Heartburn affects 5 million Canadians at least once a week. The most common class of drugs prescribed for heartburn is a Proton Pump Inhibitor (PPI). PPIs block the production of acid in the stomach. Example of a PPI is omeprazole or Losec, Porlisec. PPIs were meant to prescribed for a short duration. Evidence shows that the short-term use of a PPI for reflux esophagitis, H. Pylori overgrowth or an active ulcer is effective.
The stomach and its acid are a crutial part of a good digestive system and balance in the microbiome. Acid is important to keep pathogens at bay, help digest protein and stimulate the pancreas to excrete digestive enzymes.
Because PPIs block stomach acid production, you can see how the long term use will affect things down stream. PPIs are over prescribed and many side-effects are not discussed when they are recommended. Three meta-analysis show that the short term use of PPIs increase the risk of pneumonia by 27-39% as well as a two-fold risk of a C. difficule infection. Other side-effects of PPIs include iron deficiency, vitamin B12 deficiency, low platelet count, muscle injury and inflammation in the kidneys.
PPIs also disrupt the absorption of fats and fat soluable vitamins such as vitamin A, D, E and K as well as other vitamins and minerals such as vitamin C, mangnesium and calcium. Because of this, there's an increase risk of bone fractures, high blood pressure, type 2 diabetes and metabolic syndrome. Low levels of magnesium can also lead to inflammation and cardiovascular disease.
Furthermore, PPIs can disrubt the lining of your digestive tract and increase the susceptiblity of IBS, celiac disease, gluten sensitivity and inflammatory bowel disease such as Crohn's and Colitis.
Unfortunately, coming off of PPIs is difficult. Many people who try to come off of it experience an increase in stomach acid above the levels experienced before treatment. This results in worsening of the heartburn symptoms. Consult with your prescribing physician about coming off of the medication if it is appropriate slowly. Reflux can often be managed by changing the diet, exercising and reducing stress. Supplements such as probiotics, slippery elm, marshmallow root, dandelion root and licorice root can be helpful in treating the symptoms of heartburn.