by Dr. Quinn Rivet, B.Sc., ND
“Heartburn” is so common that in 2013, it is estimated that 112 million prescriptions for a class of drugs used for stomach acid control, known as Proton Pump Inhibitors or PPI for short, were written worldwide, 26 million in the US alone.
The drug (Proton pump inhibitors) do work well at inhibiting acid production and do provide relief for acid indigestion, however, studies investigating the long term use of the medication have revealed some startling findings. Concerns about this class of medication started as far back as 1998 and recent reviews have demonstrated that long-term use can contribute to chronic kidney disease, bone weakening and fractures, nutritional deficiencies like B12 and magnesium, increased intestinal infections, and most unfortunate is the possibility of PPIs contributing to brain disease in those using the medication who are over 75.
“We Have a Problem Houston”
Stopping the medication is not that easy. For individuals that have been on the medication for some time and who attempt to come off the medication tend to get something known as “rebound hyperacidity” which means that when the stomach initially starts to make its own acid, it has a tendency to make a fare bit. The other problem is that the stomach now has a history of consistently low acid, certain stomach lining protection systems are not running at full steam because of this, so when the stomach increases its acid production the stomach gets irritated and the symptoms come back and are very uncomfortable. So the tendency is to keep taking the pill.
The government of Canada issued its recommendations based on its consulting in a post in 2014.
The recommended dosage to be 20mg/day of for 2 weeks with no repeats for 4 months. So no more than 3 prescriptions per year. Speak with your medical doctor if you have concerns about dosing.
There are other options, another class of drugs known as the H2 blockers may be helpful for those who have serious health issues and need strong medicine. Simple dietary changes like stopping coffee, black tea, decreasing bad fats, and avoiding rich packaged foods can make a world of difference. The herbs slippery elm, marshmallow root, dandelion root, and licorice root have been used to help with stomach acid irritation.
“Heartburn” can result from many different conditions ranging from heart disease, stomach ulcers, liver problems, hiatal hernias, or certain medications. Most of the time, however, it is typically a benign functional issue that can be aided by simple diet, exercise and stress reduction applications. The doctors here at the clinic treat a variety of digestive issues and for those who have heartburn or wish to investigate if they qualify to come off their proton pump inhibitor please feel free to contact the clinic.
Examples of Proton Pump inhibitors (PPI’s)
- Meprazole (Prilosec, Prilosec OTC)
- Lansoprazole (Prevacid, Prevacid 24-Hour)
- Dexlansoprazole (Dexilent, Kapidex)
- Rabeprazole (Aciphex)
- Pantoprazole (Protonix)
- Esomeprazole (Nexium)
- Zegarid, a rapid release form of omeprazole.e
If you are on a proton pump inhibitor (PPI) and have been on it for some time please speak to your medical doctor and see if you should discontinue it and explore other options.
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- Health Canada reference for dosing :Health Canada, Drugs and Health Products, Prescription drug list Notice Prescription Drug List (PDL), march 17t, 2014.
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Xie Y., et al. Proton Pump Inhibitors and Risk of Incident CKD and Progression to ESRD. JASN April 14, 2016.