Proton pump inhibitors (PPI) are one of the most prescribed medications and one of the most dangerous. They are intended for short-term use, two weeks or less, however, many people have been on them for years. And they are now being recommended for babies! The dangers lie in the fact that we need stomach acid for optimal digestion and absorption of food. Additionally, proton pumps are part of almost every cell in your entire body, not just the cells in your stomach. So you are not only inhibiting the ability of the cells of your stomach to work, you are also disrupting almost all the cells in your body. Chronic use of PPI's put you at risk for osteoporosis, nutrient deficiency, weakened immune system, bacterial overgrowth, increased risk of cardiovascular disease and reliance on the drug because of the severe rebound effect when trying to get off of them.
This may sound counterintuitive, and most certainly not something you will be told by your doctor, but heartburn is often due to a lack of hydrochloric acid (HCL), not the over production of it. How can this be you ask? HCL is not only necessary to help breakdown food, but it is an irritant to the cardiac sphincter -- the hole at the bottom of the esophagus that leads to the stomach. When there is enough HCL in the stomach the sphincter will stay closed because the acid causes it to stay closed, however when there is not enough it does not get the message to close and that is when you get reflux.
So what causes low stomach acid? Aging is one cause. While we cannot stop the natural process of growing old, we can optimize it. Poor diet, lack of sleep, over use of antibiotics, proton pump inhibitor use, NSAID's, food sensitivities, overweight/obesity and eating too quickly are other causes that are 100% modifiable.
One last culprit that is rarely discussed is poor breathing patterns. The esophagus (food tube) pierces the diaphragm en route to the stomach. This is a problem because the diaphragm, one of the main muscles involved in breathing, is also responsible for keeping the cardiac sphincter closed. However, when breathing is shallow -- in the chest instead of deep in the belly, the diaphragm is not in the optimal position to keep the lower portion of the esophagus closed. Have you ever laughed while eating and had the lovely experience of bringing food back up? This is because when laughing the diaphragm is highly active, moving up and down as you catch your breath. When you laugh, with each exhalation, the diaphragm relaxes and this is when food has the opportunity to make its appearance. How this phenomena is related to heartburn is the simple fact that when you don't breathe into the belly your diaphragm is only partially working, therefore not fully contracting around the esophagus.
What should you do to prevent heartburn? First would be to throw away your heartburn medication! However, if you have been on it for years, it would be best to slowly ween yourself off of them. But if you are willing to tough it out a week or so, then toss them. Second, I would get in touch with someone who can accurately assess your breathing. Third, look at your diet. There are many foods that can exacerbate heartburn, many of which you probably already know. Fourth, address the stress in your life. Fifth, start taking a probiotic. Chronic use of PPI's do a number on the good bacteria in your stomach. Probiotics will help support the repopulation. Sixth, get some exercise and find other ways of getting some self-care into your routine.
Finally, if you need support in addressing heartburn, please seek help that does not take a medication approach. Schedule an appointment with me. I can help.