsy result on Monday to know if there is any bacteria on my entire GI track. I plan to start my AIP elimination diet to heal my gut. May I ask what else can I do to heal?

    • Siberian Pine Nut Oil did it for me. After endoscopy showing ulcerated esophagus I took it x 3 per day half an hour before meals (15 ml) Next endoscopy showed 100% healing had taken place. I let the medics think I had taken the omezrapole they prescribed. I recommend you buy the best original Siberian Pine Nut Oil and although expensive it is worth it to get your life back on track. I should say I had a good diet previously but cut out coffee, alcohol and bread which probably helped. Good luck.

      • This is for the person who healed her/his (sorry I didn’t see a name – I’m on my cell.) esophagus with Siberian pine nut oil. You really should be honest with your MD about what healed it. He now falsely thinks omeprazole cured it and he may well include your result in with the statistics that support this drug. That’s not helping anyone else out there. I’m glad the oil worked for you and that you shared it with us, but also tell your doctor what you took. If you want to be evasive with him, at least tell him you did not take omeprazole or any other pharnaceutical.

    • Emily, try liquid magnesium supplements to help ease the esophageal spasms. I use a pico ionic liquid version, and it did amazing things for me. Magnesium tablets aren’t going to work well because your digestive tract is damaged. Virgin coconut oil can kill H. Pylori, bad gram negative bacteria, and yeast overgrowth to help heal your gut. DGL (deglycyrrhizinated licorice) tablets taken minutes before a meal may help also. The Paleo AIP is very good at quelling irritants to your digestive tract fast. Keep a food/reaction/sleep journal to find issues. Check your B12/B6 levels and Vitamin D because if the GERD is magnesium deficiency related, then you are likely low in both of those. Reducing stress will help also. You can try a B12/B6 sublingual tablet and Vitamin D with the magnesium and coconut oil and see if it helps.

  49. My husband takes these because his stomach acid pH is much stronger (i.e. lower pH) than normal. What are the alternatives for someone with his condition?

  50. 2 questions. I’ve noticed people recommending taking coconut oil 2-3 times a day. How long should you do this process?
    Also, I have been taking Digest Basic with probiotics. I think they have done fairly well for me. I was curious if anyone could recommend any other probiotics they think might be better. Thanks!

    • Hi James,
      To kill H. Pylori, the recommended dose of virgin coconut oil is 1 teaspoon, 3x daily for 1-2 months. H. Pylori should die within a month from what I’ve seen. It is possible to later get recolonized with the bugs from a subsequent infection. Therefore, I continue using coconut oil in varying amounts in my diet to improve odds of killing it before H. Pylori has a chance to colonize. What I did was replace my cooking fats/oils with coconut oil (except for things like eggs which I still fry in grass-fed butter). I found that going full-fat and dumping artificial sweeteners for honey (though I do limit all sweets and meat intake and upped the greens/fish intake) actually has helped me lose weight. And I feel better overall. I’m almost fully paleo, but I do eat legumes if they’ve been soaked before cooking.

  51. I have been a long-term sufferer of chronic arthritic pain and have been prescribed a PPI with an NSAID for years. Recently, I have felt very tired and have been diagnosed with macrocytic anemia. My gamma GT levels are also rising despite cutting out all alcohol and I wonder if a combination of NSAID and PPI may be affecting liver function, so I am giving them up for a month until my next blood test.

    Is there reasonable evidence supporting my concerns?

    • Hi Rik,
      You need to get to the doctor’s office and ask for a check of your B12 levels. If your B12 is low enough to generate the macrocytic anemia, then you are very low indeed. You likely are chronically low in B12 and need an injection of it. This is simple and cheap to do and harmless as excess B12 will excrete from the body in urine. Also have them check magnesium, calcium, and potassium levels. PPIs interfere with proper breakdown of food in the stomach, so your nutrient absorption is decreased. There are ways to deal with GERD and other stomach issues without resorting to PPIs that damage you in the long term. It sounds counter productive, but organic apple cider vinegar, daily lemons, elimination of grains/sugars/starches, and 1-2 T of coconut oil a day would go far to healing the stomach damage without PPIs. I would try adding coconut oil at first for a couple of weeks, then continuing while decreasing the PPIs. The stuff tastes like suntan lotion, but it blends well with other foods. We’re in the beginning stages of the PPI weaning with my Mom, so I’ll update this as we go. (I know, coconut oil sounds like tinfoil hat country, but it’s full of MCTs, including lauric acid, which break down and digest easily, and have an antimicrobial and anti-inflammatory effect. I didn’t believe it either but I’ve seen it work. It kills H. Pylori. Try a teaspoon of the stuff 3x daily for a month. It’s cheap, completely non-harmful, and could help you wean off of the PPIs.) Eventually, you will need to drop the PPIs and baking soda will likely be needed until you get past the 2 month period where cells re-grow and go back to a normal state. Re: arthritis pain, a trick I’ve learned to help Mom is to slice raw ginger and put it directly on affected joints with damp washcloths that are as hot as she can stand. Change out the hot cloths as they cool until you reach 5 minutes of heat. We’ve tried it without the ginger and it works while the heat is there, but not for hours after. The ginger appears to sink into the skin and will make the pain recede and restore some mobility for hours. Smoothies with 1/2″ cube of raw ginger work as well as NSAIDs for pain relief, but with your stomach torn up, let’s get that better first.

  52. I guess I can count mysef lucky that the horrible migraine I got from only 4 doses of a PPI prevented me from taking more. I am looking for other options. Your articles on the subject are a godsent, thank you so much.

  53. All the PPI’s contain a form of polyethylene glycol, which I find to be a very dangerous substance. It’s maddening that this toxic substance is used as often as it is; it needs to come to an end. Dioxane is a byproduct of the polyethylene glycol, the EPA calls it an “emerging contaminant” as it’s poisoning our water and they have no idea how to treat it. The CDC claims to reduce our exposure to dioxane we should avoid products containing polyethylene glycol. This is very difficult since polyethylene glycol is found in medications, personal hygiene products, soaps and is the only ingredient in a very common laxative; miralax. To address any reflux issues, consider supplementing with raw, organic, unfiltered apple cider vinegar that contains “the mother”. Braggs is a very common brand.

    • Isn’t it kind of odd that the pediatricians immediately jump to giving small children with constipation issues Miralax? What happened to prune juice and oatmeal? And if prune juice and oatmeal can’t do the trick, why aren’t the pediatricians looking for the underlying cause of the constipation instead of just treating a symptom?

      In Scouts, we had camping cub scouts that didn’t want to use the pit toilets, so they’d hold it all in until they got stomach aches. We found that on a week-long camp, on the morning of Day 3 we’d line everyone up and give them a shot glass full of prune juice. Within an hour or so, they would head for the pit toilets. Once that broke the ice, the kids would use the toilets for the most part. Always were one or two that would need a re-treat of prune juice on Day 6.

  54. I have a suggestion for a RHR topic or focus of an article – why does Siberian Pine Nut Oil seem to work so well (not in every case certainly) for treating reflux, gastritis, stomach ulcers, IBS etc? I’ve been trying to find scientific research about it but no luck; I personally am experiencing massive symptom relief from IBS/reflux/gastritis using the oil, and would love to know why and how it works! Also, whether it is actually a cure or simply suppresses symptoms, meaning that treatment would still be necessary for underlying causes.

    • Hi Katherine, I looked into the makeup of Pine Oil (there’s nothing on a Siberian Pine Oil that I can find). Most pine nuts contain pinolenic acid. It does have some effect on fatty acids, but the literature is just too skimpy and there’s a lot of hype out there on it. I’m not sure that you couldn’t get an effect as good with virgin coconut oil, mastic gum, aloe vera gel scraped from the leaves, or other natural remedies to kill H. Pylori or other bacterial overgrowth elements.

  55. I was on a PPI for about 10 years as prescribed by my doctor after experiencing an ulcer. When I started learning about the side effects I decided to quit taking the PPI (omeprazole). I didn’t know about rebound reflux.

    I had terrible rebound. It was very painful. But I was determined to stay off PPI. What I decided to do was a food reintroduction similar to the way a baby is weaned from a milk only diet. So I started with very simple foods like bananas and apple juice and gradually worked my way back to a full diet.

    From my experience I would not recommend going cold turkey off of a PPI, but would do a tapering off as many people posting here have described. I would recommend a simple bland diet while tapering as that was very helpful for me.

    Almost two years ago, I was diagnosed with an autoimmune condition which I believe could very well either be the result of prolonged PPI usage or exacerbated by taking PPIs. A coworker suggested I check into the Paleo Autoimmune Protocol Diet. The diet along with soaking in epsome salt baths helped bring my condition under control. (With assistance of a topical steroid which I have used sparingly and now only for occasional flare ups.)

    Recently, beginning last October, so about a year ago I developed a cough which I couldn’t kick. It was different than any cold I have had. My throat and esophagus felt very itchy and my voice was raspy. A couple of months ago it was time for me to have a colonoscopy so I asked my doctor if she would also order an endoscopy so I could find out what was causing my cough.

    It turned out I had very bad esophagitis. My GI doctor prescribed omeprazole 40mg daily and told me I would have to be on it the rest of my life to prevent Barrett’s Oesohpagus and esophageal cancer. I didn’t want to go back on omeprazole but thought I should at least short term.

    After doing some research online I found two interesting things. There are actually many factors which can cause esophagitis besides acid reflux but doctors almost always attribute it to acid reflux and then prescribe acid-blocking medication. I also found that my autoimmune condition can be present in my esophagus. My condition is Lichen Planus and Esophageal Lichen Planus is related. ELP is considered to be a very rare condition. Lichen Planus is also considered to be rare, however I have found by taking to people on message boards that is is difficult to get a proper diagnosis so many people suffer for years and even decades before getting a correct diagnosis. I suspect that esophageal lichen Planus may also be very under diagnosed and that people are being improperly treated with PPIs which will not help ELP.

    Since Corticosteroids were used to treat my skin condition and in the study trial for esophageal lichen Planus the steroid fluticasone was used via an inhaler, I found an over the corner fluticasone and followed the dosage given in the study trial. At my follow up visit from the initial endoscopy, I discussed ELP with my doctor. He had heard of it but was not familiar with it. He had not taken any biopsies of my esophagus during the initial endoscopy because my esophagus was completely inflamed. When I was diagnosed with LP almost two years ago I was also experiencing extreme inflammation so this supports my theory about ELP besides the fact that I fit the patient demographics described in the study.

    After using fluticasone for thirty days, my cough was gone and the itchy throat irritation had cleared up as well as the general ache I felt in my chest as a result of all the inflammation. Two weeks after the one month of treating, I had the repeat endoscopy. My esophagus was much better. There was still some esophagitis but it was greatly reduced. My doctor took some biopsies this time and I will find out the pathology diagnosis in a couple of weeks.

    Now my dilemma is whether I should listen to my doctor and take omeprazole for the rest of my life. I am hoping the pathology results will support my theory that it is ELP and not acid reflux which has caused my esophagitis.

    I won’t be taking steroids continually either. I only use them topically when I have a flare up so would do the same or my esophagus. What I have found is that a Paleo diet, exercise, sunshine, and getting enough sleep always helps me. When I get off track from these things is when I have a flare up and also experience weight gain and depression. I now know that weight gain and depressions are symptoms on LP. Also carb-craving happens when your gut flora is out of balance which leads to weight gain and can cause depression too.

    AIP Paleo was not easy but over time it has become easier and my food preferences and even my palate has changed.

    I believe that taking PPIs led to weight gain, high cholesterol and high blood sugar. First the doctor prescribed PPIs, then came cholesterol reducing medication, and then she wanted to prescribe a blood glucose reducing medication saying it might also help me lose weight. That is when I put the brakes on and decided to get off the pharmaceutical band wagon.

    I believe Big Pharma will happily medicate you to death and count their profits all the way to your grave.

    • Have you got your biopsy report. I believe I have the same condition. I have LP in my head and mouth and recently when I went to doctor for indigestion issue doctor recommended endoscopy and said there are some cyst and taken biopsyand in the result it was gastric hetrotopia and advised me take PPI for 3 months. But I believe since I have LP in other parts of the body it might have spread to esophagus.

      Pleas advice about your practical handling of this condition and update how is your status now.

    • Hi Joy,
      OK, ELP has some links to Candida. If you are willing to take a slight risk, try 1 teaspoon of virgin coconut oil, 3x daily –same thing you take for H. Pylori ulcers/GERD. Hold it in your mouth, let it melt, and swallow it. The Lauric acid in virgin coconut oil is very effective at eliminating gram positive bacteria with lipid membranes and fungal elements such as Candida. You’re trying other alternative stuff and have an open mind, so this can’t hurt you –it’s benign to humans. If it doesn’t work, you’re just delaying the long term use of a PPI that could have serious side effects. The thing is, I’ve seen some skin conditions resolve with coconut oil. ELP should be seen by a dermatologist, by the way –it’s a kind of skin problem. And yes, they’ll probably suggest a steroid for it. But, I would NOT go the PPI route because it’s simply masking the damage that will continually occur to your throat. It sounds like they’ve ruled out cancer.

      • One other thing that I didn’t mention in that previous reply:
        Magnesium supplementation also helps with skin conditions. I have IBS-C and terrible muscle cramps. In fact, at one point over a year ago I popped up off the couch to answer the phone and ended up with a muscle cramp that tore my calf muscle so that I couldn’t walk on it. The doc saw a half inch divot on the back of my calf where the muscle tear occurred. She only suggested increasing bananas, but that didn’t help. I tried supplementing with magnesium because all the symptoms looked like magnesium deficiency. Tablets didn’t work. I switched to liquid supplements and the muscle cramping, lower eyelid twitching, tingly hands, IBS-C, and eczema began resolving in just a few days with a supplementation of 300-600mg of Magnesium Chloride daily (that’s only 36-72mg of elemental magnesium in that dose). In fact, I noticed that the skin on the back of my hands became supple and felt silky which shocked me –I didn’t know at that time that magnesium was a component of skin health. I had to find the right dose to make sure I didn’t get loose bowels from it. Baths in Epsom Salts increase bodily magnesium by absorbing it through skin and mucous membranes. It sounds like you found that to be a help. I would try also adding a Magnesium liquid. Warning: they taste VILE. I have tried to water them down but I can still taste it in a gallon of water. I just take the supplement straight with a little water and then chug water after it. Getting a lot of magnesium through bathing is preferable. 😉 I can tell when magnesium levels are getting low because the eczema patches on me flare up again. But this is another possible supplement to help your ELP heal.

      • I want know how to avoid PPI’s on a post-esophagectomy diet after I had esophageal cancer. I was told to take PPI’s to prevent acid reflux and damage to my re-constructed esophagus.

        • Hi Jana,
          the short answer is that I don’t think you can avoid PPIs because you no longer have a Lower Esophageal Sphincter. There is no separator to prevent damage to your esophagus by stomach acid. The only way to keep it from being damaged is to take the PPIs at this point. Instead, you can help limit the long term damage by supplementing with vitamin B12/B6 to prevent dementia. You may be facing a liquid and/or pre-digested diet from now on. You have special needs that most of the forum members do not have. You can’t digest Long Chain Triglyceride (LCT) fats (vegetable oils, olive oil, etc) because you don’t have a gall bladder and your stomach can’t produce acid. You CAN have Medium Chain Triglyceride (MCT) fats because those can be digested in the small intestine without stomach acid pre-digestion or gall bladder bile. MCTs are things like virgin coconut oil and palm kernel oil. A human does need fat in their diet to help absorb certain vitamins. I would highly recommend coconut oil to you as a dietary aid (cook with it, mix small amounts into things) and as a skin lotion since it will be absorbed by the skin and give you benefit.

          I am not a doctor. I can’t give you more than just the basic outline of certain things you can do to make your situation tolerable.

  56. Accidentally I found out about the problems with PPIs when dealing with multiple food intolerances. I decided to continue to cut out the trigger foods of dairy, wheat,eggs and yeast and attempt to repair my small intestine by taking a kefir based probiotic, bone broth, glutamine supplement. Learning that Omeprazole (40g daily which I had been taking for over 10 years for reflux) was working against the repair, I stopped taking it. It’s been a month now and much to my surprise I am not having any acid indigestion. There is still a way to go as I have bloating and fatigue still and I have had to be very careful with my diet but I believe that after 20years of food related problems I am feeling better, without drugs. Stopping Omeprazole has worked for me but watching what you eat is a must.

  57. Hi, After taking PPIs for about 10 years thanks to this website I finally decided to stop doing it. Surprisingly I didn’t feel as bad as I thought I would. Obviously I had some heartburns from time to time. However when I started watching what I eat, removed gluten products from my diet, cut down on sugar and stopped mixing different food groups on one plate most of my problems seems to disappear. In addition I even managed to loose some weight :-). There is only one problem I have that I can’t really sort out so far. About one week after I stopped taking PPIs I started having some burning sensations in my ears, nose and sinuses even when I didn’t have heartburns. They seemed to get stronger and stronger and at some point I decided to take some PPIs to see if they could help. I felt better for couple of days and again after few days that burning came back. I googled those symptoms and found out this could be Laryngopharyngeal Reflux. Has anyone ever had the same problem and knows how to deal with it naturally without taking PPIs? Thanks

    • I experienced the same thing, LPR. Long story short, low stomach acid. Took Vitamin D and Magnesium to deal with deficiencies and then drank pure unfiltered Apple Cider Vinegar. Results showed improvement. Then moved to HCL with pepsin tablets. I take 2 pills with every meal (make sure you eat protein with them). Been almost a week on the HCL and a very noticeable improvement. Medical community has failed those with GERD. PPI just tackles the symptoms, but makes the problem worse.

      • Awesome news! What kind of Vitamin D and Magnesium did you use? What kind of symptoms did you have with low stomach acid? I’ve always wanted to give HCL a try but I’m not sure about them. Do they have any side effects? Right now I’m taking Digest enzymes and they seem to help but always looking into other options to better myself.

  58. Hello everyone

    I’ve managed acid reflux for some 30yrs with antacids and/or ranitidine. In the least year, however, I’ve been taking Omeprazole 40mg, and I have noticed two things. 1, yes, I get less heartburn, but have experienced a few occasions where I have had very painful oro- and nasolaryngeal reflux-like episodes, like I’d just vigorously inhaled powder bleach. 2, my voice has become weaker; the symptoms definitely since I’ve taken the drug. I use my voice professionally, and am confident that my usage is safe; but isn’t Omeprazole supposed to reduce the vocal damage potentially caused by reflux?

    I’ve stopped taking it, but I wondered if anyone else has found Omeprazole causing voice loss. I wonder if I simply replaced one type of reflux with another when I started taking it.

  59. I had surgery on July 1, 2016 for esophageal cancer. One third of both my esophagus and stomach were removed. I no longer have a pyloric valve to stop reflux. I have had 2 incidents of reflux since I was allowed to start eating solid food again. Both were painful and frightening. I had no symptoms of indigestion, heartburn, or reflux before my cancer diagnosis in January. They found the cancer because I had a gall bladder attack in late December. Follow-up testing found the cancer, at stage 2. I had to have my gall bladder removed before I could start cancer treatment in March. I also had to deal with nausea from the chemo and esophagitis from the radiation. I was put on Prilosec 20 mg in January and was told to continue after the surgery when I started eating solid food again. I absolutely cannot afford to have acid go into my reconstructed esophagus, which is 3-4 inches shorter than it was. Paleo is out of the question at this time. I have to stick to soft foods, soup, cooked vegetables, baked or canned poultry or fish. I don’t have much alternative to not take something to reduce stomach acid, although I do not want to continue taking Prilosec, I don’t have much of a choice if I want to protect my remaining esophagus.

