The truth about PPIs – more harmful than helpful?

Are heartburn tablets helping or hindering your health?


Alison Cullen
Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
@AVogelUK
Ask Ali


18 May 2018

PPI’s – how are they meant to help?

Nowadays, symptoms of acid reflux and heartburn are a common complaint for many. The symptoms can be uncomfortable at best but often very painful, and they can easily start to interfere with your eating habits and social occasions, especially if the symptoms are persistent. In many cases, a trip to the doctor will often result in a prescription for proton pump inhibitors (PPI) medication. So how can they help?

PPI’s work by reducing the secretion of hydrochloric acid from special cells in the stomach called ‘proton pumps’. This may help to give the delicate lining of your oesophagus some time to repair and recuperate if there has been consistent reflux! Your oesophagus is a sensitive soul and if the acidic contents of your stomach make contact with it you’ll soon know about it!

So, going forward, PPI’s help keep your stomach acid levels low and in theory, should help to manage the symptoms of acid reflux.

Why do we need stomach acid and could you have too little instead?

Here’s a thought; is it always the case that we should want to keep stomach acid levels super low? See, the trouble is, we actually need sufficient stomach acid for several reasons! 

Firstly, we need sufficient stomach acid to help us break down the food we eat. We need good strong stomach secretions for proteins and fats in particular (you may notice symptoms of indigestion crop up if not). Next, it’s also a vital ingredient for helping us to absorb essential nutrients from our food including iron, magnesium, calcium and vitamin B12. If we go to all the bother of including fresh foods in our diet, we definitely want to reap the benefits from doing so by being able to absorb all the nutritional goodness! And finally, we also need acidic stomach secretions to help keep levels of bad bacteria in the stomach in check. Without sufficient levels, we risk becoming ill at the hands of bugs.

Now, in some instances stomach acid levels can be too high so here PPI drugs may be helpful but in many cases, contrary to popular belief, it seems we have too little acid. In times of stress (a huge contributing factor for many) and as we get older, stomach acid levels decrease which can put us more at risk of lots of troublesome symptoms. 

Some of the symptoms of low stomach acid can include heartburn, bloating, belching and noticing undigested food in your stools and, as above, you can end up being deficient in key nutrients, ill or suffering from further digestive upset as a result.

What are the potential risks of the drugs?

As well as potentially decreasing your stomach acid to very low levels, in recent years PPI’s have also been linked to other health concerns including stomach infections, pneumonia, bone fractures and kidney problems1

As we now know the importance of stomach acid, this doesn’t come as a total surprise, but it is certainly something to be aware of and discuss with your doctor if you have any concerns.

What’s the answer – let’s think logically

So, if you’ve been put on PPI’s, the first piece of advice from me is not to panic. Your doctor has probably put you on them for very good reason and you certainly shouldn’t stop any medication without the ok from your doctor first. 

But let’s just discuss some key points and considerations for you to mull over:

1 – Is the medication really helping your symptoms?

It always surprises me when people explain they’ve been on medication for so many years, yet their symptoms are still bothering them, or more worryingly, getting progressively worse! 

If this is the case, then you should most definitely be going to your doctor straight away to discuss this rather than taking the medication aimlessly.

2 – Is soothing Silicol an option?

If symptoms are getting you down and your chest is feeling heated, why not try some Silicol® Gel to help soothe the symptoms. 

Silicol® Gel is rich in silicic acid which can help calm the discomfort associated with acid reflux or heartburn. Whilst it won’t necessarily help treat the underlying problem, it can be helpful in the meantime while you decide on the best option going forward. Just be sure to take this at least 1 hour apart from any medication you are already on (stomach related or not).

3 – Could bumping up the bitter herbs help? 

If you don’t feel the PPIs are working so well for you, introducing some bitter herbs may be an option. Bitter herbs are especially useful if low stomach acid levels are suspected and they can be used alongside PPI’s if necessary. 

Many cuisines around the world are still in the habit of starting their meal with a bitter tasting element such as a leafy salad, as they understand that the distinctive bitter taste helps gently spur your stomach into action. Taking a tincture 5-10 minutes before eating can produce a similar effect and may help to calm a troubled tum, just in time for your next meal arriving.

 

1. Xie Y, Bowe B, Li T, et al. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans BMJ Open 2017; 7:e015735. doi: 10.1136/bmjopen-2016-015735

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