Acid reflux, Heart burn, GERD – These are all commons ways to describe a condition called gastro-esophageal reflux disease or that burning sensation which often occurs in the chest that is associated with eating. In all of us there is small ring of muscle which helps connect the esophagus to the stomach called the lower esophageal sphincter (AKA the LES). If the LES doesn’t close tightly then stomach acid can splash back up into the esophagus and cause irritation, burning, and coughing. Many people turn to various heartburn medications to ease these symptoms but don’t realize there are implications. Many of them work by neutralizing stomach acid or by stopping the stomach from making acid. Some of the common ones include:
Antacids –Tums, Almagel, Diovol
Proton pump inhibitors (PPIs) – Esomeprazole (Nexium), omeprazole (Losec), etc.
Histamine blockers (H2 blockers) - Cimetidine, ranitidine (Zantac), etc.
These medications are effective at reducing symptoms but the negative side effects and issues usually aren’t fully understood by patients:
Stomach acid is important for killing off bad bacteria and ensuring they don’t sneak through to live in our small intestine or large intestine. By having lower stomach acid these medications lead to an increased risk of intestinal dysbiosis and SIBO.
They decrease absorption of important nutrients such as iron and vitamin B12
They are very difficult to come off of – Rebound reflux occurs which can be worse than the original symptoms were
They are only intended to be used for short periods but people are often on them for many years
It is possible something else could be going on – Hiatal hernias, peptic ulcer disease, H. pylori infection, or others
The root cause is often from low stomach acid not signaling to the LES to fully close. This means we should really be finding ways to increase stomach acid in many people. Some of the options are:
Apple cider vinegar before meals to boost stomach acidity
Bitter herbs like dandelion, gentian, and yarrow to stimulate acid production
Soothing herbs like marshmallow, licorice root, and slippery elm
Avoiding foods which often worsen heartburn such as spicy food, excessive alcohol and coffee, and more
Supplements such and DGL, D-limonene, L-glutamine, or melatonin
CAUTION – There are some conditions where the medications mentioned above are necessary – Do not take yourself off of these medications without the help of a healthcare practitioner
Dr. Kelsey Murray, ND