    • Jana, your health issues are different from man of the other PPI patients here. You have a very good reason to be on the PPIs. I’ll add that your doctor should have told you that removing the upper portion of your stomach would mean that you also lost “intrinsic factor” (similar to what gastric bypass surgery for weight loss does). You have to have intrinsic factor to absorb B12 normally. Since you no longer have that, you will have to have regular B12 injections or B12 sublingual tablets (they melt under the tongue and are absorbed directly into the blood stream but they aren’t as good as an injection of B12). You will need that for the rest of your life. I would also suggest adding virgin coconut oil or palm kernel oil to your diet as the medium chain triglycerides (MCTs) in it not only provide a lot of fuel but also they are very easy to digest (unlike other fats that are LCTs) as they don’t need bile or gall to digest. They are very different from other oils/fats that you likely can’t have now (fatty meat, vegetable oils, canola, fried foods). In fact, with a stomach damaged in that manner, coconut and palm kernel oils may be some of the only fats you can handle. Plus, they will break down easily and absorb into your system with oil soluble nutrients like Vitamins E,K,D, and A pulling more nutrition into your system. I also think that the coconut oil would have a protective factor on your esophagus. You can cook with these MCT oils rather than using margarine, butter, or vegetable oils.

      • Thank you for your suggestions. I have tried coconut oil, and I take a multi-vitamin, biotin, and a b-complex supplement. I have been keeping the coconut oil in my refrigerator and it’s hard to get a spoonful out of the jar. Can it be kept at room temperature and not get rancid?

        • Yes, coconut oil does fine on the kitchen counter without refrigeration. It’s an oil like olive or vegetable oil so you don’t need to keep it in the fridge. I go through about a jar a month but it will keep for a very long time at room temperature without going rancid.

          {{HUGS}} You’ve been through so much, kiddo. I will make one other suggestion that will seem odd, but it helps. Learn to meditate. Concentrating on God (or the Greater Beyond if you don’t believe in God) and letting the love flow through you takes your brain centers to a different state. (I’ll try to find the recent medical studies on this) It has a protective effect on your brain health. And try walking outside every day for 10-30 minutes. 30 minutes of walking will undo a lot of damage done by sitting all day. Plus, there is something that is healing about being near trees and under sky. I know that sounds like it should never work, but humans are designed and wired for the outside world and our social connections with others. We deeply suffer without those things, and it impacts the body.

          Despite the damage done to you, you are part of this planet.

          • Thanks again. I will start taking coconut oil every day. I’ve also started using it on my skin. I was pretty overweight when I was diagnosed. That was probably the main contributing factor. I never had acid reflux or heartburn. It was the gall bladder attack I had that led to the cancer discovery. I tried to stick to a low fat diet, but it didn’t help me lose weight. I lost about 75 lbs in the last 10 months, 50 of it between May and August, after chemo, radiation, and surgery. I’d like to lose about 40 more. I’ve gone back to my full time sedentary job, I walk about a mile a day on my days off, and when I get home early enough and I’m not too tired. I also take care of my partner, who suffers from glaucoma and is losing his sight. I’m 63, and he’s 69. We’re also helping our son financially, while he’s looking for a new job. I definitely have my plate full, metaphorically speaking. I won’t be able to retire for another 4 or 5 years. I need to keep my insurance benefits until I have my last cancer-free scan in 5 years.Thanks again for your advice.


          • J Reads,
            I was into meditation, Taiji and a dream of the simple life, living witha german shepherd or two in a mountain in a warm country, what happened? I got married had kids, looking after my fater who has dementia and severe arthritis in knees, stress up to my eyeballs, but a ray of light shone as I read you post and about connecting with God and being still, I think I’ll get back to prayer and meditation and just being still, thanks for that.
            J Read I wanted get your ideas on gallbladder polyps and how to shrink them, of course I know any ideas aren’t medical advice but I havent found anything or anybody online to help me and Im really worried as I dont want them to turn malignant, mum passed away with colon cancer and so for those two reason been doing coffee enemas for 11yrs, I dont know if Im doing more harm than good, Ive done fasting (I.F.) and cut my feeding window down to 4hrs and in the fasting period taken serrapeptase to help break down those polyps but I wonder if that could work in shrinking them?
            I read that autophagy in the first few hrs is most powerful but I also figured that the body would first take from liver glycogen stores, then muscle then adipose/visceral fats the finally start breaking down things it sees as useless such as polyps, small tumors etc so would those few hrs of autophagy not work in the case of shrinking those polyps? Maybe I have the theory all wrong.
            If it is not convenient to answer here I have left my email [email protected] Thankyou

        • Jana, when you take the coconut oil, start very slowly with small amounts. 1/4 teaspoon a day at first –let your tolerance build. The lauric acid will kill bacterial overgrowth in the intestines. If you take in too much coconut oil at once and aren’t used to it, it can cause stomach upset (vomiting). In larger doses if you aren’t used to it, it could make you feel bad for a while.

          And the B vitamin. If you are taking a B-complex tablet but don’t have the upper portions of your stomach any more, you are wasting your money on the vitamin and not getting any benefit. You need intrinsic factor to absorb and transform B12 into something your body can use. That’s in the upper portion of your stomach only. So, taking a B12 vitamin by swallowing it is useless for you. Instead, get the injections from your doctor or find a good sublingual B12 tablet. Sublingual means that it dissolves under your tongue. When it dissolves under your tongue, the mucous membranes in your mouth absorb the B12 directly into your bloodstream. It can get directly into your body without digestion which is what you need. If you take B12 you also need B6 because they don’t work if you don’t have both. There are several sublingual tablets that contain B12/B6/Folic Acid.

  60. Chris, I am agree with you about PPI, because
    I have also experiences with persons taking PPI (like omeprazol etc) that their gastritis were almost all became worsen without any known causes. But they (others) argueing about the evidence based, although there were some easy to find answer online. Anyway, this is now about the times not easy to believe.

    Thank you.

    • I had severe stomach inflammation back in 2010 and a scope showed a hiatal hernia, schlotzkys ring and barrets esophagus. Ive been on PPIs since then. A scope in 2014 showed the barrets healed. I managed to wean myself down to 15 mg from 60! that some idiot prescribed me, but I have been unable to get off the last 15mg daily for more than 2 days without awful rebound. Does anyone have a tapering off protocol that has worked for them?

      • I was on Prevacid and tried cutting the dose in half. That did not work for me so I just quit it altogether. I suffered with rebound acid terribly. But what worked for me is eating smaller meals and skipping meals too. In retrospect what I wish I had also done was start on a good probiotic and enzymes with each meal. That would have reduced my pain considerably. Make sure you are not eating foods that can cause heartburn like sugar, pasteurized dairy, and grains. Also FODMAPS can cause heartburn too. Some people experiment with Betaine Hcl but I did not so I can’t advise about it. Hope this helps!

      • Ben, not sure how helpful this will be. But thought I’d answer anyway. I was on Omeprazole for 6 years, and my last endoscopy four months ago showed the Barrett’s was healed. I immediately went off, cold turkey because I had multiple polyps in my stomach which the doctor flat-out told me were a result of the PPI! I was on 40 mg. dosage per day. But it was making me sick! Every meal was a disaster afterward, and I had to use three separate things to feel better, like pepcid, tums, and something called hyocyamine! I still have occasional gird, and am working on that issue separately to try to improve my chances of being free of Barrett’s. I simply cannot go back to feeling sick all the time.

      • Hey Ben, like many I tired to wean off cold turkey and that is the wrong thing to do. I don’t doubt that some can quit cold turkey but that’s usually not a option for most of us. I took 30mg of Prevacid for a good 11 yrs. After reading all the bad things and not wanting to be on this forever I decided it was time to quit. I started my journey of weaning off back in late March. I did 3 week intervals. The first 3 weeks I did 30mg for 4 days and 15mg on the 5th day. The next 3 weeks I did 30mg for 3 days and 15mg on the 4th day. Basically, I decreased it by 1 day every new 3 weeks. Eventually I got down to alternating between 30mg and 15mg every other day during the last 3 weeks. After the last 3 weeks I ditched the 30mg capsule and was now focused on the 15 mg. The idea was to do the same process all over again with the 15mg prevacid. The first 3 weeks I did 15mg for 4 days and a 150mg Zantac on the 5th day. However, early on in the process I decided to try just Zantac. It seemed to do the job so I decided to ditch the 15mg of Prevacid. I took Zantac for a short time and then decided to try going without anything. So that’s where I am today. 70 days ppi free and 57 days Zantac free. It was a long process but totally worth it. I can only imagine it would have be a lot tougher had I did it another way. It takes time, you will have good days, some ok days and some days you will question if your doing any good. You have to take it one day at a time and be positive. I’m still a work in process, by no means have I totally cured myself. You have to watch what you eat and taking a good digestive enzyme really helps. I have taken Digest Basic and pretty pleased. Good luck with your quest!!

      • I have made this comment before but I’ll repeat it again so that I can get the message out. Tissue salts are a great way of safely restoring balance to gastric acid. The most common one to use is Nat Phos 6X. Dissolve 2 in the mouth after each meal and whenever burning occurs. If this does not help then see a practitioner, usually a homeopath who can look at what other T S’s or remedies may be needed.

        • Also Pulsatilla 6C can help acid reflux if other symptoms agree. (1-2 tablets twice a day as necessary until improvement, then stop)

  61. Im 56years old, and have had experienced heart burn/reflux when I was pregnant at 29years.
    I had a colonoscopy and endoscopy a few months ago, due to gut problems (now diagnosed IBS, which is drastically helped by low fodmap diet). I was also diagnosed with erosion of the oesophagus due to my pregnancy and diet years ago .
    After coming out of anaesthetic the doctor handed me a prescription for PPIs and said ‘take these’. I was a bit ‘miffed’ because there was no other dialogue between us until my follow up appointment which was in 6 weeks.
    I refused to take PPI’s as I eat a strict low carb (LCHF diet) and have absolutely NO PROBLEMS with reflux.
    I mentioned this to him, as I hadn’t even filled out the prescription I didn’t suffer from Reflux or heartburn. His advice was it would help heal my oesophagus! What a lot of rubbish I said, and what about all the side effects from PPI’s I asked? He told me that the side effects were not proven. I thought hmmm is he getting a bit of a side kick from Big Pharmas? I have still not filled the prescription and I had my diagnosis 9 months ago, still haven’t needed them and everything is fine. Ive also cancelled my six month follow up because I don’t think I need one.

    Definitely think about Low carb diet it will work for these conditions and much better outcome than taking PPI’s.

  62. Hi Chris,

    I have been on PPIs for Gerd for many years unfortunately. When I try to wean off of them, I get a rebound effect, even when weaning very slowly. I don’t understand how adding acid to my stomach would solve my gerd issue if my acid levels increase in my stomach while weaning off my ppi…and my symptoms worsen. Can you help me understand this? Thanks!

  63. Hey guys, it’s been a short while since I last checked in. As of today I’m proud to say I have been PPI free for 25 days and 11 days free of acid suppressing medications. I have been watching what I eat and getting some exercise. I can honestly say I feel much better. In all honestly, I think the Digestive enzymes have helped me big time. When I first started taking them I couldn’t tell if helped or not. I was still taking Zantac everyday and I think it cancelled it out. Since quitting Zantac it’s working like a charm. I am amazed of the progress and it has given me hope. That being said, I still have work to do. I’m not a 100% free of heartburn and discomfort just yet. I still occasionally get some indigestion if I eat certain things. Same goes for if I don’t eat enough. Generally speaking I feel good most of the time and if it flares up it’s not horrific, just enough to make you uncomfortable. These things take time, it’s a lot of trial and error and educating yourself. I’ve gone this far, there is no turning back. Looking back I think acid suppressing drugs hurt me in the long run. I took the medication for reflux and yet it gave me reflux. Makes sense, right? Now I must master the occasional flare up and heal my stomach. Only then, I just might be free. Any tips that might help get me over the hump would be appreciated. Right now I’m only taking Digest Basic w/ probiotics . I’m open to suggestions! Also, one last thing I want to say before I go. For all of you suffering I feel your pain. It has been a long and awful road for me personally. Many times I have thought I would be on this medication forever. It can be done, it takes time and whatever you do don’t quit cold turkey. I’m a true believer that weaning myself off helped make it so much easier. During this process you will hit road bumps and you will feel like giving up. Don’t! Take it one day at a time and do whatever it takes to provide relief in a good way. Also, you have to keep in mind we all react differently. What works for me might not work for you. It all goes back to what I said earlier, it’s a trial and error process. Hang in there and keep pushing forward. It can be done! Last but not least, I’m not telling anyone to quit taking their medication. That’s up to you. If you truly need it by all means keep taking it. I just wanted to update you all on my current situation and give you trying some motivation. Thanks for listening and hope to hear from some of you!!

    • Good for you James! I’m also taking digest basic with each meal but I’m also taking a probiotic pill – Dr Ohhira’s twice a day. Both those things really help. It has carrageenan in it, so I’m going to switch to PrescriptAssist (which does not) and see if it helps as well or better. Hope so! Don’t eat probiotics with sugar in them like Activia. Sugar cancels out the effect.

      • Hey Ginny, thanks for the comment. As of today I am 70 days PPI free and 57 days Zantac free. It has been a long process with some highs and lows. I guess that is to be expected after taking PPI’s for so long. In my case, I took them for a good 11 yrs. I’m still a work in progress and haven’t completely got rid of my problem. I still deal with a little heartburn but nothing major like I used to. Generally when I don’t eat enough I tend to feel a little discomfort. If I work late and take a early lunch the same thing happens. I start feeling the burn and bloated with gas on a empty stomach. I’ve noticed certain foods do bother me but generally nothing to set me livid. Things that bothered me early on have seemed to gotten better and I assume whatever bothers me now in time will do the same. I have come so far from where I used to be. I’m pretty happy with my results but I still want to get even better. I feel like I need something to get me over the hump. Digest Basic I feel has helped me. I also tried Xtendz Life Kiwi Klenz, pretty much feel the same as taking Digest Basic. Digest Basic is much cheaper. I feel like certain foods bother me and I wonder if I have developed a intolerance to them? I generally feel this shortly after consuming them. I think I’m going to order more Digest Basic but should I consider one that’s got more range of benefits? Any other suggestions I could take to help benefit and get me over that hump I can’t get over?

        • If I recall correctly, it took me about 4 months to be almost completely free of heartburn. But I did it the hard way, without the benefit of a probiotic pill nor enzymes.

          If you truly have too much stomach acid, you could Zollinger-Ellison syndrome. Here’s a link:

          Your doctor can diagnose you by drawing a gastrin blood level.

          Your doctor should have already talked to you about this. Unfortunately, the treatment for this is….proton pump inhibitors. But don’t despair. Medicine and surgery are all that medical doctors know to do. But that doesn’t mean you don’t have more options. Since my problem is the opposite of yours, I don’t know how to advise you. I would submit a question directly to Chris at his office to see what more can be done from a functional medicine perspective.

          • Honestly, I don’t think it’s a matter of having too much stomach acid. If anything, maybe I don’t have enough? So many possibilities, it’s hard to say. Since quitting PPI’s and acid suppressing medications I don’t feel worse. I felt my worst before and during taking them. I feel like I’m still trying to adjust with life without them. That being said, certain foods can bother me. Foods that are acidic or deep fried tend to be the top offenders. I have noticed cereals, oatmeal and some muffins have set me off. Sometimes I think bread bothers me. Last but not least if it’s really spicy I might as well raise that white flag.
            Eating better and taking digestive enzymes has done me well. I just need to get past the feelings of slight heartburn, the occasional upset stomach, ect. I have noticed my stomach feels hungry sometimes later after I’ve eaten.

            • Like I said before, you are going to have to quit eating sugar/dairy/grain. You just told me they bother you. Quitting these will get you over the hump. There’s no other way. There is no pill to make these foods stop causing heartburn.

              • Yeah, guilty as charged. I need to figure out a plan. It’s definitely a challenge and I want to get this done. It’s a matter of figuring out a plan and running with it. Whatever I do, I have to deal with the consequences if I give in to temptation. The ball is in my court, what am I going to do?

                • Not sure I could give up dairy. I make my own greek yogurt using only milk and a bit of starter from the last batch, I eat a cup every day with berries, and I adore cheese. My doctor wanted me to give up breads/grains, potatoes, pasta and corn, which I had no trouble with, and have lost 18 pounds in 2 months doing so. I feel so much better not having all that processed stuff in my body. I still have a long way to go, would like to lose 60 more pounds. Working on weaning off the omeprazole.

                • I spoke a bit too sharply James – I apologize. It’s been one of those weeks. Change is sure not easy but it sounds like you are headed in the right direction. I had to experiment with what worked for me too. My tastes have changed over the years. I used to drink 3 pepsis a day. Now I can’t stand it. It’s way too sweet and chemically tasting.
                  I thought I would never get over heartburn but I finally did. I still have to watch what I eat. And I still suffer with a little heartburn if I cheat. But now it’s nothing like before. You will figure it out too James. You’ve made such good progress in such a short period of time. Kudos to you.

              • I totally agree with Ginny. I gave up “white foods” (cereal grains, starches, sugar, and dairy) with great success to my health. I used to drink 4-5 cokes a day which led to kidney stones and (likely) magnesium deficiency. Giving that up was very hard, but it’s been so worth it. Yeah, I added coconut oil blended in a VitaMix with my morning tea or coffee. (I still drink coffee.) But the lack of the white foods has increased my energy. I’m celiac, so cutting these out made a big difference. I notice the acid indigestion when I eat sugars, dairy, chocolates, and anything made with rice flour. I give myself one day per week to eat white foods, but I find that I mostly don’t want them.

    • Thanks for your success story. I had taken PPI’s for 25 years for acid reflux but at the first of this year I developed Rosacea, eczema, and abdominal bloating – all symptoms of SIBO and/or IBS-C. My Dr insists I’m overly concerned and hasn’t been receptive to getting tests done – So, I’ve been trying to get well on my own. I’ve been off my PPI for 8 weeks now and just using Zantac at bedtime if I eat dinner too late and go to bed soon after eating. I take enzymes with my meals and i try to eat small meals, but sometimes the acid is rough – belching acid. Sometimes I just feel a vapor in my throat – symptoms of LPR (Dr. Kaufman’s term). I’m still trying to figure out the best diet – I have lost 30 pounds, sleep with my upper body elevated, and still wake with some sore throat and some throat clearing. I don’t want to go back on PPIs but concerned my Dr will continue to push them on me because my endoscopy revealed Barrret’s w/o dysplasia. Any input out there around living with Barrett’s w/o taking PPIs?? Thanks, Stephen

      • I would say make sure you eliminate all the foods that cause your stomach to be upset. Especially grain/dairy/sugar.

        Before I eliminated these, I had trouble swallowing. Food would get stuck about half way down and it burned at that place every time I drank something acidy. That doesn’t happen anymore, thank goodness. Barrett’s is serious and your diet needs to change so it can heal.

  64. Fascinating article. I was recently diagnosed with a grade 3 esophagitis, erosive antral gastritis and was placed on 60mg of a PPI called Dexilant once a day. It seems to be helping.

    I’ve been on it now for a month and even after reading this article by Dr. Kesser I’m not sure what is the next step to take.

    It’s not just reflux but I have a lot of damage to my esophagus and stomach. How do I actually start healing without the PPI drugs?

    I’m following a low acid diet per Dr. Jamie Koufman’s book called Dropping Acid and I’m eating mostly soft, alkaline foods.

