Heartburn? Avoid Antacids & Proton Pump Inhibitors

Heartburn drugs are a $15 billion-a-year industry in North America.

Heartburn can be a sign of:

• Ulcers
• Gastritis
• GERD (gastro-esophageal reflux disorder)
• H. pylori infections
• Zollinger-Ellison Syndrome (rarely seen)

What Is a Proton Pump Inhibitor?

The most popular and powerful of all the heartburn drugs are the proton pump inhibitors. They get this name because they bind or inhibit an enzyme (hydrogen potassium adenosine triphosphatase) that is also known as the proton pump.

The proton pump causes the parietal cells in the stomach to produce acid. Through this proton pump inhibition, stomach acidity is reduced or eliminated much more than the histamine H-2 receptor blockers (e.g., cimetidine or ranitidine) and for much longer periods of time.

The best known of this class of drugs are:

• Esomeprazole (Nexium)
• Lansoprazole (Prevacid)
• Omeprazole (Prilosec, Losec)
• Pantoprazole (Protonix)
• Rabeprazole (Pariet)

Side Effects of Proton Pump Inhibitors

These drugs are well tolerated if used for a few days or weeks, but common side effects include:

• Constipation—a frequent symptom of excessively low stomach acidity
• Diarrhea
• Headache
• Skin itch
• Skin rash

Rarely, there are reported cases of:

• Acute pancreatitis
• Flu-like illnesses
• Vomiting
• Low platelets
• Hepatitis
• Autoimmune disorders

The adverse drug reactions are variable from person to person but can be quite devastating when used for extended periods of time.

Hip Fractures

Both proton pump inhibitors and the histamine H-2 blocking drugs can raise the risk of hip fractures by 44% if taken for longer than a year. This is because when you block acid production, you make it more difficult for the body to absorb calcium.

Irritable Bowel Syndrome

When you decrease or eliminate acid production with these drugs or liquid antacids (e.g., Maalox, Gaviscon, Mylanta, etc.), you make it harder for the gastrointestinal tract to digest food. This can cause gas, bloating, and constipation. Sometimes this set of symptoms is labeled as IBS (irritable bowel syndrome), for which further medication is often prescribed.

Colonic Irrigation, Anyone?

When either proton pump inhibitors or the histamine H-2 receptor blockers like Tagamet, Zantac, or Pepcid are used, stomach acidity can become so reduced that the body fails to absorb vital nutrients like iron, calcium, zinc, and numerous others.

You also reduce your primary defense against bugs in food (bacteria, parasites, and fungi like Candida). This then can lead to both acute and chronic gastrointestinal infections and often sets one up for a lifetime of IBS, Candidiasis, and food sensitivity syndromes. Essentially, you are increasing your risk of food poisoning every time you use these “remedies.”

Clostridium difficile bacteria can cause life-threatening colitis. A 2005 study in the Journal of the American Medical Association discovered that people taking proton pump inhibitors were almost three times more likely to have a C. difficile infection than non-users. Those taking H2 receptor antagonists were twice as likely to have the infection.

Interested in Getting Pneumonia?

A 2004 study reported in The Journal of the American Medical Association concluded that the risk of pneumonia was 89% higher for those using proton pump inhibitors and 63% higher for those using H2-receptor antagonists.

Acid-suppressive drug users were four times more likely to have pneumonia than nonusers.

Stomach Acid is GOOD?

This pneumonia study underlines the importance of stomach acid as a systemic immune-boosting substance. Suppressing acid will have its infectious disease consequences, especially if this is done on a long-term basis.

In 2000, the histamine H-2 receptor blocker Propulsid was taken off the market due to associated cardiac deaths.

While it seems to me that only cardiac deaths are the sole reason the HPB and the FDA takes drugs off the market, perhaps increasing rates of life-threatening pneumonias and C. difficile infections ought to be considered for drug removal as well.

AVOID These Drugs!

Proton pump inhibitors and the histamine H-2 receptor blockers should be used sparingly—if used at all. Certainly, the natural alternatives are a better option here.

In my next blog, I will share the best natural remedies for dealing with heartburn.

Additional References:

Vanderhoff, Bruce T., and Rundsarah M. Tahboub. "Proton Pump Inhibitors: An Update." American Family Physician 66 (2002): 273-80.

Physicians' Desk Reference 2005. Montvale, NJ: Thomson Healthcare, 2004.