Are PPI’s Really Helpful?

Are PPI's Really Helpful?
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What is a PPI? A PPI is a Proton Pump Inhibitor and it is marketed under the names Prilosec, Prevacid, Aciphex, Protonix, and Nexium. They are designed to reduce stomach acid for symptoms of Gastric Esophageal Reflux Disease (GERD). The original design of these drugs was that they were to be used for a limited amount of time with dietary changes. However, they are one of the most widely prescribed drugs by medical doctors today, and, in some cases, it is an unnecessary prescription.

Why are PPI’s problematic?

Stomach acid is necessary for breaking protein bonds, mineral bonds, and keeping pathogens in check. Why is this significant? If you can not break mineral bonds you will be able to unlock the minerals necessary to absorb calcium. Hydrochloric acid is necessary for the digestion of proteins (it unwinds them so that pepsin can break them down), absorption of vitamin B12, and utilization and absorption of minerals such as calcium. Use of PPI’s for longer than a year raises the risk of osteoporosis and bone fractures. Suppressing the production of stomach acid through the long term use of PPI’s will lead to incomplete digestion, poor B12 absorption, poor mineral absorption, and a decreased ability to fend off pathogens.

Michael D. Howell, M.D., M.P.H., of Beth Israel Deaconess Medical Center and Harvard Medical School, and fellow researchers studied the records of more than 100,000 patients discharged from hospitals over a five year period. Daily PPI use, they discovered, was linked to an estimated 74 percent increase in infections due to Clostridium difficile (C. difficile), a bacterium that can cause life-threatening diarrhea and inflammation of the colon. (Source)

PPI-Related Rebound Pain

Reimer and colleagues recruited 120 healthy adults with no history of acid reflux disease for the study.
Half the study participants were treated with daily 40 milligram doses of the PPI Nexium for eight weeks, followed by four weeks on a placebo. The rest took a placebo pill throughout the 12-week trial. Each week, the participants completed a standardized questionnaire designed to rate the severity of gastrointestinal (GI) symptoms. Although symptoms were similar in the two treatment groups at the start of the study, a big difference in symptoms was seen in the weeks after the active treatment group stopped taking the PPI.

In the PPI group, 44% reported at least one acid-related symptom in weeks nine through 12, compared to 15% of the placebo group. By week 12, when the PPI group had been off active treatment for four weeks, about 21% reported symptoms of heartburn, indigestion, or acid regurgitation, compared to slightly less than 2% of those who never took a PPI. The study appears in the July issue of the journal Gastroenterology.

Calls to study participants three months after PPI treatment was stopped confirmed that these symptoms had resolved. “We don’t know how long this rebound effect lasts, but we can say that it is somewhere between four weeks and three months,” says Reimer. This rebound is theorized to the result of an overproduction of the stomach acid-stimulating hormone gastrin in response to PPI-related acid suppression.

When the medication is stopped, the extra gastrin in the blood signals the stomach to work overtime to produce acid. When gastrin levels return to normal, acid secretion leveled out. (Source: Acid Reflux Drugs Cause Rebound Symptoms. Stopping PPI Drugs Can Lead to Increased Acid Reflux. By Salynn Boyles,WebMD Health News. Reviewed by Louise Chang, MD)

I have found in my practice that most GERD related pain is related to food intolerances and/or low stomach acid. By changing the diet, timing of eating (not after 6pm), and adding a digestive enzyme, NeoLife Beta-Gest and Intestine Enzyme, I have seen resolution of symptoms in my clients.

Please DO NOT stop taking your PPI without first consulting your doctor, because of the potential for acid rebound. I am happy to discuss with you a plan to help your digestion.

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