    • Paul, the most common cause of gastritis is H. Pylori infection. I know this may sound like snake oil, but try taking 1-3 Tablespoons of virgin coconut oil daily for a few weeks. It should kill off any H. Pylori in your system, plus it does soothe irritated skin/mucosal membranes. (It’s the lauric acid in it. Lauric acid breaks down the cell walls of bacteria and fungal cells and the outer coats of viruses.) It’s non-toxic and pretty effective at resolving H. Pylori. I’d just try 1 teaspoon 3x a day for a few days (1 Tablespoon total). If you don’t feel a lot of relief in a week, increase it to a larger dose for a few weeks more. However, I bet you will start feeling better. Most people resolve their H. Pylori infections with that 1 teaspoon 3x daily of virgin coconut oil within a month. With some cynicism, I note that the challenge studies of herbal remedies for H. Pylori in 2014 came to the conclusion that no herbal remedies truly eradicated H. Pylori and that a vaccine for it was desperately needed. They compared everything but virgin coconut oil (ie, garlic, green tea, licorice, honey, etc). Yet, here is a 1996 study which compared medium-chain monoglycerides (MCT fatty acids…coconut oil) to various antibiotics and found that the ones that contained lauric acid were effective at eliminating H. Pylori. “In contrast, lauric acid (C12:0) was the only medium-chain saturated FFA with bactericidal activity against H. pylori.” and “Collectively, our data demonstrate that H. pylori is rapidly inactivated by medium-chain MGs and lauric acid and exhibits a relatively low frequency of spontaneous development of resistance to the bactericidal activity of MGs.” (MGs are monoglycerides which is what coconut oil breaks down into. Coconut oil is about 50% lauric acid in composition.)

      We know coconut oil works. We know why it works. It won’t work for everything, contrary to rumor, but it works really well as an antibacterial/antifungal/antiviral on certain organisms.

    • Paul, one last thing, if you start taking coconut oil and have never done so before, start slow with it and mix it with things so that your body gets used to it before you start adding in Tablespoons worth every few hours. I started by adding a spoon of it (probably 2 teaspoons worth) to my coffee in the morning and blending it in a VitaMix with cinnamon, cardamon, vanilla, and honey. That was about 1 teaspoon per mug of coffee since I brew a small 4-cup pot (which is about 24 ounces) for the morning. I now tolerate 2 Tablespoons in my morning coffee mugs (yes, I still drink coffee or black tea and yes I should probably stop but it’s my only nootropic). I also cook with it.

      Too much coconut oil too quick can make you feel sick (vomiting, nausea, diarrhea). It makes sense –would you chug a bottle of olive oil cold turkey? 😉 I hope not. Coconut oil is killing some pretty nasty bugs in your system, so it can also have flu-like symptoms while it’s killing the bugs.

  65. I think one of the important aspects of PPIs associated with dementia is that most of these drugs have an anticholinergic mechanism of action. There are many other drugs with anticholinergic action which are also associated with cognitive dysfunction and dementia, such as muscle relaxants, tri cyclic antidepressants, antihistamines, benzodiazapines, anitspasmotics, antiarrhythmics, anti parkinson’s drugs, antiemetics, antipsychotics. The common aspects–all are anticholinergic.

    • Yes, I agree that the anticholinergic properties are damaging. However, another really damaging element of PPIs is that lowering the stomach acid stops the effective processing of Vitamin B12 and other nutrients from your food. Plus, lowered stomach acid allows for “bad bacteria” to overwhelm the “good bacteria” in your gut as it allows the bacteria to pass into the intestine. That’s a double whammy. If you look at Vitamin B12 deficiency, it looks a lot like Alzheimer’s dementia. The lack of uptake of B12 (B12 deficiency), nutrient deficiency and the gut bacteria decimation stopping the creation of bacteria-processed vitamins in the gut lead to incredible neural damage in the long run. Your body will trade long term benefits for short term gains because it is designed to pass on genes (procreate). But starving certain neural processes of these nutrients in the long term leads to neural damage in old age.

  66. I want to give warning that relying on diet to get rid of the bacterial overgrowth may just give it more time to damage tissues. I have had SIBO I estimate for 10 years. 5 years ago I was warned by chronic iron deficiency that something was wrong. I had many of the symptoms of SIBO as well. Finally, 2 years ago it was diagnosed and 18 months ago I started Xifaxan, 2×550 mg/day , with a month off then repeat 13 times. I think I am now free of the bacteria, but I believe that tissues are permanently damaged, and I am on my 28 iron infussion. I am concerned that we just learn to live with this organism, while it causes us permanent damage.

    • I wanted to add that I believe the SIBO came about from long-time daily use of opioid pain medicine and prilosec .

    • Douglas, if you have iron deficiency, you likely have B12/B6 deficiency. That’s likely what is causing tissue damage. Vitamin D deficiency will cause B12 deficiency. I would suggest trying a sublingual tablet of B12/B6 to help heal the iron deficiency. Look up B12 deficiency for more information. Getting your diet right may help, but not if the SIBO is not treated. There are natural methods of keeping certain bad bacteria from overgrowing your digestive tract (virgin coconut oil, mastic gum, aloe vera, rosemary, etc). There are companies working on a vaccine for H. Pylori, but I don’t happen to think that’s a good idea at all. While an overgrowth of H. Pylori is bad for us and causes gastritis, we don’t really understand the colonization and it’s too common an organism to want to eliminate it without understanding how it fits in the digestive ecosystem. We just need to control the overgrowth. Normally, humans would eat a variety of foods that would keep the numbers of the bugs down. But sugars/starches increase bad bacteria in the gut.

  67. I’ve been thinking about my acid reflux and was curious about something. Over the years, including more recently I have made some poor choices of eating spicy foods, beer, ect. I’m curious why I have been able to eat these foods with no consequence. Not saying I haven’t got reflux from spicy foods because I have. It’s just I should have gotten it more than I have but didn’t. They say beer doubles your stomach acid. Could drinking beer give me the extra stomach acid I lack and that’s why I’m fine? Perhaps I lack stomach acid and it’s not too much? Yet, I have days I watch what I eat and drink and something sets me off. I guess I’m just puzzled. It’s weird things I consider safe set me off, yet sometimes eating pizza or gumbo I can be fine. Anyone else deal with it this way? Could it be a food allergy or something that mimics reflux? Could I lack stomach acid after all? These are questions that come to mind during my process of coming off ppi’s.

  68. Hey all, just checking in. Thanks to all who chimed in on my comments with suggestions and your personal experience with reflux. It really does help. I’ll probably keep posting updates on occasion since you all are so responsive. I post comments on other boards but usually get ignored. Anyway, I’m nearing 15 days ppi free. In some ways I feel much better but I still have things to work out. Since weaning myself off of ppi’s in late March until quitting recently I have to say it’s been a roller coaster. I have really good days, some descent days and some days that are quite bothersome. I assume that is the process and my body is still getting used to life without the ppi. For those who haven’t read my other posts, I am currently taking Zantac 150 in place of my ppi. Doing pretty good with it. Seems like late evening and night is when I struggle most. Not so much in the morning like I did at first. I do have the feeling of needing to clear my throat and a bit of a cough. Hopefully that will soon pass. Otherwise, I have been trying to eat better and bike when I can. I’m really interested in the Paleo diet. It’s been mentioned to me by a couple people here. Been doing some research and thinking of ordering Chris Kesser’s book. Also, I have been taking Digest Basic w/ probiotics with each meal. Guess it’s helped, not sure if it’s made a huge difference or not. I might give Dr Ohirra’s probiotic a try. Seems to get rave reviews and actually help with reflux. I’m willing to try just about anything if it helps get through this process a lot easier. While I haven’t been in complete agony I’d say this process has been pretty descent. For all those suffering with terrible reflux I feel your pain. It can bring you down and make you feel like giving up. Take it one day at a time and do what it takes to limit your symptoms. It will take some work but will be worth it if you hang in there.

  69. I was prescribed PPI’s for a persistent cough. Before taking the PPI’s I had never experienced heartburn (that I can remember), but after coming off them I now get it frequently. Wish I had done a bit more research before taking them.

  70. Might have been mentioned but I got off lansoprazole with deglyzzerised licorice tablets, some diet change and some suffering through rebound. My doctor shrugged off concerns about prolonged off label use. Just wanted to try a month and now out of the cycle. Still keep a bottle of licorice (get it at any superstore or amazon) and some famotifine around but mostly good. Fishermans friend helped too gotta give credit 😀

  71. This may sound really strange, but it seems like every time I go to the dentist, I end up with a recurrence of reflux about three or four days later. This has happened three times this year. Each time I was given a local. The second time I was given Arestin, an antibiotic, under the gum line. The dentist said this shouldn’t cause any problem with acid reflux, but this is just a big coincidence. That time it lasted for about six weeks. Could a local injection bring back reflux for some reason?

    • I was mistakenly diagnosed 10 yrs ago with acid reflux & have been on 40mg of Nexium daily since. Recently, due to really rotten egg gas burps coming out of my mouth increasing, constant hyper listing, & constant horrible naseaus ( those were my original complaints 10 yrs ago) with gastroparesis, tests showed that my stomach muscles are basically 90 percent paralyzed, so I can’t digest mostly anything in solid form. I have read up & been given all kinds of info on it, but I’m afraid of getting the gastric pacemaker, just to control the symptons. I am looking for a permanent fix but have been told there isn’t one. Is there a connection between my prob & acid reflux or a d cad long Nexium usage? Is there anything Hong I can do besides the diet prescribed? Please help me, I am so sick of being sick. It’s ruining my life. I am a 50 yr old female. By the way, I can’t do Paleo as I can’t break down fruits/veggies & are to avoid fiber as I can’t digest it, per my gastroentologist. Liquid diets suck. Doing it, but I miss chewing, enjoying food!!

  72. Just wanted to stop in and give a quick update on my situation and possibly get some feedback. Back in March I decided to start the process of weaning off 30 mg of Prevacid. I decided to do 3 week intervals to allow myself some time to adjust. I did 4 days at 30mg and on the 5th day I did 15mg. Basically, I would decrease the 30 mg by one day every new 3 week period. After several weeks of the process I was going every other day with the 30mg and 15mg. After the 3 weeks ended 30mg is no longer in the picture. I was ready to begin my next 3 weeks doing 15mg for 4 days and a Zantac on the 5th day. Basically I was going to repeat the process all over again with the 15mg and Zantac. However, since then that has all changed. I tried the Zantac during my first 3 weeks and felt really good with it. So I decided to give it a try for the next couple days to see how I felt. I felt pretty good so I decided to quit taking the 15mg Prevacid. I’ve been PPI free for a week and 2 days. I have to say I feel much better without it,however, I still have work to do. During the process of weaning off I had good days but I also had not so good days. I noticed this each time I started a new 3 weeks after decreasing my dose. I’d say I would have a couple days of not feeling great but I would usually bounce back after that. It was a bit of a roller coaster process, still is as I’m still adjusting. I’m rather pleased with my progress. I think to myself it could have been much worse. Weaning off slowly over a long period is the right thing to do. Right now I’m taking 1 Zantac 150 a day. Still doing pretty good with it. I have been watching what I eat and trying to eat better, which helps a lot. I was getting up in the morning with some reflux feeling but the last couple days feel pretty good like maybe that has passed. I have been getting some reflux symptoms mainly late at night. Does anyone think this could be rebound related? Did I avoid major rebound by weaning off like I did? Any tips what I can take at night to help get me over the hump? Otherwise, like I said I’m pretty pleased with my results. I’d like to think getting through the weaning process and doing descent now is a good indication. Also, I did go most of the day with no Zantac the other day but felt little discomfort so I gave in. No need to make myself suffer. I have also been taking Digest Basic w/ Probiotics with each meal. Not sure how much they play in the role of me feeling better but happy with the product. Yesterday I felt really good all day, had a steak for dinner and felt blah after. It’s almost like it was just sitting there and eventually had heartburn late last night. Could this be a indication maybe I don’t have enough stomach acid? I have been wanting to try HCL with pepsin. Any insight, help or suggestions would be appreciated. I’d like to know what you all think, am I making progress? Thanks!!!

    • Can’t sleep tonight, having a pretty good flare up. Not sure if it’s something I ate or the rebound is starting to kick in. I’m not sure what to think. Like I said before I have done fairly well during the process but the last couple days noticed more of a flare up, more than anything at night. I really hate this, it brings me down. Makes me feel like I can’t conquer this. I have done so well my first week off the ppi but now don’t know what to think. Do I stick with the plan and keep pushing on? Perhaps, I should return to taking the 15mg ppi and wean off like I intended? Any insight would be great, thanks!!

      • James
        I actually cut my Prilosec pills (not tablets) down until I was taking about 1/4 of a pill and kept on each dose until I felt pretty good on each one. This seemed to work for me. When I finally quit, I couldn’t tell any difference. I still have flare-ups and I take a Zantac. My worst flare-up is if I take an antibiotic. I now refuse antibiotics.

        • So, I’m wondering if I should maybe start back on 15mg and gradually decrease over several weeks alternating on some days with the Zantac? That was the plan but I felt pretty good taking the Zantac. So I ditched the 15mg Prevacid and like I said in my previous post done pretty well without it, with the exception of a little flare up. The flare up’s happen mainly at night or late evening. Last night was the worst, not sure if it was from something I ate or just rebound kicking in. All I know it wasn’t fun and makes me very discouraged. I feel like maybe now I got to rethink everything and unsure where to go from here. Do I go back to 15mg, wean over several weeks. Keep eating better and hopefully that works. Or do I stick with the Zantac a few more days and see how I do before going back?

      • Hi James, are you taking a really good probiotic (one that gets rid of heartburn)? If not I’d recommend Dr Ohirra’s probiotic. Works really well for me! (Order from his site, not from Amazon.) Also take a good enzyme capsule with each meal.

        Like you, I was on Prevacid 30 mg a day. I started weaning to every other day but it really did not help. So I just completely stopped it, and endured the pain, cut down the total amount I was eating, and even skipped the next meal if the heartburn was really bad. That helped a lot! I probably would have had a lot less pain if I had just taken probiotics and enzymes when I quit Prevacid. Live and learn. Getting off it is the most important thing. You may want to look at low FODMAP diet, in addition to Paleo, to help also. Good luck! If more questions feel free to ask.

        • Hey Ginny, thank you for the response. It’s very much appreciated. To answer your question I just started taking Digest Basic w/ probiotics with each meal. Not sure if they have helped much, but I’d like to think they have. Could you explain the difference between the probiotics you speak of in comparison to others out there? I’ll check them out for sure, I’m willing to do what it takes to feel better. I will also read up more on the Paleo diet and perhaps try incorporating that into my diet. Thanks for the info, feel free to add any more info if you think out it!

          • Hi James, when I started weaning Prevacid, I had already started the paleo diet – no grains/dairy/sugar/legumes/veg oils quitting those foods helps. But what was so hard was all the meat I was eating all of a sudden. I had been a carboholic before paleo so my stomach did not know what to do with protein. Plus after having been on a PPI, food just stayed in my stomach for hours, even with the increased stomach acid. I think SIBO and chronic constipation were to blame there also.

            So go paleo and try low FODMAP as well. FODMAP is quite restrictive but you will only need to be on it a short time, then slowly reintroduce foods one at a time to see if you can tolerated it or not. Also reduce the amount you eat and even skip a meal or two. Fasting helped a lot. Stopping grain/dairy/sugar reduced the inflammation and bloat.

            I just started taking Basic a Digest about a month ago. Started Dr Ohhira’s this January.

      • James, I forgot to ask. Are you still eating grain and dairy and sugar? If so, quit those altogether. Those are probably the most inflammatory foods you can eat.

        You might also want to consider low-FODMAP foods for a time too. I think with FODMAP’s you can slowly reintroduce them over time.

        But quit grain/dairy/sugar. There are some great recipes for quick almond flour or coconut flour breads so you won’t even miss grain breads. They are really good!

        • Do I consume grain, dairy and sugar? Yes! I can be weak when it comes to avoiding foods with those ingredients. I have been trying to eat better. However, I have given in a lot more recently. That could explain why I have ongoing symptoms.

      • Can I still take Digestive Enzymes, Probiotics and Prebiotics when taking HCL with Pepsin? I’ve been taking Digest Basic with Probiotics. They seem to be doing me good. I just ordered Xtendz Life Kiwi Cleanse. Heard good things about it. Always wanted to give HCL a try though, so maybe I’ll have to give it a shot.

  73. Disappointing that you mis-quoted the authors of the paper in your 3rd reference article here, who were specifically saying that omeprazole acts SELECTIVELY on parietal cell proton pumps under physiological conditions!

  74. Very low carb diet vs. Paleo? While there are some similarities in these diets, they have some major differences. Is it just a matter of trial and error to see which one works for reflux? What process did you all go through figuring out which worked? I am on a very low carb diet and have cut my Nexium dose down to 10 mg and am still experiencing the throat burn (no heartburn). Suggestions would be greatly appreciated.

  75. Does anyone else get heartburn from not eating? If I eat very little or nothing at all acid reflux starts creeping up. Not only that but I get gas too.

  76. I have read the publications on this website regarding reflux and PPI’s and just finished reading the book Heartburn Cured by Norm Robillard. My take-away, if I’m understanding correctly, is that our diet choices (grains, carbs, etc.) are creating a gas that pushes the LES open allowing acid into the esophagus. Which leads me to my question….if gas is the culprit, would taking something like Gas-X or Beano (along with dietary changes) help the reflux situation? Or, is it a totally different kind of gas and these meds would be of no help? If anyone has any info on this subject, I would greatly appreciate it.

    • You have to treat the root cause, not just the symptoms. I’m right in that boat you’re describing, and my SIBO is the source of my bloating and reflux. When that has pushes up in your stomach, it also can sometimes create hiatal hernia. You need to test for SIBO and treat that, also test for adrenal fatigue with is very common with SIBO. Also, think about trauma you may have had in the past. These three always go together nortiously well, and you must treat all at the same time or it will never heal. As for gas Meds, they don’t work and only cause more problems like PPIs, just avoid them and eat a proper paleo diet. SIBO will also require a paleo diet but more restricted on FODMAPs. Good luck!

    • As soon as I stopped taking prescription medium ( after 2-3 years, plus prescription pepcid at bedtime, I had hypomagnesium symptoms. Triggered by other meds, skipping meal, activities, …I had tetany in my face & now I know if I feel scattered, spastic, or tight , and dysarthria as well , time to take my ca&mag. Coincidentally, I am being treated for “polyarthropathy, idiopathic”, (I read/ stopped PPI and only take famotadine @ twice monthly, (causes depression , fever rapid pulse… Thyroiditis & hypothyroidism s/s) after finally winning a battle to have an u/s ordered, have a colloid cyst, a shrunken left lobe, plus a “slightly enlarged” right lobe– have been running around w/ a bipolar thyroid, sacked out vital signs/palpitations,… On & on , hot mess, & ran gamut of disorder symptoms, just @ to luckily land on prob. SLE– definitely in the anger stage telling this- usually I’m doing best to educate myself/ others. We have neglected to advocate our last two busy/trusting/stressed parenting generations; our politeness and fear of challenging the superficially educated bottom feeders in the cesspool of capitalistic poisoning for profit (they had us coming & going),
      has been a tragic unfolding of senseless suffering —

  77. I have taken omeprazole or protonixfor nearly ten years. About two-three months ago, after reading a lot of information like the stuff Dr Kresser puts out there, I quit cold turkey. I started taking about 1/2 oz of Apple Cider Vinegar before every meal. Acid reflux never recurred. I still had bad heartburn 24/7. When I started on the low carb diet a few weeks ago, the heartburn went away. I still take the ACV plus a digestive enzyme with every meal. Things are going fine, but I need to figure out how to get my digestive system back to how it should be so that I can eat carbs again. This is an horrible diet!

