The Dangers of Proton Pump Inhibitors | Chris Kresser
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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).

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

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.
Making diet and lifestyle changes is crucial for dealing with any type of digestive issue, GERD included. Switching to a low-carb Paleo diet and eating for gut health are generally much safer and more effective than taking acid-blocking medications like PPIs.

But, even with the knowledge that certain foods or habits are worsening GERD symptoms, it’s not easy for people to make lasting lifestyle changes. That’s because information isn’t enough to inspire change—but the empowering support of a health coach is.

At the ADAPT Health Coach Training Program, we teach you how to leverage mindset, presence, communication skills, and knowledge of Functional and ancestral health to help people who are trying to achieve their goals and change their lives. Our year-long, virtual course is designed to give you the tools and skills a successful health coach needs, while providing you with ample opportunities for hands-on practice.

It’s not easy to leave behind long-held habits. But as a health coach, your support could make the difference for someone who is trying to eliminate PPIs and alleviate their GERD symptoms. Health coaches are powerful, and they have the potential to change the lives of their clients. If that sounds like the right career for you, I encourage you to learn more about the ADAPT Health Coach Training Program.

445 Comments

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  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

        Cheers

    • 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.

  8. 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

  9. 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.

  10. 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!

  11. 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.

  12. 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?

  13. 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!

  14. 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.

  15. 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.

  16. 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!

  17. 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…

  18. 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 🙂

    • Trying using waterwatermelon water to reduce stomach acidity. I was on Omeprezole for 10 years, completely stopped and experienced the acid rebound. I read watermelon water works, tried it and have not had acid problems.

  19. 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?

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