The Oxymoron in taking Acid Reflux Meds…
Millions of people suffer from digestive issues around the world. One of the most common conditions is GERD, also known as acid reflux. Approximately 20% of adults in western culture suffer from this. In the US, it is between 18.1% to 27.8% of the population. However, the true prevalence of this disorder would be higher because of the frequent use of over-the-counter acid, reducing medications.
GERD is also often associated with other conditions such as hiatal hernia, IBS Irritable Bowel Syndrome), IBD (Inflammatory Bowel Disorders), hypochlorhydria (low stomach acid; seems to be paradoxical to the idea of having antacid, doesn’t it?), H. Pylori infection, candidiasis, food allergy/sensitivities, and so on.
If the symptoms are severe enough, most doctors may order upper GI endoscopies such as EGD (Esophagogastroduodenoscopy) or barium enema, usually followed by PPIs (Proton Pump Inhibitors). But more often than not, the symptom sufferers are blindly prescribed PPIs or antacid meds without any tests or further clinical consideration.
As there are such a depth and many layers of this topic, in this blog, I’d like to focus on the following discussion;
- Are there any other possible causes for my digestive issues other than too much acid or acid reflux?
- Are there any other options than PPI or antacid meds?
- What are the side effects of PPIs?
Are there any other possible causes for my digestive issues other than too much acid or acid reflux?
The answer is YES. Many other conditions may cause similar symptoms as GERD. The physiological impact will be discussed in more detail below. There are conditions such as hypochlorhydria (low stomach acid sounds like an oxymoron, but oftentimes they cause very similar symptoms!), IBS (Irritable Bowel Syndrome), IBD (Inflammatory Bowel Disease), Gastritis, hiatal hernia, exocrine pancreatic dysfunction (inability of the pancreas to produce digestive enzymes), and so on.
Here is an interesting case report that discusses the outcomes of PPI prescription, medication-induced hypochlorhydria, and other aspects of nutritional intervention.
An NCBI Case Report – GERD, IBS, Hypochlorhydria, PPIs & Nutritional Intervention
There is an “HCL Challenge” mentioned in this study at the end. It allows one to find out how much stomach acid/HCL is proper to take.
Are there any other options other than PPIs or antacid meds?
Is Antacid Medication the Only Solution for indigestion or acid reflux (GERD, Gastroesophageal Reflux Disease)? Are there any healthy alternatives without having side effects from PPIs?
The answer is also YES!
Before we discuss other options, let’s take a brief look at why stomach acidity is essential. As the causes of the symptoms can vary, as we discussed above, one can approach with proper lifestyle modification if one suffers from food sensitivities and allergies that constantly inflame the GI system. This improper immune reaction will disrupt stomach acid levels. If one has hypochlorhydria where the food bolus is not properly digested and move along the GI tract, this can cause indigestion along with gas, bloating, and irritation to the gut linings that will trigger other chemical reactions as well as reflux. If this is the case, one can start taking some HCL (Hydrochloric Acid) or Betaine HCL that would also trigger more pancreatic digestive juice and bile to be released into the duodenum. HCL that is produced in parietal cells in the stomach will also trigger a digestive enzyme called pepsin to be released in the stomach. That will aid more proper digestion of all macronutrients in the upper GI to help better absorption in the small intestine. Therefore, the idea of suppressing the acid is very counter-productive, especially when one is experiencing the lack of acid. It appears more so that the food bolus sitting in your stomach has a likelihood of getting refluxed as the sphincter will not get proper stimulation by the absence of the optimal amount of stomach acid. The long-term use of PPIs may also worsen the risk of “Medication-induced hypochlorhydria” for individuals who already have low stomach acid.
More importantly, the presence of stomach acid (HCL) also kills and removes potential pathogens in the GI tract, preventing all sorts of infections. Therefore, artificially lowering acid may create a vulnerable GI environment for H. Pylori, candida, SIBO (Small Intestinal Bacterial Overgrowth), and dysbiosis to thrive by allowing other opportunistic bacteria to grow. If a high amount of acid is present, one would have erosions and ulcers in the GI tract. And they may be visible via endoscopies and radiographs.
There are options for finding out more about your GI function. GI-MAP (Comprehensive PCR Stool analysis) will check the presence of GI pathogens, including parasites, protozoans, H. Pylori, Candida, dysbiosis, and the overall health of your GI system by checking the health of your pancreatic enzyme production, immune function, and more. Simple CMP (Comprehensive Metabolic Panel) will reveal the possibility of hypochlorhydria with zinc and Chloride levels as they may affect the production of the stomach acid. If one has a food allergy/hidden food sensitivity issues, digestive issues are likely. EILSA/ACT may reveal what foods cause these unwanted biochemical reactions in one’s GI tract.
In Eastern/Chinese medicine, “dampness” in the organs, especially “Yin” (the organs that have characteristics of nurturing) ones like the spleen and the liver may produce sluggish digestion and stagnation. Acupuncture treatments and herbs that clear the stagnation would normalize the balance in digestive ability. Visit the Acupuncture Page
From the tests above, The recommendation can be made with lifestyle modification, avoiding allergy/food sensitivity causing foods, digestive enzymes/HCL, anti-candida, anti-H. Pylori, dysbiosis regimen, digestive aiding nutrients and herbs, acupuncture treatments, and so on.
Dr. Choi’s GI Repair Paleo Protocol
What are the side effects of PPIs?
Let’s now discuss the PPIs closely since it is the most popular choice of conventional treatment. This treatment should be short-term, 8-12 weeks in maximum, as the medications block the absorption of vital nutrients. So, taking these medications long term will bring serious side effects such as;
- Bone weakness/fractures
- Kidney disease
- Heart diseases/cardiovascular incidents
- Higher risks of dementia (75 and older)
- Loss of ability to absorb vitamin B12 and calcium
- Decreased serum magnesium level
- Increased Clostridium Difficile infection
- Pneumonia
Check out the links below for the sample reports of the test mentioned above and some of the available supplements that can help with the symptoms.
GI-MAP Test
Food Sensitivity/Allergy Test (ELISA/ACT)
Blood Test (Basic, Expanded, Super Panel)
Enteromend
GI-Encap
Bio-Gest
Digestive Enzymes with HCL
Probiotic GI
It is not a simple topic to be discussed in one blog post, but I hope this helped you understand the different perspectives of this issue, especially if you or someone you know is dealing with this health issue.
Hope you found this helpful!
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The products mentioned on this page are not intended to diagnose, treat, cure, or prevent any disease. The content in this blog should not be used as a substitute for the professional advice and/or recommendation of qualified healthcare practitioners or licensed physicians. The content presented in this blog is intended for information purposes only. Consult your doctor or healthcare practitioners for your current conditions.
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