  78. I took PPIs for severe GERD symptoms for about 20 years (essentially my whole adult life to that point) and tried to wean off of them several times, but had a really rough time and could not do it for more than a few days. Then I started the GAPS diet about 3.5 years ago, at which point I was able to quit PPIs entirely within about a month of my diet change. I currently eat more variety than GAPS allows, with an eye towards Paleo ideals for the most part, but I still seldom have reflux issues. What issues I do have can usually be solved by some homemade raw sauerkraut juice and not eating too close to bedtime!

    It’s hard to tell whether the research was looking only at people who were currently taking the medication as opposed to those who were not (and presumably never did). Does the any of the research address long-term health of people who have taken them for extended periods but have stopped? I won’t touch them again, but I can’t take those 20 years back, and now I worry a bit about the damage I might have done.

    • Sorry — ill-formed sentence there! I meant to say that it is hard to tell whether any of the research followed people who had taken PPIs at some point, but were not taking them currently. It looks like they are all using subjects who either were taking them during the study period or were not (and presumably had not previously). I would like to know how permanent those risks are!

      • I personally believe with faith, natural/homeopathic self-education, regular exercise (even when you modify for bad days/weeks), and switching health providers to one who accepts your treatment philosophy in conjunction with safer /conservative minded pharmacology ( in other words a smart doctor who reads)- then you have the best opportunities for optimal healing. One of our most renoun spiritual- eastern experts tell us that “every cell in the body” renews every “seven years”. Think of seven years ago- you probably had other physical complaints at top of your list. But you also had other honed skills, daily patterns, paradigms you lived under. Not every paradigm is the last great truth- the best ones do not get replaced, only sometimes they receive bad press due to others’ agendas.

        Many answers come from seeking guidance from your higher power. I think folks like Dr. Mercola provide , through his own guided truth-seeking , some pretty amazing information on some important health issues Americans face today.

        As for myself, I am lucky I have a doctor now that listens, observes, supports (not in writing) whole heartedly my decision to take Iodine/selenium supplements, and respects my health and goals of healing vs managing as much as possible. I do not need a lupus or ra or scleroderma diagnosis at this point – I need the best encouragement and treatments for the pathophysiology causing my symptoms without limiting my psyche to mold my functioning under a label.

        Also, check out Edgar Cayce foundation for wonderful advice on healing specific ailments of the body/mind.

  79. I have a hiatal hernia and I have taken omeprazole for ~20 years. I tried to wean off PPIs twice last year: once on my own using Betaine HCL, DGL, etc. (per Chris Kresser’s publications) and a second time with the help of a gastroenterologist. I had esophageal damage both times. So, I’m back on PPIs. Any suggestions for minimizing the effects? Thank you in advance!

    • Check out articles re: magnesium deficiency by this site/others resulting from PPI treatment. Heed any warning for cardiac patients w/ magnesium supplements. I like to find out all I can and read lots on nutrients in general; helps to understand any decision to replace a medication with adverse effects. And strengthens commitment to improving a health condition overtime vs. overnight.

      Also you can locate certified biochemistry nutrition counselors who have the knowledge base to assess and show you safe interventions for your symptoms. I have met one at local ER (she works p/t as a receptionist) , who charges $30 for her sessions- her way to give back to others after suffering severely with Scleroderma.

      Some of the most generous spirits are encountered in the midst of their greatest sufferings in life. Don’t give up!

    • Try sucralfate. I’m using that to get off my ppi. Sucralfate coats the esophagus and stops the interaction of acid and bile. Use the sucralfate to get you through the rebound acid secretion

  80. I’ve been using Omeprazole for several years now, and am beginning to notice some colon problems. I pretty much eat a paleo diet with a treat once a month (usually coffee ice cream) but when I try to get off the med my Acid Reflux comes back with a vengeance. It was starting to burn my esophagus when I started on the med, after trying everything else on the market. I’m going to try taking it every other day for a while to see what that does. Doctors say mine is not from diet but from having too many children too fast.

    • “Doctors say mine is not from diet but from having too many children too fast.”


      Did you eat them too fast? 😉 The only way I can see that having acid reflux could be related to childbirths too close together is in the exhausting of nutrients in the body. Check yourself for magnesium deficiency. If you are having other symptoms of magnesium deficiency, try taking a long hot bath in epsom salts (2 cups for a 1/2 bathtub of water, 20-30 min soak) and possibly a liquid supplement. All of the ‘zoles (omeprazole, etc) will exhaust magnesium. Try taking a sublingual tablet of vitamin b12 (try the 1,000 version) with b6. (b12 and b6 are synergistic, so you need them both to get the needed effect.) ‘zoles also interfere with b12 (and other nutrient) uptake, so b12 deficiency is common.

      Try increasing stomach acid with things like apple cider vinegar (ACV). I found that drinking ACV when I have rare heartburn hurt when I swallowed it, but did seem to actually eliminate the heartburn. Try watering it down and drinking a bit.

      I’d try the coconut oil trick of 1 teaspoon 3x daily for a month or so to see if the acid reflux could be related to H. Pylori.

      And of course, you’ll have a backlash effect from taking the PPI for a while.

      • And I should clarify that magnesium deficiency does cause or worsen acid reflux because you need magnesium to allow the lower esophageal sphincter (LES) to relax so that food will pass into the stomach. If your magnesium is low, the LES could spasm. PPIs lower stomach acid but also lead to magnesium and b12 deficiency.

  81. There is also a component o autonomic nervous,system imbalance. Ulcers use to be treated by cutting the vagus nerve. I think many only focus on diet and neglect practices that would improve digestion like meditation, eating more slowly, chewing food thoroughly , improving sleep quality and duration, exercise
    If you have failed with only a dietary solution try incorporating some of these other practices.

  82. Hi Chris,
    I am very excited to say that I started a HFLC diet at the end of April. After just 2 weeks of eating this way I am off Nexium and per blood tests I have gone from Hypothyroidism to Hyperthyroidism (with medication). My next goal is to rid myself of Hashomotos disease. One meal at a time.

  83. I had been on Pepcid since I was a teenager. The stress of law school and moving away from my family made my reflux tons worse and I was put on PPIs. I had my first scope at 27 and was told I had Barrett’s Esophagus and had to be on PPIs the rest of my life or I would die at 40. Needless to say I didn’t go back to that GI Dr. Fast forward a year and I was hunting for answers to severe stomach issues (turned out to be a wheat allergy/celiac.) Found a Dr. who knew food allergies and he confirmed my wheat allergy (which I had deduced from an elimination trial) and ask said my redux was likely due to Candida brought on by a hidden food allergy. Turns out I had an allergy to CORN. The allergy itself causes reflux, plus I do battle with Candida. Both issues would be eliminate with a low-carb paleo diet (though with Candida there would be the die-off). I saw a GI Dr. shortly after finding all this out and stopping my PPI (for good). She laughed in my face and told me Candida causing reflux was ridiculous. I haven’t been back to a GI Dr. since. I also haven’t had reflux except when I’ve ingested corn (can be hard to avoid, especially in medications) and when I was pregnant (fortunately Pepcid helped then.)

    My son also suffered from reflux as an infant and was on Prevacid for 3 months. We hated giving it to him, but him writhing in pain and refusing to nurse was a bigger problem. He has several food allergies and we were trying our best to sort it all out and help him heal. But we had a very candid discussion with our doctor who explained that PPIs for infants are formulated a bit differently and are much more effective than H2 blockers. He disliked giving the medicine, but my son had to start gaining weight or he risked developmental delays. And it worked for him. He was a different baby. He got back on the growth charts, we were able to figure out his allergies and get him off the meds. He’s now a happy, healthy 2-year old who’s never had any other pharmaceuticals. A paleo diet wouldn’t work for a 3 month old, and it wouldn’t have worked for me to do for him as he’s allergic to nuts and eggs and several spices (we had to do paleo AIP for him.) Eggs for him especially cause reflux, even baked into things.

    So as much as I dislike PPIs as an ongoing treatment for reflux, they do have a purpose and can be extremely useful with short-term use, just like many pharmaceuticals.

    This also goes to show that sometimes relux is caused by an allergy, and that allergy may fall within the scope of a paleo diet. (the allergy reduces the stomach acid that results in reflux, then allows bad stuff to grow, as the article stated, which exacerbates the problem.)

  84. For someone who has been on PPI’s for several years and now down to 1 Zantac a day, how do you go about taking HCL with Pepsin? I always wanted to give it a try but unsure how the process works. I was always afraid to try while on PPI’s. I’ve been off PPI’s for about 3 days now.

  85. Thanks Chris. For your book, and regular advice columns, which literally changed my health and life for the better. To get off PPI’s and anti-depressants, I simply had to cut out wheat. We follow a loosely Paleo diet, but are far from strict. But if I slip up with wheat, I have the bloating, heartburn (within the hour) and mood swings. I don’t slip up often anymore! 🙂 Thanks again!

      • Thanks for sharing your experience. it’s encouraging to hear. i’ve recently gotten off PPIs after taking a double dose of nexium for more than 20 years. I had my first GI series at 12 years old and suffered from heartburn all my life and after my dad died of esophageal cancer, i was put on the Nexium. I was warned about its effects on my magnesium levels and adjusted for that but after seeing that i had a 145% greater risk of hip fracture i decided enough is enough. In fact, by that time, the nexium didn’t even seem to be working for me. Meanwhile, i had also quit taking zoloft for depression which took me 4 months to wean myself from. i believe the zoloft caused a problem with my balance and the increased risk of fracture was the last straw. I had an endoscopy last week and it turned out that i have an ulcer and a lot of erosion so I’m tightening up my diet and i believe that wheat is a major factor for me along with dairy. She wants me back on a PPI but i’m not going that route. trying to find a local doc who will work with me on this now… thanks again.

  86. Thanks Chris great article, a year ago I had HP treated,antibiotics x2 and proton pump, told me it had sorted it but still get tummy pain occasionally, had a HP retest x 2 stool & breath, all clear which was great to hear,doctor considers I have slight gastritis and prescribed 30 mg lansoprazole (I’m in UK by the way)i asked for a b12 test before I would start to take tablets, this was done via blood and received result two days ago -which was 333 ?? Verbally on phone told that was the norm, and fine to start course of tabs 55 ,one a day, on reading your super article (just in time) not going to go that route nb. I’m male 60 years, have always beamed in on your site & receive your e/ms so doing big homework tonight on a friendlier ,to me route.

  87. I really wish the alternatives listed here would work for me. I’ve had six years of silent reflux that makes it hard to speak, and I’ve had to give up singing, which was one of my passions in life. Ironically, I never had any problems with reflux until I went on a strict low-carb Paleo diet for a year (followed by three years of moderate-carb, but also strict, Paleo). I’ve tried all the recommendations Chris has made for improving gut health– probiotics, prebiotics, Betaine HCl, herbs to promote good bacteria, bone broths, ferments, etc. I’ve tried it all, but the chronic pain in my vocal cords has continued for all these years. I avoid PPIs, but it can’t be good for my throat to be constantly bathed in stomach acid, either. That can lead to things like throat cancer. I only wish I knew what to do.

    • Have you gone to a gastroenterologist? I had similar symptoms and ended up having surgery for a hernia. After the surgery I went on paleo which resolved years of damage. I got my life back again.

      • Deb, did the hernia surgery help at all? How do you know which helped if you started paleo soon after surgery?

    • I used sucralfate to help me get off PPIs. It might help you too. I get the pure powder form from a compounding pharmacy and mix 1gm with about 10ml of water. Swirl it around to mix and down the hatch. It coats everything on the way down including vocal chords. You can use it as a preventative after getting off PPIs as well.

    • Consider Standard Process supplements. 100% organic with no contraindications to medication. For Acid reflux and other related digestive conditions they have excellent products. I believe second to none. We have tremendous success inour office with patients who have IBS, Chrones and other digestive disorders. Chris may have these products or consult a doctor who sells them. (Can only get from health care professional’s office)

    • I knew about some of the dangers of PPI’s and came off them and, like you, tried everything to control my acid reflux in otger ways but nothing helped. After a year of trying different methods I’ve had to go back on them. The stress from the discomfort on top if all my other stressors in life is too much, and if I’m going to get throat cancer anyway from all the stomach acid up in my throat constantly then I may as well be comfortable while I can. When I read articles like this it makes me want to try and come off them again though.

      • I can definitely relate. I think about going back on them, too. If I’m going to get some dread disease either way, I’d at least like to sing before it happens, and I can’t sing off PPIs.

    • Samantha, try taking 1 teaspoon of coconut oil, 3x daily, for a month. The lauric acid in it eliminates the bacteria and yeast that cause GERD. I put in a much longer post about it in the comments above. If you remove the bacterial overgrowth, it will likely fix your GERD. If you have never taken coconut oil before, start a bit slow and work your way up to that dose. Because coconut oil is killing yeast and H. Pylori, you may get some symptoms that seem flu-like. (and if you load too much coconut oil into your system too quickly, it can cause nausea, vomiting, and diarrhea [think of chugging a bottle of olive oil. You wouldn’t want to do that either. Just build up slowly instead of diving in.])

  88. I have tried to get off PPI’s while eating a low carb/paleo style diet. I also used all the natural remedies I’ve read about while trying to do this. I couldn’t tolerate the discomfort of the reflux returning, and had to again start taking the PPI after a few days so I could lead my life. I would LOVE a step by step – day by day program of how to wean off a PPI while introducing the natural remedies. If this exists somewhere I’d love to know! Thanks!

  89. What is the general concensus on antacids like Roland’s or tums for treating occasional heartburn?

    I have a hiatal hernia and suffer badly whenever I make poor good choices. I know the long term fix… just asking for input on antacids.

  90. Hi Chris,

    So my father had a stroke this past March and during the process of testing they found 5 tumors in his brain. He had initial rounds of targeted radiation on his brain. They have since determined primary lung cancer with metastases in his brain, spine, and hip bone. He apparently has a rare mutation that has made him a candidate for drug therapy called Xalkori. Throughout this whole process they have had him on prilosec 🙁 First as a precautionary measure for the radiation treatment and now because he has actually had symptoms of heartburn. I am determined to get him off these and am wondering what you might recommend for someone in his situation as his doctors have zero interest in shifting him to anything else and unless I go in with another option, it is unlikely I will get any support from his doctors 🙁 My dad has always been open to alternative approaches but this recent diagnosis just has him so scared that he only wants to do what his doctors tell him. We had him on an alkaline/anti-inflammatory diet and his doctors told him that wasn’t necessary so he’s stopped following it. As a side note, he hasn’t had any cancer symptoms this whole time. Still struggling with stroke symptoms – cognitive function, and left hand motor skills. Being on prilosec seems like it could just be compounding these problems so any ideas are welcome! Thank you!!

    • You might try switching to an H2 blocker, such as famotidine. H2 blockers decrease stomach acid by blocker a histamine receptor in the stomach. This is a totally different mechanism than proton pump inhibiters. While there are Histamine2 receptors on other cells in the body, it is less likely to inhibit the vast array of basic processes that the PPI’s do.

    • This is what I do for my patients on PPIs:
      If you withdraw from PPIs , you need to VERY slowly withdraw from them WHILST
      supporting your gastric and peptic mucosa . Decrease PPI by 1/2 every 2 weeks( or every week )

      Start supplementing immediately with VRP Ceasefire which contains mastic gum ..
      ( NB: Check to see if this safe in cancer patients )

      Start supplementing with Metagenics Endefen which contains glutamine (NB: Check to see if this safe in cancer patients )

      Start supplementing with Bioavailable curcumin BCM 95 or Meriva which contains available turmeric to heal the gut and for the stroke affects on brain . Contra indicated if patient on warfarin

      Start supplementing with Metagenics Zinlori which contains carnitine and Zn (NB: Check to see if this safe in cancer patients )

      NBBB : He needs an overnight Sleep Study to exclude Obstructive Sleep
      apnea which can cause a stroke and MI (Heart attacks) .

      NBB : Please note that the info in this response is not meant to diagnose any condition or provide conclusive treatment options for a given condition. The final decision on such treatments can only be made after a full history is obtained in person and a physical examination is done as part of a consultation in person. The information contained in this communication is confidential and may be legally privileged.
      Please consult with a Functional/Integrative Medicine practitioner for a full evaluation

  91. If it helps I weaned myself off taking magnesiunm citrate x 2 per day. No idea when it worked. Took them for 10 yrs and couldn’t get off this worked and even if the mag has side effects I think less so than this

    • How exactly did you wean Lou? Did you just stop taking the ppi and jumped to the mag citrate? Or did you go down the list of less potentially troublesome OTC heartburn meds such as ratidine?? Thanks!

  92. What’s scary is that there are so many babies and kids on PPI’s nowadays. I’m talking about sick kids with G-tubes. They all puke like nobody’s business. I keep trying to gently tell their parents about my experience with Prevacid but have found they do not want to listen. WTH?

    To make matters worse, the first ingredient listed on their tube feeding formula is “corn syrup solids”. Horrifying!

  93. My husband had very bad reflux all his life, and a hiatal hernia. He was swallowing rennies like sweets. I read a previous article here, that said stop ALL carbs for a time, and then try one at a time. He found that wheat family and potatoes caused the problems, he can eat as much rice as he wants. it is probably different carbs for different people. The occasional treat if eating out causes no harm.

    • Now that you are talking about wheat, I wrote an article here (unfortunately it’s just in italian but you could try google translate) about a little research that I did. Rothia bacteria are gliadin degrading species, thus associated with gluten consumption. Interestingly they are associated with pneumonia, endocarditis and other bad stuff…and not just in immunodeficient people. Not a good idea to harbor them eating wheat, and even worse thinking to take them as probiotics

      • Interesting Alessio. We have wondered why italians eat so much wheat without having as much of wheat related problems as for instance Sweden. And swedes that do better without wheat that go to Italy do not get as much problem. Do you have any idea? Is it the type of wheat that makes a difference? Mostly durum or?

  94. I was diagnosed with stage 2 esophageal cancer in February 2016, after a gall bladder attack in late December 2015, which I originally thought was food poisoning. I was told by my GE to start taking Prilosec daily. I had to have my gall bladder removed in March before I could start chemo and radiation. I was told to keep taking Prilosec the whole time by all the specialists. I got esophagitis from the radiation and had to take carafate for that. I am having a partial esophagectomy on July 1. The surgeon said I will have to continue to take a PPI after surgery to prevent acid reflux in my reconstructed stomach and esophagus and sleep elevated at 30%. I will NOT be able to eat a Paleo diet after surgery. I will be very limited in what I can eat and will have to eat every 2 hours in order to ingest enough calories to stay alive. I DO NOT want to take PPI’s the rest of my life. I am a 62-year old woman. I am supposed to have a nutritionist help me figure out what to eat after surgery. What do you suggest I do?


    • You definitely need to take an acid blocker until you are all healed up from surgery. You do not want your surgically reconstructed esophagus and stomach to be bathed in stomach acid with a pH of 2 – it will prevent the surgical areas from healing and forming a nice, tight connection.

      Follow your post surgical instructions to the letter as far as diet goes – very small amounts, only liquids to start etc. I am an RN and took care of all the patients with esophagectomies. The ones who tried to advance their diet too quickly got perforations. Eventually when everything is healed up you should be able to get off the acid blockers and eat normal foods – but that will be months down the road. Hang in there – it’s a long process – but many patients live long and prosper afterwards.

