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The Dangers of Proton Pump Inhibitors


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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.  

proton pump inhibitors
Prilosec and other protein pump inhibitors reduce the acidity of the stomach, but not without side effects. istock.com/Roel Smart

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.

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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).

Proton Pump Inhibitors (PPIs) can harm your heart, brain, kidneys, and gut. There are other alternatives. #PPIs

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).

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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.
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Join the conversation

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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)

  11. 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.

  12. 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!

  13. 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: http://www.webmd.com/digestive-disorders/zollinger-ellison-syndrome

          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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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 😀