PPI (proton pump inhibitor) prescriptions written for in the U.S. last year totaled $9.5 billion in sales. These are given to patients who complain about digestion issues, primarily heartburn, flatulence and bloating. Many do not need to be on these medications. The FDA has approved these medications for short term usage (8 weeks), but most patients find themselves on these for the long term and are unclear about why they should try to discontinue usage and how to do so.
How did we get here?
Over the last one hundred years, we have morphed our diet into what has become known as the SAD diet (Standard American Diet). This acronym is appropriate because there are often not a lot of nutrients in the heavily processed foods, trans-fats, and sodas that a lot of us have come to ingest daily. We also are eating far more sugar than we did in decades past and many of us also consume alcohol, which also is acidic and contains much sugar. Many of our modern food choices are highly acidic in comparison to whole, non-processed foods, and these new foods aggravate our stomach.
How are stomachs work as we age:
After the age of 40, at least 40% of us do not produce as much of the stomach acid we once did, and foods that contain a lot of acid actually become harder to digest. You actually need more stomach acid to digest these foods in many cases, but we run on lower acid making abilities as we age. This is actually the cause of many of people’s heartburn symptoms. So, actually taking PPI’s or H2 blockers (which further reduce stomach acid production) is not actually helping to digest food and absorb nutrients, but just addresses symptoms of heartburn by cutting out the acid that would have aided the digestive process. The end result is that we no longer absorb things through the stomach and digestion is delayed until food hits the small intestines.
Consequences of the diet and taking PPI’s and H2 blockers: One of the main consequences of this change in the digestive process is that we do not absorb calcium, iron, vitamin B12 and folic acid. Another consequence of taking these medications is that with low acidity and the presence of undigested food, harmful bacteria are more likely to colonize the stomach and interfere even more with digestion. Normal levels of stomach acid help to keep the digestive system free of harmful bacteria and parasites.
So, a lot of people think they have too much stomach acid when they actually have too little to do the job of digestion. They treat the symptoms causing other larger health problems. Then, they ultimately lose the capacity to make stomach acid and end up on continual use of medications.
PPI’s are stronger than H2 blockers: the former stops all stomach acid production (shuts down proton pumps) and the latter blocks receptors in acid producing cells.
How to get back on track/ Weaning off of PPI’s and H2 blockers:
-Generally: choose more natural whole foods in diet (and red wine over white wine or beer). Use bitter foods and herbs in cooking, such as artichokes as an appetizer, which stimulates more stomach acid production, aiding digestion.
-Here is a method to wean off of these meds. If on PPI, you’ll be first gradually substituting with an H2 blocker or Swedish bitters (1 teaspoon 10 minutes before each meal.). If using H2 blocker, switch to Swedish Bitters as the substitute.
-For first 2 weeks of weaning: skip the dose of PPI every 3rd day, instead take an H2 blocker like ranitidine or famotidine or use 1 teaspoon of Swedish Bitters 10 minutes before meals.
– Next, skip the PPI or H2 blocker every other day with using Swedish bitters every day for 3 weeks. You may stay on this step longer than suggested, stretching out using any medications beyond Swedish Bitters.
-Finally, switch entirely to using bitters before meals as needed to manage symptoms of heartburn. What is key here is to be eating differently as then you should have less tendency to flare up. Eating differently means avoiding soda, white wine and beer, processed foods.
-Other products that can ease this weaning process: 2-3 cups Herbal Medicinals Throat Coat tea daily, which coats digestive tract and soothes. Drinking 2- 4 oz of Aloe Vera Juice before meals. Tablespoon apple cider vinegar (use in salad dressing). Take probiotics several times weekly to help populate your gut with helpful bacteria.