      The only thing I would advise you to do is to stay away from the liquid meals like Boost. They are full of sugar. Much better to make your own, low sugar, milkshakes or smoothies. Eating sugar is to cancer like pouring gasoline on a fire.

      • I don’t think many physicians are yet clued-in to the role of sugar and carbohydrate restriction in cancer treatment. we are almost at the 100 year anivesary of the initial discovery of the role blood glucose but these things do seem to take time.

        • What upset me the most working in the hospital was seeing what is in the commercially prepared tube feed and the bottled liquid meals like Boost. SUGAR, SUGAR, and more SUGAR plus some soy protein and soybean oil. This is the worst thing you can feed a person who just lost their mandible or their esophagus to cancer. Diabetics would see their blood sugar go out of control. People sensitive to soybeans would have terrible diarrhea.

          If you know anyone who has to receive nutrition through a feeding tube, or be on a liquid diet – please look into how to prepare healthy foods with real, whole foods so they are liquid and safe to put through a feeding tube.

          These preparations are made by Nestle and are downright criminal in my opinion.

      • Thank you so much for your response. I really appreciate it. I am very apprehensive about what my life will be like post-surgery. I was planning to retire in about 5 years. Now, I’m just hoping to stay alive for the next 5 years. The surgeon said he will remove 1/3 of my stomach and 1/3 of my esophagus, and rejoin them. At least it’s not as extensive as I had originally feared. I have other issues to deal with as well. My husband is legally blind due to glaucoma and cannot drive. He is also a cancer survivor from rectal cancer and has an ostomy. I have to help him change his ostomy bag to make sure it’s positioned correctly. Our son is supposed to help him while I’m recuperating, but he is also looking for a new job. Thanks again.


        • Jana, I wish you the best of luck in your recovery. Be aware that this is a very extensive operation and you will not get out of the hospital for 5-7 days at the earliest. Because they have to open up your chest cavity to get to your esophagus, you will have chest tubes placed. You will be on all intravenous fluids and medications until your esophagus heals up a bit. Not even a sip of water for you! No going home in a day or two! Some patients are in the hospital up to 10 days depending on how things go. Not to scare you, but so you can plan for your husband to have the care he needs while you are in the hospital.

          Before you go in, I would recommend getting a really good blender so you can prepare healthy, low sugar liquefied meals. Really, really stay away from the sugar.

          • Thanks again. My surgeon is very experienced and plans to do the partial esophagectomy laprascopically, with several small incisions. I am supposed to be in the hospital 6 days and be sent home with a feeding tube for another week. He also prescribed a home hospital bed so I can sleep elevated. My insurance is supposed to pay for it. He seems to be pretty optimistic about my outcome, but he isn’t the one who has to live with it . I wish I could be as optimistic about it. I do intend to survive and end up cancer-free.


  95. I completely cured my symptoms of GERD by switching to a low carb grain free paleo style diet. Had been advised by GP and various gastroenterologists to just take PPIs on an ongoing basis. Finally met a gastroenterologist who recommended low FODMAP/Paleo and I’m fixed.

  96. I was prescribed a PPI (omeprazole) for a number of years in my early-mid 20’s by a Navy flight surgeon to counteract debilitating acid-reflux (which made it near impossible to fly some days). I was also advised to avoid spicy and acidic foods.

    Fast forward three years and I started crossfit, which got me interested in the paleo diet. I then read a study somewhere about brittle bones from chronic PPI use. Resolving to do something about it, I immediately switched to a paleo diet and quit the once-a-day (at least) habit of the PPI. While there were some withdrawal agonies, about three weeks later the heartburn was gone and as long as I don’t veer too far off the paleo wagon (lots of bread/cereals is the worst, as is a lot of alcohol) I’m good. I now follow a paleo + dairy (no milk but cream, cheese, greek yogurt, etc. seem okay for me) diet with some occasional rice (mostly in sushi). The rare heartburn seems to come from too much sugar or indulging in bread/pizza (which is very rare to even have), and is controlled with a few rolaids or tums.

    For the N+2, my little sister had the same issues, and I convinced her to try going paleo several years ago. Her PPI use was 2x day, and she had the same miserable three weeks getting off them, but has much the same experience I do now.

  97. I have suffered from heartburn since my late 20’s which was
    not managed by my GP correctly. It would appear from personal experience that during the early to middle 80’s my General Practitioner knew little about heartburn, cause, prevention or treatment. During the late 90’s I was scoped and informed I had a hietal hernia causing GERD and was provided with a prescription of Lanzoprazole 30mg which I was to take for life. On the last occasion when I was scoped, I was told that I had Barrett’s Eosophagus together with gastritis and Larangopharyngeal Reflux (Silent Reflux). The latter I was advised to change my PPI (i tried three others) – all of which resulted in intollerable side effects, so I reverted back to Lanzoprazole. I have since learnt by my own research that PPI’s do not treat this condition. Recently I have been advised to take 10ml Gaviscon Advance four times a day, as this neutralizes the enzyme Pepsin, which apparently is the cause of having a continual sore throat.
    Unfortunately, here in England it seems that for anything Gastro related there is a ‘blanket’ treatment! I have never been informed of the dangers of PPI’S. Indeed have been reminded of the importance of taking them!
    Naturally, I am very worried about my health diagnosis. I would be very grateful for any help and advice that I could be given with regard to alternatives that I could take to manage my situation.
    Thank you for providing the general public with such valuable information and giving me the opportunity to write this post.

    • You might ask your doctor about pursuing a surgical intervention for your hiatal hernia. They can pull the stomach down out of the chest cavity, tighten up around the opening so it won’t float back up, and then food has a nice easy flow out into the intestines. No more reflux! No more drugs!

  98. I am currently taking Lanzoprazole twice a day (15mg morning and 15mg evening) for about 2 years now and have always had a suspicion that something else was the cause of my Reflux. I’m not even sure Reflux is what I would call it because I’ve never had heartburn or the standard reactions, I simply get weird feeling like my airway is constricted and its harder to breath, and this is almost always in the evening and after eating food. Doctor(s) of course all just said “here, take lots of these pills”, which never really seemed to do anything, but then after taking them for a year a doctor politely said to me that he wouldn’t recommend stopping them now as stopping them would mean I would make the problem even worse! It was like I’d been conned by a professional conman and was now stuck on these pills.

    My problem is I’ve sought answers relentlessly to my original problem and still not came to any definite conclusions. I’ve heard it might be SIBO, or hernia (had endoscopy, no record of hernia found) or yeast overgrowth, candida, weak sphincter etc etc etc ad infinitum.

    For me, the severe reflux began literally overnight, when after a night drinking on a holiday, I awoke with a pain in my chest and was short of breath, which then became dramatically worse after eating something, so much so that my friend called an ambulance as I was complaining of feeling light headed and unable to breath properly. I was sent home the next day and felt absolutely fine, even so fine as to not have any need to think it was reflux or worry about what I eat.

    Oddly some days now when I eat foods that I feel SHOULD cause reflux, I don’t get any bad effects, and then I have days where I cut out all sugars, grains etc and feel worse. I remember joking to my doctor that perhaps I should begin drinking more alcohol eating more tomatoes and chocolate because i seemed to do fine for years eating that stuff, it wasnt till quitting most of that that I began to feel worse. Anyway I have found light exercise seems to help alot, especially riding a bike or walking. (This leads me to believe slow digestion is the issue and perhaps the cause of any reflux).

    Either way I am astonished at the gobsmacking criminality evident within western health authorities who literally dish these pills out like water. The problem is though, it seems for me and many others, the rebound effects of coming off the PPI’s is so utterley overwhelming (I do NOT want to feel like I can’t breath properly after every meal) that we are stuck between unhealthy PPI’s and debilitating conditions when not taking them.

    I would literally give my right arm and sell all my possesions for a PROPER cure at this point, as I simply do not believe that people’s sphincters just randomly stop working overnight without cause, and the only apparent solution is to take acid reducing tablets which mess up your entire system for the rest of your life. Thats no choice at all is it.

    • What you mention above is almost identical to my personal experiences. I’m in my late 20’s and found this ‘reflux’ problem started virtually overnight! I also have the strange experience you mention regarding the foods I eat, sometimes the foods i’d consider should give me problems often do not and vice-versa, strange?

      I’m currently on 30mg of lansoprazole per day and have been for around 2 years, but am looking to at least reduce this. I feel it may be some kind of nerve damage causing my issues but obviously cannot be certain.

    • Look at magnesium deficiency information. You need good levels of magnesium to allow the sphincter to relax and let food pass without spasms.

      And, much reflux is caused by H. Pylori infestations in the stomach (or food allergies, usually cereal grains). To kill bacteria and yeast overgrowth, try virgin coconut oil 1 teaspoon 3x daily. You may have to work yourself up to that level.

  99. Hi Chris
    I would like your thoughts on my husbands situation. He has been diagnosed with MEN1, Zollinger Ellison Syndrome and Polycystic Kidney Disease. He has been taking Nexium 40 mg three times a day for the past six years and the endo has even suggested he take more as his gastric is now at 900. I have him on a gluten free paleo diet and make my own kefir and include fermented vegetable in his diet. We supplement to promote glutathione which had good results in the first year but not now. His cholesterol is rising and he is borderline diabetic. To look at him he looks well but I know from the hyper parathyroid and arterial calcification he is likely to have a major and possibly catastrophic event I am not able to prevent. I would appreciate any advice from anyone in this feed.

    • The Ckd causes many problems including insulin resistance, ldl resistance raising cholesterol and causing an inability to break down and excrete fats. Gut motility slows and this results in reflux. Sodibic helps both the Ckd and reflux.

  100. I had used Omeprazole for six years, due to being told I had Barrett’s esophagus. Have had regular endoscopies for the same amount of time. This last endoscopy showed that I no longer had Barrett’s. However, now I also have a hiatal hernia, plus “multiple stomach polyps”. The Dr.’s advice was to keep on “managing my symptoms” by using the Omeprazole. But my digestion was so poor that I could barely eat anything without also having to use Tums, Pepcid and sometimes another drug, hyocamine, for the bloat, which I had constantly! It may not have been the right way to discontinue the drug, but I felt I was dying of having a poor appetite, only being able to tolerate carbs but not meat, and being constantly in pain. So, I’ve been off the Omeprazole for close to six weeks now, and the difference is amazing. I am hungry again for healthy foods, my digestion works well and I have not used the Tums, Pepcid or hyocamine even once. I do have fear of the Barrett’s esophagus returning. Yet, so far my GERD is also somewhat better. Now, I feel like I have enough acid in my stomach to actually digest something and it’s a good feeling! I am hoping and praying that I do not have irreversible damage due to the six years of using Omeprazole. But so far, I am tolerating the change fairly well. Have been slowly changing my diet to more meat, vegetable and dairy and am hoping for a natural remedy for the stomach polyps (called nothing to worry about since the one they biopsied was benign!). Not sure what I will do in the future to address GERD if it doesn’t completely heal. But I feel so much better that I don’t feel I can go back on the Omeprazole! Thanks to Chris, I also feel that I have some resources besides the regular practitioners who only treat symptoms but not the underlying causes.

  101. Fascinating article and comments. Insidious and sinister practices by the medical “profession.” Given that my son was nearly killed as a child by numerous doctors, I haven’t seen one in over 10 years and am in excellent health. I will say that my family and I eat very few carbs/sugar, but when I DO eat even one piece of gluten-free bread, I usually am awakened at night by this awful hot vomit coming up my throat. So I have learned to stay away from that type of “food” – definitely not worth it! I sympathize with all who have been tricked by their doctors and their drug reps. I would say to check out as many books about the Paleo Diet as you can from your library and learn as much as you can. Believe me, you will be more intelligent than your doctor about nutrition! For the person who had skin prick tests to ascertain allergies, request an IgG panel, which is a blood test. Also an Antigliadin IgG Antibody test for gluten to see if you have circulating antibodies to the protein in wheat, barley, rye (and sometimes oats, due to cross-contamination in the fields and during processing).

  102. Chris, can you address the factors that cause weakening/dysfunction of the LES, and which ones are reversible? Does constant pressure from carbs/food intolerances/messed up bacteria actually damage the muscle, or just make it open frequently?

    My GI doc gave me a GERD handout that mentioned drugs that can weaken the LES – is that reversible if you stop taking the drugs? How common of a side effect is that? They included antihistamines – I’ve been taking them (Allegra or Claritin or Zyrtec) for maybe 20 years. I wonder if long-term use of those meds could contribute to GERD on top of dietary problems.

  103. I was first instructed by my doctor to take PPIs in my 20s. I was thin and had a pretty good diet but my acid reflux was getting worse and worse. An upper endoscopy confirmed esophagitis. I was on various acid reflux medications for about seven years. The PPIs always worked for a while, but then would stop working as well. My GI doctor would have to increase my dosage or switch medications entirely over and over again. Finally, he switched me to a high dose of Dexilant (a prescription PPI), which I was on for about two years. My acid reflux was much better but I was beginning to experience other issues such as bone pain (in my 30s). I really began to seriously question the dangers of PPIs after I had a relatively mild fall and severely broke several bones in my foot. Following this injury, I decided to research PPIs (which was the only medication besides birth control pills that I was taking at the time) and was startled by what I discovered. I approached my doctor and asked to taper off the medication. He seem surprised but let me do so.
    I’ve since found a functional medicine doctor that has helped dramatically reduce my acid reflux. I switched to Low-FODMAPS diet which helped tremendously. When I tried to re-introduce some of the FODMAPS foods, my acid reflux would come back with a vengeance. So, I plan to stick with the Low-FODMAPS diet. I am also now Paleo, which is extremely helpful as well. Lastly, my functional medicine doctor tested me and later treated me for SIBO. All of this together seemed to mostly eradicate my acid issues. While I will still have mild acid reflux on the rare occasion, it is manageable. My improvement has been truly remarkable.
    What disturbs me the most after reading this informative article and other articles, is that most traditional GI doctors never seem to explore the underlying factors that could be causing the acid reflux. Instead, they push medication on patients with no exit plan. These drugs are simply not meant for the long term.

  104. I just want to say that it is because of you, Chris, and some others that I read in the past that helped me to get on a low carb diet and I really believe that going gluten free was also instrumental in resolving my GERD. I never would have believed it though and I remember the first time I read that low carb would be helpful I really didn’t believe it. I am a nutritionist and had never heard this and didn’t believe it. I went gluten free due to Hashimotos and started low carb living.
    Anyway, my reflux which had led to Barrett’s Esophagus is no longer an issue for me.
    Thank you, thank you over and over again.

  105. A few years ago I had some reflux that bothered my throat. No heartburn. Went to Mass Eye & Ear and they said LPR. Put me on what I now know is an extraordinarily high dose of 80mg of Prilosec AND 300mg of Zantac. Crazy in hindsight but I trusted them. Bad idea. They also told me to eat lots of carbs and stay away from red meat ,,, which I now know if polar opposite of what I should have done. So I ate loads of pasta and bread and stayed away from red meat. After a month I had lost 10 pounds and started to feel much worse. Decided to stop taking the PPI’s but I got whacked with acid rebound. Excruciating heartburn, which I never had in the first place. Wtf.

    Back on the meds but started to try to wean myself off. LPR got worse. Bad sore throats. I was all messed up. Miserable. Turns out the PPI’s gave me SIBO….there had to be a link. Got tested and confirmed but only after I self diagnosed. Doctor refused to believe there was any linkage. In fact, a doctor at Mass Eye and Ear refused to treat me unless I took at least 40mg of Prilosec a day. I felt so bad I thought about suicide. The docs also wanted to put me on big doses of antibiotics to kill the SIBO but I wised up and read a whole bunch about other potential issues related to that. I wasn’t going to follow any more doctors orders. I was on my own.

    I read about low carb solutions and changed my diet. And designed a meticulous plan to slowly wean myself off PPIs. Got off the Zantac first. Then titrated the Prilosec VERY slowly. Took 9 months.

    Lost 20 pounds. Doctor thought I was crazy to get off drugs but I had read enough from Chris and others. Wanted no part of PPIs anymore.

    Long story short: took almost a year to get of the drugs. Paleo helped the LPR a lot. Got to a point I thought I could live again. The SCD diet and consulting with Jordan gave me the conviction to stay on the path.

    6 months later I retested for SIBO and came back negative!! I couldn’t believe it.

    3 years now since no drugs. Still stick to a mostly Paleilo diet, but I include potatoes now. Have regained 15 pounds. Still have lingering stomach issues which I believe is linked to a bacterial Imbalance in my gut caused by PPIs and SIBO. But the LPR is largely gone. No more scorching throats. I can manage around stomach aches (which I think relates to gas from bacterial imbalance).

    I think the next step is probiotics but I am nervous to throw my system out of relative balance again and have yet to find a natural Doctor that can understand what I have been through and how to get me over the last 15 yards back to perfect health.

  106. My 87 yr old mom has lived with us for the last 2.5 yrs. We eat a mainly paleo diet. In February she had a perforation in her duodenum and need surgery. She also has Alzheimers. She was put on a PPI after surgery that she is still on. They said this kind of surgery is common in the elderly. I would not be surprised if her past diet and stress levels didn’t cause this problem but now what should I do? Where do you find a doctor who understands all these things?

  107. I worry about my son: he was diagnosed with silent reflux as a small baby and put onto omeprazole for more than a year. He now has hypomineralisation of his big teeth and has always suffered from a sensitive gut. Are PPIs even licenced for use in babies?? There was certainly no discussion of side effects with his paediatrician at the time.

  108. I was prescribed PPI’s in 2008 for GERD/acid reflux, and was also struggling with IBS-C and anxiety at the time. While the PPI completely eradicated my reflux symptoms (and it felt great to be able to eat whatever I wanted, even straight shots of alcohol!) I did not want to be chronically taking medication that was just treating my symptoms, ad infinitum. When I made the decision to stop the PPI’s, I took acid blockers off and on, and they were not as effective. It almost seemed like my reflux got worse after the PPI’s. Fast forward to 2014, after many years of research, I read Wheat Belly and decided to cut gluten completely to see if it helped – and it did. Upon further research I discovered the condition SIBO (small intestine bacterial overgrowth) and just had a “gut” feeling (pun intended) that this might be my underlying issue. After much exploration and testing with my N.D. I tested positive for SIBO and began the treatment protocol – a Paleo diet, the first 3 weeks being strict AIP. Now in 2016, I can say I am SIBO free, IBS/reflux free, and 45 pounds lighter as well. I maintain about an 80% paleo diet and the other 20% is still gluten free, just includes limited grains such as some organic corn, quinoa and some legumes. Still, I can feel the difference when I eat grains/legumes so do aim to limit those. Long story…but what I mean to say is that the gut issues we are having, they are most definitely related to food choices, and other environmental and internal factors like anxiety, and toxins. But I was fed up with my M.D.’s suggestion that I’d be chronically taking PPI’s for the rest of my life if I didn’t want to have reflux. All it took was a lot of research, finding a good N.D. and commitment to a new diet. Couldn’t be happier even though it’s been a long journey to get here.

  109. I took a PPI to treat/prevent GERD for more than two decades. Then I had a bout of diverticulitis, which caused a fistula between my colon and bladder, which had to be surgically repaired. However, the laparoscopic surgery destabilized my abdominal wall, which a year later resulted in an umbilical hernia, which also had to be surgically repaired.

    Just after getting out of the hospital the first time, I saw a New York Times article on increased awareness of the dangers of long-term PPI use. I immediately suspected the PPI might have something to do with my diverticulitis, and decided to stop taking it — but how could I do it without the GERD returning?

    An internet search on that question led me to Chris Kresser’s website, where he explained how to wean yourself off of PPIs by using digestive enzymes and betaine HCL. I’ve been taking them with every meal ever since, and I only experience mild acid reflux once or twice a month. A little Angostura Bitters in water relieves that symptom.

    But my digestive system has been permanently changed. I got eczema for the first time in my life, and with the help of info on Chris’s website, I determined it was due to leaky gut, with gluten as the worst offender. I’m managing it with dietary changes.

    What’s outrageous is that (as Chris explains in previous posts) PPI use is based on a completely erroneous assumption — that acid reflux is caused by excess stomach acid. PPIs not only disrupt normal digestion, they’re completely unnecessary, since enzymes can treat reflux naturally. For me, PPI use resulted in three hospitalizations, two surgeries, and a lifetime of dietary restrictions.

    So forget the FDA. If your doctor wants to prescribe a PPI for you, threaten to sue him for malpractice. With what we know today, that’s a plausible charge. Maybe if people started doing that, we’d get doctors’ attention.

  110. A great article. I was on PPIs (Omeprazole) for over 7 years, prescribed as my stomach could not tolerate the NSAID (Meloxicam) I had been prescribed for pain (I have fibromyalgia and an underactive thyroid). I was warned off them by a private doctor and nutritional expert but just felt I could not stop the NSAID. My stomach was not happy so I stopped the NSAID. I have now been in pain for many months. I am not sure what else I can do. For the past 6 years I have been on a low carb diet (no bread, pasta, rice etc just the occasional complex carb like lentils). I cut out coffee 10 years ago and now drink hardly any normal tea (just redbush). I eat a good diet of fresh foods. I still get oesophageal spasms from time to time. I also have a hiatus hernia. I was recently treated for generalised candida overgrowth but it came back. I am now wondering if this was caused by the PPIs. I could cope if I was not in constant pain, but is is totally dragging me down.

    • I can relate to your story because I ended up seeing two different rheumatologists for the development of muscle pain head to toe which of course led to the diagnosis of fibromyalgia. Which is a label for “we don’t know what is causing your pain” which for me included plantar fasciitis, restless legs, Piriformis syndrome with sciatica, and shoulder/neck pain radiating down my arms into my hands. This was after I could not recover from a bad car accident and my second time in physical therapy ended up being useless.

      Here is the problem: One doc recommended I stay on PPIs instead of using my foam ramp to control acid reflux at night and to take NSAIDs for my pain all while causing my symptoms to worsen. On top of that he suspected that I was low in magnesium and only recommended I consume foods with magnesium to help while having no knowledge that taking Prilosec and Zantac were causing my issues. Also he failed to recommend supplements or even foods containing the highest levels of magnesium like nuts and greens and kept pushing bananas and orange juice. I knew orange juice was I a no go due to it having as much sugar as a soda so I downed coconut water constantly as it seemed to help some. I began my third round of physical therapy with two steps forward and two steps back while seeking alternate therapies via a naturopath and a chiropractor again.

      When I finally Googled my meds and the accompanying side effects, out of desperation, I found out they were responsible for hypo-magnesium and nephritis (basically an intolerance to the meds that was slowing poisoning my kidneys and causing water gain). After stopping these meds my restless legs and morning stiffness subsided immediately and after a week or two I felt like a person again with bloating gone. My doc was shocked and puzzled at my findings I shared at my last appointment where I tried not to rage over my three years of pain, suffering, and poisioning at his hands. PPIs and acid blockers as Chris mentioned block the absorption of essential minerals, especially magnesium which results in the frequent misdiagnosis of fibromyalgia. The reason is without magnesium your muscles cramp and can’t recover. This why I struggled to improve in physical therapy over several years. This is also why the manufactures of PPIs add magnesium to their formulas to try and combat this issue. But it’s pointless as the other components of the PPI will not allow for the absorption.

      It saddens me how many people are taking things like Cymbalta or other meds for restless legs and muscle pain when they could just take magnesium supplements and eat better. Then to top that off the PPIs cause fatigue for numerous reasons he outlined including inability to absorb B12 and disruption to how cells function healthily. Strangely enough my doc did recommend supplements to help with cell function and energy levels. But what was the point with the PPIs and acid blockers continually damaging my body and preventing normal function.

      As you mentioned the NSAIDs are definitely horrible for stomach issues. My doc had me on Celebrex too since naproxen wasn’t doing the job. But I learned that acid reducers cause these medicines to break down sooner in your digestive system causing even more reflux and upset stomach. There is tons of research out there now on how NSAIDs result in gut permeability and gluten intolerance, which in turn causes more inflammation in the body including muscle pain. This also serves to explains the sudden rise in so many people going gluten free due to our reliance on popping ibufrophen for any and everything when the jury is still out on if these meds are even affective in reducing muscle pain. Most meds prescribed for pain only serve to trick the brain into thinking the pain is not there. They do nothing to promote healing and solve the root cause.

      All of the drugs I mentioned ended up causing more problems then I started with. So what supplements have calmed down my muscle issues? Ones that contain a blend of magnesium citirate, glycinate, and malate with potassium and B6 included (for max absorption). Also Yamuna balls to break up muscle tension. What have I done to curb my GERD/acid reflux and chronic laryngitis then? Small meals (usually slow carb or paleo style but allowing for a few cheat meals a week) consumed without drinking a large beverage as it can interfere with proper stomach acid levels and digestion, dinner early (by 5:30 each night) consuming real yogurt loaded with probiotics (organic kefir, Stoneyfield) or high quality probiotic supplements every day, and elevating the head of my bed or in my case using a memory foam ramp, and finally I had sinus surgery to reduce night time post nasal drip which was causing irritation to my vocal chords, chronic cough, and ultimately my stomach thought the snot was food so it kept on producing more acid to digest it. Terribly gross I know but this has eliminated much of my nighttime acid reflux issues and stomach nausea in the am.

      Also look into natural enzyme supplements you can take with meals that aid digestion after you have tried a food elimination diet to remove offending foods since food allergy tests are inconclusive as they l don’t detect food intolerances. I discovered nightshades (like peppers and tomatoes) bother me, and uncooked onions. Finally, I learned that stimulants used to treat ADHD patients can really help those with chronic fatigue and fibromyalgia get their life back as they increase energy and raise dopamine levels blocking pain and reducing neurological issues resulting in extreme sensitivity to pain. The only drawback is these meds can cause constipatation and dehydration resulting in more issues again, however it is a wonderful last resort for those who have exhausted all natural treatments with only minimal relief. I really hope this information helps others. One day soon I hope to share my struggle via a blog or elsewhere on the internet so that more people can find natural solutions and help for themselves as you really can’t trust western medicine or that your doc is up on current research.

      • Eat only fruit for breakfast, raw or steamed vegetables for lunch and a salad for dinner. Add some real organic olive oil (not supermarket garbage) to the salad and avoid all vinegar dressings. You will automatically be healthier week by week.

        Never eat your fruit after a meal, only before. Your health will change dramatically. When you are healed add your favourite foods one by one for a week and take note.

        Obviously avoid all processed carbs and starch during this time.

  111. I used nexium for several years at 3x the recommended dose until they stopped working. The specialist recommended the gruesome surgery used in severe cases. I had been following a macrobiotice diet that I found online which was recommended for reducing acid reflux symptoms. But it was useless. What saved me was Norm Robillard’s book, “Heartburn Cured”. As Chris suggests as well I went on a low carb diet and found that if I stayed at about 30 grams net carb a day my symptoms are minimal. It is very low but that was my only option. I also use digestive enzymes to help digestive efficiency.

    • If blocking proton pumps all over the body is not safe, then neither is blocking H2.

      The problem is not the proton pump nor the H2.

  112. I’ve been on PPI for two decades – on and off. Mainly on. Recently I experience an ER visit after not being able to breath – acid had sprayed my throat and larynx and I thought I was suffocating. Dr prescribed 40 mg Prilosec 2xday plus 300 mg Zantac at bedtime.
    After healing my throat and esophagus with this regime – Dr telling me to stay on the meds because an endoscopy revealed Barrett’s esophagus (no dysplasia).
    My issue: I want to be off these drugs – my gut is a wreck. My skin is bad – rosacea and eczema. My stomach feels bloated all the time.
    I’m eating a Paleo diet now for a few weeks and feeling much better – but when I stop taking the drugs, my acid reflux is a bear to deal with. I’m seeing a surgeon next week to see if my LES is damaged and that surgery is my ‘cure’.
    I feel like I’m going crazy! Has anyone stopped using PPIs been though you have Barrett’s?? Please share.

    • I “RETRAIN” the retrainable. Are you? How do I do it?

      With Mother Nature’s FARMACY….simple. On the way to becoming a “Doctor” but shifted to a Doctor of NATURAL healing via Sprouting, juicing, culturing, dehydration and Anaerobic Fermentation…[email protected]. I help those willing to help themselves. GI tract is OUT OF WACK. Food sensitivities. STOP going to Doctors of Death

    • I had a Nissan Fundiplication in 2002 thinking it would help my GERD and I wouldn’t have to be on medication. I lasted one year off the PPI’s and had to suffer another 13 years before I figured out a way to get off the PPI’s. Surgery is not the answer despite what the surgeon told me. He said he would guarantee that I would be fixed for life. Not true. I would love to find a Integrated GI doctor like Robyn Chutkin MD who has written several books on gut health. Thanks Chris for this forum and your help getting us all educated.

      • Study Andrew Saul PhD. Genius Othromolecular Medicine. Dr. Axe leaky gut. In order to cast aside years of DIS EASE you have to COMPLETELY change your life for the better. Whatever it takes. Half-assed measures deliver half-assed results.

    • Hi Stephen / Chris and others….I suffered from GERD for probably 30years, I’m now 63. I’ve had all the treatment stuff, both over the counter and prescription during that time …all giving only temporary relief ….nothing worked long term. Up to a couple of years ago I was on both Nexium 40gm and Prevacid together in a last ditch attempt by my doctor to counter the ” strong stomach acid”. I became very ill because of this. In desperation I read all I could on this matter including Chris’s Kresser articles and I can now say I’m over my GERD and all its effects. This is not what I expected. The ” magic bullet ” for me was and is Apple Cider Vinegar. It seems too simple but that’s it. I take it at each main meal. Please read up on it. For me it truely was a “miracle”. Cheers

      • Geoff, I’m really happy for you that you learned a better way to deal with GERD. My sister-in-law used apple cider vinegar for her GERD, and it worked great. I’ve read different places online that acv is great for stomach problems, and it seems to work for so many. Unfortunately, as soon as I try it (with water or in a mixed with other suggested liquids or spices), I get the worst case of heartburn! I don’t even think it tastes that bad, so it would be great if it worked for me. Did acv cause you any problems when you first tried it?

        • I’m 59 and after 2 years of Paleo diet, using pea protein to raise my protein intake, and near zero carbs and gluten for 1 year, now adding back carbs, and ocassionally gluten, paired with twice a week strength training, I have been able reduce from 4 blood pressure Meds to 3 blood pressure Meds.

          I’m currently reducing the Bisoprolol/Concor as I daily track my blood pressure sometimes up to 3 times a day – one upon waking up, one after ingesting two cups of coffee in the morning, and once before sleep.

          After reducing these blood pressure Meds, I have reduced PPI from daily to twice a week, with one (not the usual two) Veragel on days when I don’t take PPI. I think it’s not being carb and gluten free but also one must also do more strength training and increase pure protein intake. I’m targeting to be Meds free eventually.. And I also hope to reduce need for supplements.

          I still dare not reduce the statins I’m taking because I still believe I have to maintain my LDL cholesterol below 100 (or 2.6 depending on whichever measurement) as I have 3 stents already put in for 10years.. I’m worried of my clogged arteries acting up.. Chris, is there a forum where I can read about people with stents attempting to reduce statins maintaining the 100/2.6 LDL cholesterol reading. No read about replacing statins with red yeast but I understand that red yeast is also a statin. Thank you in advance.

        • In reponse to Terri_Dp

          Hi Terri….great to hear about your sister-in-law success with ACV. I started with two teaspoon of ACV in a glass of water, with each main meal, which gave nearly immediate relief. I didn’t have any issues in transferring from the PPI to the ACV …I was just glad to get off the PPI in the ends as I was getting quite ill using them.
          Liquid form was not the most conveniant way to take ACV, so I checked out if there was a pill form…and yes there is. I use Apple Cider Vinegar Tabs made by Source Naturals . I get them posted to me here in Melbourne Australia through Iherb which is an online suppliments company. Each pill is 500gm equivalent to 2 teaspoons of ACV there is no additives preservatives etc…I take one with each meal and can eat anything unlike whist on the PPI…as mentioned this has been a total success for me re the end of GERD and its harmful medications. It worked for me a hopefully you. If you try it I’d love to know how you go….good luck. Cheers

          • Thank you so much for the information! I had no idea I could get acv in any other form. I will definitely get some and see how they work for me.

            • Thanks Terry….yes,I thought a tablet form would be the answer, so I did a web search and the “iherb” site came up . It has a few to choose from but the “Source Naturals” fitted the dosage etc that I read was needed in the liquid form. Each bottle has 180 tabs at approx AU $4.00 per bottle and lasts me a month. Not at all a big expense ! As I said I take one with each main meal and have been doing so for the last 2 years. You might get some “kick back ” at first coming of the the other Meds, I didn’t , I just stopped “cold turkey ” as anything would have been better. It changed everything for me , I felt like a got my life back. When I told my doctor about what I had done , he just said …” good, what ever works” Please let me know how you go , I would be very interested. Best Wishes ..Geoff.

              • I tried the acv for about a week before I decided it wasn’t worth the pain. I don’t know if I’ve had any worse heartburn in my life. I am so disappointed it didn’t work! I know from experience that what works for one won’t work for another, so I’ll try some other things I’ve seen here and see if they help.

        • reponse to Terri_Dp

          Hi Terri….great to hear about your sister-in-law success with ACV. I started with two teaspoon of ACV in a glass of water, with each main meal, which gave nearly immediate relief. I didn’t have any issues in transferring from the PPI to the ACV …I was just glad to get off the PPI in the ends as I was getting quite ill using them.
          Liquid form was not the most conveniant way to take ACV, so I checked out if there was a pill form…and yes there is. I use Apple Cider Vinegar Tabs made by Source Naturals . I get them posted to me here in Melbourne Australia through Iherb which is an online suppliments company. Each pill is 500gm equivalent to 2 teaspoons of ACV there is no additives preservatives etc…I take one with each meal and can eat anything unlike whist on the PPI…as mentioned this has been a total success for me re the end of GERD and its harmful medications. It worked for me a hopefully you. If you try it I’d love to know how you go….good luck. Cheers

    • My husband was diagnosed with Barrets esophagus about 5 years ago. He was on Nexium for a year and his reflux symptoms had subsided, but after reading of the dangers of PPIs, I urged him to stop taking it. Instead, he took HCL pills with meals to help his digestion, and when he’d have occasional heartburn, he took papaya enzyme tablets for relief. At his follow-up endoscopy, his gastroenterologist said everything looked about the same, no change since his last endo. He told my husband to keep doing what he’s been doing. (We didn’t tell the doctor that he’d been off of Nexium for the past 3 years.)

  113. Chris, thanks so much for delving into this topic!

    I’ve had reflux since childhood and I’m now in my late 50s. I took a variety of antacids over the years. 9 years ago I was put on Protonix by an ENT doc who suspected that my ear and throat problems were due to reflux. I was told by my gastroenterologist that many people do well on it for an extended period of time. (I’d also had an EGD to stretch scar tissue near my esophageal sphincter.) The ENT was correct in her dx and the ear/throat issues improved on Protonix. But after 6 years on the drug I felt like I was dying… anxiety, depression, very susceptible to viral illnesses and it took me weeks to get oversimplified colds. I had severe muscle cramping in my diaphragm when I’d cough… also severe cramping (sometimes leaving bruises) in my toes, feet, legs, and hands. I was starting to get tingling sensation in my arms. I couldn’t sleep even when exhausted and to top it all off I had developed severe osteopenia. I’d travelled to Africa several times and each time I was the team member who would get sick with gastroenteritis despite precautions.

    I decided I was tired of having my symptoms treated while the root cause was never investigated so I took myself off Protonix cold turkey. It hurt like crazy for about two weeks then began to ease up. My daughter urged me to try the GAPS diet in an attempt to begin to heal my gut. It helped. I then gradually reintroduced foods. I felt better on a Paleo diet but couldn’t keep my weight up on strict Paleo. It was a couple of years before I could tolerate very many carbs. I developed Barrett’s Esophagus during that time. It’s now 3.5 years later and I am much better. Have finally put some weight back on. I eat a modified Paleo diet these days. I was tested for food intolerances and cut a few of the offending foods out which improved my stomach inflammation. My last EGD showed NO Barrett’s! I feel pretty good these days. I still take Magnesium religiously because even one day missed and my legs start to cramp up. So some things are probably still screwy with my mineral absorption. But yeah, I do better on a mostly Paleo diet.

  114. I’ve been on Nexium for 6 to 8 years and did not know of the dangers as described here. Two years ago I was diagnosed with Barrett’s Esophagus; this year I had a biopsy which was negative. I’d like to know if it is still advisable to wean off due to the precancerous condition. I brought 38 pages of your article regarding GERD to the Gastroenterologist and he would not even look at it. Are there good Naturopathic Doctors in the Phoenix metro area you could recommend who are in line with your thinking about these studies? Thanks, Mary

    • My experience is almost exactly the same. GI Doctor wants me on PPIs. No real listening for alternatives. Weary!

      • Yep, my GI doc was super irritated that I had done any research and looked around on the internet, and had no interest in hearing about food intolerances I’d figured out. Is also irritated I refuse to take PPIs or get scoped (barium swallow didn’t show any problems and I’m just 36). We have a looooong way to go…

        • Mine doctor at least let me cut down to every other day. I have Barrett’s, have had it for many years and have been on Nexium for as long as I can remember. Developed major gut issues and food sensitivities. I am now eating Paleo and feel great. It’s been about a year. My last scope was good and I don’t need another one for 3 years! He still wants me to take the PPI every other day but my goal is to wean myself off them. I think I can talk him into it. (as long as my diet remains in check) I do notice reflux if I cheat. I take a probiotic every day. Not sure how much it helps but something is working. 🙂

      • Doctors sell drugs, that is what they are taught to do and paid to do. just a salary should be enough, but they rewarded by their paymasters with kickbacks of all kinds.

        Meanwhile, relying on the dodgiest of their industry financed trials, the more they sell the bigger the pay-out.

        Fines for fraud within the pharmaceutical industry for the last decade are six billion and counting.

        I am sure there are well meaning doctors, but if they are guided by a corrupt industry, what chance is there of truth.

        Any visit to a doctor should come with a health warning.

    • I am in the same boat Mary and also live in the Phoenix area. I have been on Protonix for about 5 years and was switched to Dexilant for about the last 5 years (twice a day). Paleo and better than Paleo helped but after trying to wean off the nastiest reflux started to occur again. We need some alternative(s)

    • Mary, I don’t personally know of any Naturopathic Physicians in the Phoenix area, but you might try searching for one in your area by using, which is the web site for Arizona Naturopathic Medical Association.

  115. I have been on Omeprezole for at least 12 years. Now notice huge stomach which I have addressed with probiotics and is getting better. I switched to Zantac 150 after reading the negatives on Omeprezole and it does not touch my heartburn. The pain can be pretty bad. So I take Tums and that stops it for awhile. I am also Type 2 diabetic and I have a lot of stress being the only caregiver to my husband who is totally disabled. So you think a Paleo diet will help me? I should also take enzymes? Where would I purchase a comprehensive book on Paleo eating or at least a name of the best book to get? Any help would be much appreciated as my doctor just wrote a RX for Omeprezole again and no discussion of something else to try. Thanks.

    • Yes, a paleo diet will help and from experience, I truly believe it is the only solution. I have suffered from GERD since the birth of my daughter 19 years ago. I have tried PPI’s on and off and I always get muscle cramping. I have tried a low carb diet twice in the past 4 years, and each time the GERD symptoms have disappeared. I now continue to eat small low carb portions several times per day. If I do eat a large meal, I have symptoms, so I have no desire anymore to eat large portions and I keep the carbs down. I prefer not to take any medications. I will turn 50 this year, and I currently take no prescription drugs. Again, I truly believe that you are what you eat!

      • Wow how did you do it? Just go paleo, but aren’t fats bad for GERD it slows down transit time of food in the stomach so reflux is more likely. And by eating protein this ups the need for acids as well.

        Ive been on prilosec for 21yrs and started tapering off and no GERD or stomach pain BUT duodenal ache and small intestine twinges, thinking of tapering off and adding slipper elm and other herbs to protect the mucus lining of my gut, bck on the 20mg of prilosec cause of the tapering off aches, I want to heal my gut for 6 weeks then strt another taper off of the PPI.

  116. I was diagnosed with Barrets Esophogus (BE) end of last year after an endoscopy. The GI doctor immediately but me on Omeprazole. I have been taking them since with no heartburn but reacetly started to worry about the potential long term effects. I have been having more stomach issues since I started taking them and have gotten sick more often. Not sure if coincidence but I believe it could be related to this medication. Another doctor also added famotidine on top of it. So now I’m taking both. I was told by my mother in law who’s a top pharmacist for 2 decades most people only go on Omeprozole for 6 months then transition off to famotidine. My GI doctor said I must stay on it “forever” because BE is irreversible and serious concern for becoming pre-cancerous. I really want to unravel this long line of health garbage, I’m only 36, have a young child and another on the the way and now I”m getting scared. What the heck do I do?? I don’t want cancer and I don’t want these pills to fundamentally change my gut health!

  117. I had been on PPI’s for several years. Have been off now for three months. With the help of a Natrapath who gave me supplements such as melatonin and many others I am finally down to just taking one Zantac a day. It was very difficult. I was sick with stacks after every meal, but I persisted. Finally seeing the light. My advice is to get help and power through. It can be done.

  118. I have been on Nexium for over 8 years now. I tried to stop about 5 years ago but probably went too quickly as I ended up with erosive esophagitis. Went back on them…plus Zantac..stopped the Zantac but not the Nexium. The doctors just keep prescribing them…crazy..
    Now I have issues with my thyroid, heart and blood sugar. And the doctors just want to give me more pills !!
    I see a Naturapath doctor next week.I am trying to get off the Nexium..went to every other day for now..watching what I gluten,sugar, never ate dairy.
    Hopefully the Naturapath Doctor will be helpful.

  119. After being put on ppi’s in my early 30s I now am off and well after 11 years on them. VLC diet combined with every kind of gut assisting / gas reducing natural meds has done the trick. Try reading the “low carb miracle” to get off ppi’s and all of Chis’s other gut articles. When weaning off ppi I recommend cutting your regular pill in half with a knife and taking it that way for a while (just half dose) then space the dose out to 30 hours then 36 to 40 to 48, I was able to wean off after one week but you need to do very low carb diet for at least 1-2 weeks as you wean off. 4 months after dropping the ppi’s I am acid free most days and only get mild symptoms some days that I manage easily without ppi

  120. Unfortunately, I was allergic to the PPIs that my doctor put me on (actually several doctors) who assumed I had acid reflux because I had a constant cough. As I rarely take drugs, (they
    are toxins) I only took a couple of tablets before stopping the original prescription. A week later, my face and ears swelled and became very hot. The doc put me on oral prednisone to stop the reaction. Two years later, another doctor assumed the same, and prescribed that poisonous purple pill, Nexium, which I took for several days and then quit. A week later, I was in the ER with swelling face and tongue for 3 hours and a dose of epinephrine. Two years after that, my EMT doctor prescribed Prilosec – I took only one capsule and was in the ER later that afternoon with the same reaction as above. As it was the ONLY prescription drug I was on and it showed up on the hospital’s computer monitor, we finally realized the PPI was cause for the symptoms. Since taking that original dose in 2005, my health started a nose dive that continues even to today, 11 years later – with a resulting plethora of symptoms – none of which the medical community have any clue as to how to treat or resolve: i.e., I deal with the following symptoms every day: heat and sun intolerance (we have to keep the thermostat at 70 or cooler at all times, which is expensive as we live on the Gulf Coast), and, since I’m sun intolerant, I have to stay inside most of the time – my husband and I can’t go to the beach or take a walk without my face, ears and neck becoming feverishly hot, red and swelling); I have also developed histaminosis and have a very limiting diet (multiple, MULTIPLE food allergies) where if I eat any offending foods, have the same reaction as above; I have edema in my legs and feet which requires I use lymphedema boots for an hour each day to address the swelling; I also have significant eczema and other skin problems; plus intestinal pain and swelling along with several other very concerning side effects. It has had a devastating effect on my and my husband’s quality of life – taking a drug you may be allergic to can affect more than just yourself.
    I’ve taken the time to share this with you all so that you can be informed of the really horrible side effects these drugs can cause for about 1-2% of users (check out side effects in Nexium’s information sheet – in its usual 4point type – and you’ll see that they KNOW that about 1% of us will be COLLATERAL DAMAGE and have our health impaired or destroyed by taking this drug. And the fact they’ve stated such in their 4 point type, pretty much protects them from any fiscal responsibility for the damage they do. I’m now 65 years old and I don’t intend to spend the rest of my life trying to sue a pharmaceutical company with very, very deep pockets. Besides, it took me five years to determine what was causing my symptoms because of the delayed reaction on my body which would put me outside of the time limit most states provide for suing a company. The doctors kept telling me it SIMPLY COULDN’T BE the drug because it wouldn’t cause a delayed reaction. WRONG! Everybody’s BODY is different.
    Let me suggest some alternatives to PPI’s: have a packet of natural (not smoked or salty) almonds with you and chew a few when you feel you are getting “acid-y”. Or carry a container of sliced cantaloupe or cucumbers with you and nosh on them.
    Foods that are naturally alkaline will help counteract the acid
    causing your problem. But be sure to check and see if acid is the problem – maybe you just don’t have enough HCI in your stomach (it naturally declines as you age). Take a sip of apple cider vinegar when you’re having a bout and see if it helps or worsens your problem. If it helps, you’re possibly low in hydrochloric acid. If it makes it worse, eat something alkaline. The ironic thing is, I didn’t have reflux. I had a milk allergy that made me cough. Beware of doctors that ASSUME you have an illness. Demand that testing be conducted and a diagnosis be confirmed BEFORE you take any prescription. Drugs are not innocuous substances.
    Take it from someone who knows.

  121. Hi Chris,
    I was diagnosed with GERD in April of 2012 and have been on and off PPIs ever since. I have a Hiatus Hernia and erosive esophagitis. I have used Nexium, Tecta and Dexilant. At first, the PPIs worked well for my GERD. But then I started having abdominal pain and extreme bloating. So I went off PPIs for close to 1 year. As I was having a lot of heartburn and esophageal pain, I went back on the meds for approx. 9 months. Again, I suffered severe bloating and abdominal pain. I did a lot of research and came across your articles about PPIs and GERD. I followed your advise and started a low carb diet. I then discontinued the Dexilant in April 2016. Also at the same time elevated the head of my bed by 6″ (Inclined Bed Therapy). At first, I experienced extreme heartburn. But I persevered and the heartburn and indigestion stopped after approx. 1 month. I am currently in the process of improving my gut health. Would you recommend a probiotic and a digestive enzyme and if so, what kind would you suggest? I would really like to stay off the PPIs but I recently had an endoscopy and am worried that the specialist will recommend I go back on the meds.

  122. My son was diagnosed with a hiatal hernia, which allows acid to flow up and into the lower part of his esophagus irritating it to the point that it goes into spasms and will not allow food or liquid to go through. There is a strong family history of this issue. His grandfather and great grandfather suffered from similar symptoms. His father had surgery to repair the same issue 15 years ago rather than live on PPI’s, which were the only thing that kept the inflammation down. Multiple times before his surgery he had to have his throat stretched because of the narrowing caused by the constant irritation. Back then there wasn’t much info about the risks of PPI’s, but we were concerned about the affects of long-term use all the same. Now we are so glad that he had the surgery. Still, my son’s symptoms are not as bad as his father’s were, and he does take PPI’s occasionally when the irritation in his esophagus is to the point that he has problems swallowing his food. Taking Prevacid two or three days in a row seems to calm everything back down. He can go for weeks and weeks in between with no issues. He never complains of heartburn. The only symptom he has is his throat closing up on him. What I want to know is this–does intermittent PPI use carry significant risk? Dietary changes and such just don’t cut it when it comes to a hiatal hernia, but the surgery is pretty extreme. It would be an easy choice if he were as bad as his father and had to take PPI’s every day, but that isn’t the case.

    • Dawn, this is very left field but your son’s symptoms sound very similar to those that I experienced (I too have a hiatal hernia). The throat closing up symptom (which for me went from intermittent throat discomfort to chronic dysphagia over time), turned out to be a vitamin B12 deficiency (as Chris goes into in great depth in other parts of this site). The only way I was able to figure this out was through having a vitamin B12 injection for completely unrelated (or so I thought) reasons and waking up the next day being able to swallow again, then having it wear off over a couple of weeks, going back to the doctor for another B12 shot, waking up the next morning and bingo able to swallow again! I used Chris’s protocol on this site methyl B12, TMG, Metafolin and potassium (since I couldn’t get my doctor to listen and since then have figured out that the methyl form of B12 works much better than cyano injections anyway), and six weeks later, absolutely no sign of any further swallowing issues/dysphagia. I also did Chris’s 14Four program and have since been just doing the Specific Carbohydrate Diet to ensure full gut healing occurs, since I can’t get any doctors to listen I have even been writing a blog about this ‘miracle’. I think that the B12 deficiency runs in families a bit, it certainly does in mine. I don’t take PPI’s nor would I ever (my mother was diagnosed with early onset dementia 11 years ago after 20+ years of Losec (Omeprazole) use, I think she was low in B12 anyway and chronic usage of this drug meant she struggled to get B12 from the food she was eating. But have a look at one of the lists of “symptoms of B12 deficiency” out there, there are over 100 symptoms, and my bet is that you’d find your son has a bunch of the other symptoms too.

  123. Very good article. I would like to have seen some encouragement and tips for those like myself who were on PPI’s and have been working on restoring their health. The dementia link is something I wasn’t aware of, but must be due to the gut flora disregulation. I believe my SIBO diagnosis was from taking PPI’s for years. I weaned myself off of them six years ago, and I am still working on healing my digestion. I have been very strict Paleo for two years. Some people like myself can’t do an 80/20 or 90/10 and have to be “Paleo Perfectionists”.

  124. I was prescribed a PPI for gastric erosion, I took one on two consecutive evenings as prescribed. I then had severe diarrhoea and headaches, so severe that I was unable to leave home for three days. It took me three weeks to overcome the diarrhoea and I am resolved to find a more natural method to heal myself. I have also just found out that I have H Pylori which requires two antibiotics plus a PPI to treat conventionally, antibiotics cause acute Candida so I will not be taking that route either.

  125. I am on 40mg of omeprazole for a peptic ulcer. I was rushed to the hospital from severe anemia because of the ulcer. I know this PPI is supposed to repair the ulcer, but it’s been 10 weeks and my GI doc wants me to stay on for at least another month when I will have my 3rd endoscopy since the hospital stay. Do I even need this 3rd one Chris? And although I know it will only be 14 weeks on the PPI I’m wondering how soon the bad effects take place. I am currently by the advisement of my doctor taking B12, magnesium, D3 (and I get sun), C and a probiotic. Any advice from anyone would be great. Btw the only difference I’ve noticed in my health is joint pain in my feet and increased headaches all which my diet has previously fixed. Been Paleo for 5 years and I’m 48.

  126. I had eaten paleo/real food for several years, including homemade sauerkraut and hemp milk kefir. Well I never felt heartburn but finally got esophageal pain because of esophagitis. I guess I am the silent GERD type. So frustrating….many functional doctors discuss preventing heartburn and GERD, but rarely discuss healing esophagitis, because eating sauerkraut can hurt the damaged area. Luckily the dr didn’t see anything requiring a biopsy but I have taken PPI for 3 months to heal. I am slowly getting off it now and having a follow-up scope next week but I still feel a little something on the esophagus. I have been doing natural treatments too. I’m 57 so maybe the sphincter got weak from low acid but I was eating right so it’s frustrating. He said I had a small hiatal hernia too so it’s scary that the acid, while very important, will continue to hurt my esophagus. These side effects are scary, but cancer is too. Any advice would be appreciated.

    • Sometimes that ‘something’ on the esophagus is a bit of neuropathy caused by a vitamin B12 deficiency (have a look at Chris’s explanations around testing for B12 levels, before you believe your doctor who says your B12 levels are ‘normal’. I also can’t eat fermented foods or drinks like kombuscha and am paleo. Have a look at the Specific Carbohydrate Diet and also instead of PPI’s try Betaine Hydrochloride with Pepsin supplements, they are incredible and despite my hiatal hernia etc… I don’t need PPI’s.

      • Thanks, Diana. I have been taking methyl B12 but maybe it’s not enough. I’m just scared not knowing which foods, however healthy, may be triggers for me. Not a single one seems to make it worse. I’ve just been told that acidic/vinegar types will hurt the esophagus more. Sometimes I even wish I had heartburn so I’d know what
        helps and what hurts. I have been adding slippery elm tea and bone broth to heal the esophagitis.
        As I wean off PPI I will start adding HCL and see what happens. ENT told me to be scoped every year since I don’t feel anything until the esophagus is damaged.

  127. Very interesting article. in 1988 I had a Partial Gastrectomy followed in 1992 with a Total Gastrectomy for Peptic Ulcers of which 12 were found after the Partial. Six months after the TG acid reflex started and has been a problem ever since. After numorous tests no real conclusion as to why this is happening. I am on Pantoprazole 40mg x 1 and Ranitidine 300mg x 1, for the forseeable future unless someone comes up with something else. So having been told I wouldn’t need tablets any more I’m still on them, so this article is worrying. I live in the UK and am under St Thomas’ Hospital in London.

  128. I was on PPIs prescribed by my doctor for 8 months to treat GERD. I developed numbness and a burning sensation in my feet and hands, joint pain, inflammation and panic attacks. After reading Martie Whitteken’s book Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec & other acid blockers, I realized I needed to change what I was doing. I changed my diet to quasi Paleo and my reflux symptoms subsided within a week. My other symptoms have gradually diminished over the course of a year.
    There are alternatives to the PPI poisons. Diet and nutrition are the key and the guts to try alternatives to conventional medicine.

  129. I’ve been taking omeprazole for GERD for years. I mean YEARS… 6 years? I recently started doing some research and found out it supposed to be a short term drug. Thanks Doc! In the mean time, my kidney numbers are high and I’ve developed so many new conditions (probably traceable back to omeprazole) that need more medications, including heart problems for which I’ve been prescribed Xarelto which has now caused gynecological problems. It’s such a vicious cycle. I’ve fired my general doctor and found a wonderful osteopathic doctor who is helping me get off the drugs.

  130. I have been on PPIs on and off fro the past 3 years. I had an episode of what I thought was bad asthma on January 18, 2016. I went to the GP for asthma and was prescribed Simbicourt a steroid inhaler. Within 3 days I burned from the throat to the stomach. Went back again and was told I had an allergic reaction and stop the steroid. Pain got progressively worse. Went to the gastroenterologist. He did an endoscopy with biopsies and PH monitor and all it showed was some chronic reflux. Put me on Dexilant was allergic, Esomeprozole was allergic and then regular Nexium which didn’t work. Told me he couldn’t help me and see an ENT. Went to an asthma specialist first who confirmed my wheezing was from Acid Reflux. Just an aside I am in the medical field so I have been researching my condition from the beginning. I had wheezing, coughing, thick white phlegm on waking, heartburn, hoarseness and a permanent lump in my throat. Bought the book Dropping Acid by Jamie Koufman, MD ENT and followed her Induction diet. Started to feel a little better then saw an ENT. The ENT prescribed Protonix and Carafate. More medicine! I was besides myself. I am 5’2 and normally weigh 108lbs. I am now down to 98lbs. I was determined to fix this and went to see an allergist. I thought maybe I am allergic to foods. He did 51 skin tests. Yes I am allergic to several things including hazelnuts and peanuts BUT he said he thought I needed some prednisone to calm down my gut and esophagus. I took it for a week and started feeling better. He called the following week just as I was finishing an article on how yeast and bacteria fill the esophagus from acid reflux and not having enough acid. The article said to give erythromycin and prednisone therapy for 2 weeks. he said to me on the phone to do exactly what I read and he would wean me off the Protonix and fix this whole mess with a plant based diet and cut out all dairy! I am a new person! Struggling a little with rebound heartburn but managing well. No dairy, no coffee, no tea unless Camomile, no alcohol no red meat, very little carbs. Still thin but bloodwork came back excellent! Please believe that diet change is the answer because it really works. Very slowly make changes and the results are huge!

  131. For how long you have to be on any PPI to experience all the listed negative effects….2 months or 2 years? I have been prescribed PPI for 2 months

  132. I was on Paleo diet and after 1 year and after using myfitness pal to focus on the macronutrients, got my weight down but more importantly my waist started reducing too.. I was then on nightly omeprazole and one motillium twice a week. This controls my stomach indigestion pains very well. Then about 2 months back after reading about PPI dangers and because of warnings about arrythmia for motillium, I managed to reduce PPI to twice a week, and half tablet of motillium twice a week. Other non PPI days, are replaced by one tablet of stronger antacid called Veragel. So, I will go on this for a few more months, and after reading your article, will try to get off motillium first, then eventually the twice a week PPI. What do you think of this plan, Chris? Or do you think I should be more aggressive to just get off PPI completely?

  133. We finally got our son off his prevacid after three attempts. ( We had wean him to a low dose, add a low dose of another ppi, slowly remove of prevacid and then slowly remove the second drug.) He needed nutri-west total enzymes for a year after, along with his probiotic and a couple other herbals for schpincter and stomach lining health. I would love to see more recommendations on how to heal after taking PPIs.

  134. Thanks Chris for the in-depth article on PPI’s. I too was on a pump inhibitor for almost TWO DECADES. I can’t even begin to explain the life altering experience i had to go through due to those drugs. Years of GI related issues, IBS etc etc followed. Eating (insanely) well, Paleo/FODMAP i was able to function semi normal and finally seeing Dr Amy Nett, gave me the “road map” to a solution. It has taken me 4 years of trail and error to get through this. I highly recommend you find a integrated natural path doctor that can help you through your approach. It is NOT easy, and it takes enormous effort and consistency, to recover. If your on a PPI, do you sell a favor, find the source of HB and get off the “bandaid” asap.

  135. Can you recommend a schedule for weaning off of PPIs and can you suggest alternatives? I found the article very interesting in pinpointing the problem but it did not give sufficient information as to how to live without PPIs. I have been paleo for years and still need the PPIs. I already take digestive enzymes. Thanks for any help!

    • Elizabeth

      I don’t know if this will help, but when I got off Prilosec I started by actually cutting the tablet (won’t work with capsule) in the beginning cutting about 1/4 off the tablet and staying on that for about a week, if I felt pretty good at the end of the week, then I would cut back a little more, and so on, until I was totally off Prilosec.

      • Judy, did you change anything about your diet? Did you have to add in any less troublesome acid reducers or relievers such as ratadine or tums, etc.?

        • I eat something between a gluten free and sugar free and paleo diet. I use no sugar at all at home (honey, maple syrup, monk’s fruit, sometimes Zylitol, stevia). I eat gluten free at home. When I eat out, I do cheat. I take a Zantac occasionally. I take a digestive enzyme, magnesium, a lot of supplements Dr. Kresser recommended. One thing I did take which was recommended on line by a doctor was Mastic Gum. I don’t know if it helped or not, but I did get better.
          I was on Prilosec for only about 6 months when I weaned off. Now I’m weaning off again since I was given an antibiotic, which I cannot tolerate and had to go back on Prilosec for about 6 weeks.

  136. Just a quick question for now, I’ll get more in depth about my situation with PPI’s later. I’m in the process of weaning off PPI’s and was curious what the best digestive enzyme would be to help aid the process? Thanks!!

    • I’d try the most basic kind, that contains all the enzymes like amylase, protease, and lipase. I take one called Digest Basic which has 11 different enzymes altogether. It’s by Enzymedica. I take one with each meal.

      I also take Dr. Ohhira’s Probiotic. Twice a day.

    • My problem is a hiatal hernia which allows the LES to leak acid into my esophagus. I have pain under the left rib cage which sometimes travels across to the other side along with reflux (at it’s worst I have spasms in the esophagus). On my last visit to the emergency room ( my left arm felt numb, along with the reflux) this doctor mentioned the vagus nerve might be causing some of my problems. I went back on Prilosec temporarily and will ease off, but what is my alternative?

  137. So, what do you do if the reason for the PPI prescription isn’t GERD, but to protect the stomach lining because you have to take NSAIDS everyday for pain? (35 years of Rheumatoid arthritis and daily Indomethicin) )

    NSAIDs tend to prevent the stomach lining from regenerating adequately so they lower your stomach acid to save your stomach lining.

    I know it’s causing me problems, but without the anti-inflammatorys I can’t work.

    • I’ve had RA for 10 years and have had good success with Humira (also not great for you) combined with using Curcumin and fish or cod liver oil. With RA, your choice is often between what does the least harm and helps the most unfortunately. I also eventually discovered that nightshades are very bad triggers for me and things have been much more manageable since. Good luck

      • Thank you Johnny,

        I’d rather stay away from things like Humira for now. Some research says Celebrex has significantly less stomach problems associated with it. Any feedback on Celebrex?

        • I will say the pain Celebrex caused me was the same pain I get with aspirin, naprosyn and ibuprofen, yet others have no trouble with it. I think it’s something each person needs to try to see if it works for them without causing undue stomach distress.

    • I too have RA and have been on Protonix for years and take Naproxen twice a day, as well as Humor injections. I am on a Paleo and intermittent fasting diet to lose weight as well. I am trying to get off as many med’s as possible. Any answers to the stomach protection issues for nsaids users?

      • I have a good friend who had RA and was on very strong meds .She is much better now and off all meds . I’m sure she would tell you what she did .

      • I have gone to EOD Prilosec. This is what has worked for me after initial mild discomfort our bodies give us with changing meds it gets used to. Once a day preferably about an hour + after dinner I drink 6 oz of Organic apple juice with an once (for now) of Organic (Lily of the Desert) Aloe juice ounce of Kumbucha, and 1/2 tsp of Organic Slippery Elm (buy by the 1 lb. Amazon) and 1 tpsp (no more) Apple Cider Vinegar (Bragg). (I don’t know why but do not use w milk or there will be ‘war’ in your belly).

        Although we are all unique and wonderfully made but this drink mix has enabled me to slowly cut my Prilosec in half. My first step was to go from every 24 hours to every 36′ then every 48 hours. I wondered if you can just cut the pill in half and do the same thing, but I was not sure about the how the protective coating of the pill works.

    • Your RA points to an autoimmune disorder. Which also points to a very leaky gut/food intolerances. Fix the leaky gut and you fix the autoimmune disorder which means you fix the inflammation 🙂 there’s a good chance anything in the nightshade family is really aggravating your rheumatoid arthritis

      • Gelatin is a goody for soothing a leaky gut, like great lakes gelatin. Raw apple cider vinegar and raw sauerkraut juice can help boost stomach acid production to help digest your food properly

    • I have nasopharangeal GERD and a million allergies. I have used zinc carnosine supplements, including GastricSoothe by Source naturals and deglycyrrhinated licorice lozenges before meals to protect my stomach lining, and my wonderful gastroenterologist recognized what they are for and told me to continue. I also use digestive enzymes–With the meal, Thorne Bio Gest, which has ox bile as well, since many older people are short on bile, which is needed to digest fats. After the meal, Tropical Papaya by Country Life. I cannot use NSAIDS. Instead I use a lot of turmeric extract, which is calming to your stomach and can make things move along a little also. I have been off Lansoprazole for a week now and feel better. I am also withdrawing from the awful drug Ropinerole (for restless legs–RLS). This is both nauseating and constipating, and I think it really aggravated my GERD, to say nothing of the involuntary twitches I got when it rebounded and augmented. If you are taking this or any dopamine agonist, talk to your Dr. about weaning off. My new Dr. told me even the lowest dose of Ropinerole will eventually rebound. I dropped the Lansoprazole in order to try to get my minerals straightened out to address the possibility that depleted minerals were causing my RLS. Had tried to drop PPIs before, but not succeeded. This time it worked because I had read books re GERD and found out about the zinc carnosine and DGL, and because I was so motivated to do anything to get through the Ropinerole withdrawal.

      • I was diagnosed with the same kind of GERD. See my comment above for help with restless legs. Magnesium supplements do wonders for me as well as getting off the acid reflux meds like Prilosec and Zantac.

  138. I was taking PPIs while living in a sub-Saharan country and have had SIBO for the past 6 years. I ENTIRELY believe that PPIs caused/were part of the reason I developed the overgrowth.

  139. For someone who has been on PPIs for years and then quits, how reversible are these conditions? What can be done to restore your body to its original proton pumping state?

    • A friend found out how harmful PPI’s can be and weaned herself off of them.
      I do not know specifically what she did although SLOW is key.

    • I’m not sure how reversible these conditions are, I’d say it’s different for everyone. Like Mary said taking it slow is the best way to accomplish the task of getting off PPI’s. I have been taking PPI’s for about 11 yrs. Have they done me any good? Yes and No. While it helped provide temporary relief it has also caused me to feel uneasy in more ways than one. I’m not one to be dependent on something for the rest of my life. After struggling for many years and reading about side effects I decided to take a stand. I won’t lie, I was afraid to quit. The unknowns of how you will react to the process and wondering if I’ll make it worse crossed my mind. Keep in mind everyone is different. What might work for me might not work for you. What you need to do is research and educate yourself on the facts. Figure out a plan and give it a try. I started the process of weaning off in late March. I have been doing 3 week intervals. My first 3 weeks consisted of 30mg for 4 days and on the 5th day 15mg. The next 3 weeks consisted of 30 mg for 3 days and on the 4th day 15mg. Basically, every 3 weeks I’d decrease by 1 day until I got to the point of taking 30mg and 15 mg every other day. I have quit 30mg and the plan is to start the process all over again with the 15mg and a Zantac. I took my first Zantac today and felt pretty good. I’m toying with the idea of just taking Zantac for a few days to see how I do. Hopefully I will feel good enough and I can forget about the 15mg PPI. This could be the turning point for me and I can finally say goodbye to the PPI’s. I will mention taking this approach makes getting off PPI’s easier. That being said you will still have your moments and days with flare up’s. I had my share and still feel it somewhat. I suppose that’s part of it and it will take awhile to bounce back. So don’t give in and give up on your bad days. It can be done. I still have a road ahead of me but feel like I have a pretty good start.

  140. I am a CAM practitioner and I have found the very simple, cheap and safe alternative of prescribing 2 x Nat Phos Tissue Salts to be dissolved in the mouth after each meal works very well for most people.

      • Dee, a quick search for homeopathic remedies online should give you several outlets that sell them. I believe you may be able to get this at Amazon as well.

      • You can get it from Cell Salts Tissue Salts World.
        I don’t remember the website name exactly but that should be enough to find it. I buy the Luyties brand on there in a 6x potency.
        Hope this helps:)

      • No it is not the same as baking soda. It is one of the 12 salts that our bodies are made up of and it is triturated to a 6x potency. There is no chance of taking too much.
        Here in Australia all health food shops sell them.

      • An excellent source of homeopathics in U.S. is (I have no affiliation with them nor profit from mentioning them-I have just relied on them as a source of products myself!)
        They not only sell homeopathics but have detailed explanations of symptoms etc.

  141. An article I can wholeheartedly agree with. The revelation that the FDA is virtually a criminal enterprise, is not new, but thank you for reminding us.
    The stool pigeon of Big Pharma, Agro cartels and other sundry corrupt conglomerates, the FDA is any corrupt companies dream come true.

    As for PPI’s being seriously damaging to human health, this is history too. This information is decades old, but thanks for reminding us all.

    • You don’t just stop. Your body has been suppressing it’s natural processes for a long time (depending on usage length). Invest in slowly weening yourself off, and looking at holistic/natural approaches to fixing your diet. It’s a cumulative effort to fix your body, changes don’t happen overnight!

  142. I’ve answered before in your articles on heartburn, but I can’t say enough about this. I am a nurse with 25 years of experience. I have probably 40 years experience with with OTC heartburn relievers and PPI’s.

    Have you taken PPIs?

    Yes I took OTC Tums, Rolaids, Gaviscon, Mylanta for years with not much relief. Then I took OTC Pepcid (which is an H2 blocker) for years before my doctor put me on Prevacid 30 mg twice a day for six months and then once a day for over a year after that. While taking it twice a day I had constant diarrhea, but not C-diff.

    Did you know about the long-term dangers?

    No, my doctor only said she didn’t want me on a high dose for longer than 6 months. But I continued on once a day for over a year more. No warning about the long-term effects.

    Did you notice improvement in your acid reflux by switching to a Paleo diet or reducing your carbohydrate intake?

    Yes, almost immediately I noticed some improvement! But progress was slow. The heartburn didn’t completely go away on Paleo because I was still on Prevacid and weaning myself off it. I should have let my doctor give me a taper schedule.

    At first I started staggering my dose to every other day. When that failed to help, I just quit it altogether. I experienced some really BAD rebound heartburn off Prevacid – especially at first – but kept tweaking my diet (going Paleo is a process!) and doing some intermittent fasting (both those things helped a lot!) I found that two meals a day was all I needed because all of a sudden I was eating way more protein than I was used to eating.

    In hindsight, if I had started taking a good probiotic and also digestive enzymes, I probably would not have had such a rough time. But now I’m completely off PPI’s for good. I haven’t had a cola for almost 3 years now and I can’t stand them! I used to think I could never live without them, but your tastes do change!

    I have to say I am quite angry about not being informed about the dangers of PPI’s not just damaging the stomach and it’s ability to digest and utilize nutrients, but it’s effect all over the whole body. I don’t know what you want to call it, but I call it malpractice.

    • I feel the same as you. As a nurse for 35 years I thought my doctor knew best. I have suffered with occasional heartburn my entire life. Dr perscribed PPI 10 years ago at age 44. I took them for 9 years then stopped last year when I started reading literature about problems with long-term use. Had my 1st bone density at age 54 ( during 1st year of menopause) and guess what?…I have osteoporosis!! Also diagnosed with Vit D deficency recently. Also, found out after going to a Nautropathic doctor that I have SIBO! As a life long suffer of IBS with constipation I can now say after proper treatment of my SIBO I know longer need a laxative daily! Hopefully after taking high doses of Vit D, stopping PPI and getting gut flora in good shape my next bone density will show some improvements.

      • Hi Amber,

        What did your SIBO treatment consist of? Are there natural (Homeopathic) remedies that work for you, or do you need to take Antibiotics?

    • Ginny,
      I have found it a good idea to investigate EVERY prescription I am given.
      for a UTI my doctor wanted to give me a fluoroquinolone antibiotic (Cipro family) that has some VERY serious possible.
      I asked him to order a different antibiotic AND took d-mannose along with it.

      • I had been on Prevacid once before by a surgeon who diagnosed me with an ulcer but for only 60 days at a minimal dose back in ’98. So maybe I wasn’t so suspicious of it since I’d been on it before. But she also wanted me on Simvastatin for high total cholesterol which I had been on before and it made my liver numbers go up. I told her I would not take this drug and she seemed ok. Probably thought I was an idiot. She also wants me on an antidepressant too. The office has gotten a little bit snooty with me since I’d said no to that one too. It’s amazing how blind people can be. I could say something to them but they are deeply steeped in the goodness of medicine. Maybe one day an illness of their own will open their eyes like it did mine.

  143. Hello,

    I took Nexium, which I believe to be a PPI, for roughly 4 years, until just a couple weeks ago. For gastric reflux. I have been having all sorts of discomforts for years as regards the digestive system. I underwent a series of tests recently to try to pinpoint the origins. Endocrins blood tests, gynecologic tests, general blood tests, hepatic blood tests, ultrasounds, cat scan and magnetic resonance. Nothing wrong, say the doctors, other than my liver and pancreas are oversized. They sent me home with the recommendation to cut alcohol for a while. Which I did not abuse to start with. Not satisfied, I started reading more about my various symptoms, which all seem to point to yeast overgrowth. i did read about antacid encouraging such overgrowth, so I decided to quit the medicine about two and half weeks. My reflux had never stopped with the medicine in any case, but I believed it would be worse without. Now I am without, nothing worse, just a bit from th start of this week. To be noted however, I have cut all refined sugars and most others as well (grains, alcohol, fruits other than grapefruit and bluberries, dairy, etc.), and have had in any case a healthy diet with no junk food, little prepared food, no sweets, lots of fish and poultry and veggies all my adult life. To answer your question, no, my doctor never told me of the dangerosity of this medicine. She just kept on renewing the prescription.

  144. I’ll paraphrase my favorite line of this piece. It’s almost criminal that the FDA allows PPIs to be prescribed in such numbers.

    One could say much of what the FDA allows, and often doesnt allow, can be perceived as almost criminal. I now see the FDA as more like the Chamber of Commerce. More a protective and advocacy agency for Big Food Businesses and Big Pharma, then one to protect the general public.

  145. I was on PPI’s for 15+years. 2 years ago I was admitted to the hospital for acute pancreatitis. I was on Prilosec, canasa,zantac and mylanta in high doses. All encouraged by my gastroenterologist. Over several months I weaned off all these drugs. I’m now suffering the side effects for this long term usage. I’ve had 4 fractures in 3.5 years and have osteoporosis. Occluded my coronary artery requiring a stint. Developed cognitve decline and significant brain fog and memory loss. In the last 2 years I have had so many gut bugs. H.Pylori, Blastocystis Hominis and a inbalance in good and bad bacteria in my gut. It has taken so long to clean up my gut from the prolonged use of these drugs. I would encourage anyone on these drugs to bite the bullet and get off. It helps to have a functional medicine practitioner to guide you on this path. Good luck

    • But you didn’t die from esophageal cancer and the pharmaceutical industry made money, so you are a medical science success! Its a good example how your interests and the interests of the others involved in your treatment have quite different goals and measures of success.

      • Yes, so true. And meanwhile the poor gullible public consider their doctors and medicines to be such blessings!


    • Yikes. thanks for sharing. My husband uses PPI’s often. Sometimes, it seems he eats them for breakfast (he uses them so much). I will definitely let him know

  146. Great article. Adding in more HCL and enzymes is another great action step, once people rule in or rule out infections and addressing inflammation to prevent issues taking it.

    Dr. Wrights book on “why stomach acid is good for you” is a must read!

    Thanks Chris!

    • I found I had disrupted digestion causing excessive bloating and consequently even worse reflux, and then even while standing upright. Stopping taking them made things even worse for a few days but then slow improvement to far better than when taking them. It makes sense, with lowered stomach acid digestion would be retarded causing food digested less completely to pass to the intestine, augmenting the amount of fuel for the gas generating bacteria. Why do Engineers always have to figure this stuff out? Its as though thinking of consequences is a foreign concept in biomedical science. Maybe consequences are the enemy of a drug’s financial success so are best ignored. Also I believe many drugs are developed and approved for one-time use or very short term use and PPIs may be OK for a single isolated use. The hypocracy is right on the box. The instruction is to take one a day for up to 14 days and never more often than every four months. The box contains 42 pills. Why would anyone need a years supply which has an expiry-date only six months out? Doctors typically tell patients to take them every day for ever or they will die from esophageal cancer.

      • Americans want quick fixes, they don’t want to work on and do hard stuff to fix their illnesses. “Doc it hurts when i do this…so give me a pill, doc, so I can go on doing what I’m doing.”

        Look at how OTC antacids are marketed. Someone is overeating, they get indigestion, in comes the Saving Formula, and its back to stuffing bad food down their maw. Or as they are now marketed, as something to take pre-meal so to avoid their usually bad reactions later.

        No one makes money telling people to stop eating like sh -…

      • I read a story once, can’t recall where, but it sounds like it may be true. A man complained to his doctor that every time he ate biscuits, his heart began to race. The doctor actually put him on a beta blocker???? Oh sure, that makes perfect sense. So is prescribing a pain pill to someone who says every time he hits himself in the head with a hammer his head begins to hurt.

    • I just finished reading “Why Stomach Acid is Good for You” yesterday. Makes perfect scientific sense. I’ve been on PPI of one kind or another for 8 years. Have tapered off to every other day & added digestive enzymes (from Zenwise). I used to take bitters when I was younger & am going to revisit them. Also considering some of the other supplements mentioned in the book & in this discussion string. My diet could use some work too. PPIs are a harmful enabler of poor eating. Along w/ all of their other faults. Just glad to know I am not alone!

    • HCL allowed me to get off PPI’s in about 2 weeks after years of use. I prefer Thorne Betaine HCL & Pepsin but I’m sure there are others.

      • Hey Scott I have ordered some HCL with Pepsin. Had to order from the US as it’s impossible to find in Australia. So it’s expensive to get here. Have you needed to stay on these for continued relief?

      • Hey Scott, could comment more on your situation? How long did you suffer from reflux and how long did you take ppi’s? What route did you take to getting off the ppi? I was on ppi’s for a good 11 yrs. I think they helped me to a extent but I also feel they equally caused me problems. I’m taking ppi’s for reflux, yet they cause to have reflux, makes no sense. I have been off ppi’s for a week. I replaced the ppi with Zantac 150 each day. I feel better taking this vs the ppi, yet the reflux is still there. It’s mainly in the morning or late at night. I wouldn’t say it’s so bad I can’t stand it type of burning but enough to know it’s there. I have been trying to eat better during this process. I started weaning off the ppi late March and have done fairly well. I noticed your comment about HCL and was wanting some insight on it. I’ve read about the possibility of not having enough acid causing similar symptoms to acid reflux. I have always wondered if this could be my problem. I’d like to give it a try, what’s the worst that could happen? If you could elaborate on HCL and what I could do I’d appreciate it. Anyone who wants to chime in that would be cool too. Also, I just got Digest Basic in the mail today. I’m going to give that a shot too,plus it has probiotics.

        • Try LCHF diet (which is exactly as Chris mentions here). I have erosion of the oesophagus (Im in Australia too). I do not ever take PPI’s even though I was told too by my gastro doctor.
          You will not be sorry if you do this, you will find you not only stop getting reflux/heart burn you will lose weight too, plus plus plus many health benefits.
          Check out

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