Acid Reflux – Why Acid Blocking Medications Are Not the Solution

Acid reflux also known as GERD (Gastroesophageal Reflux Disease) or heartburn affects millions of people on a daily basis.  As a result, acid blocking medications like Pepsid, Prilosec, and Nexium are some of the worlds best selling drugs with annual sales in the billions.  These powerful pharmaceutical drugs were originally developed and marketed as a short-term solution for severe cases of peptic ulcers with a suggested use of no longer than six weeks.  Despite this fact, the majority of patients I see who have reported reflux symptoms to their doctor have been placed on one of these medications as a long term solution and have been taking it for years.  Prilosec is even available over the counter now without a prescription.

The danger of taking these drugs in this fashion is that you need stomach acid to digest food and absorb nutrients properly.  Long term use of acid blocking medication has been shown to lead to a myriad of vitamin and mineral deficiencies like magnesium, calcium, and B12 and increased risk of osteoporosis, insomnia, depression, anemia, fatigue, nerve damage, and dementia.  Long term use of acid blockers can also lead to overgrowth of bacteria in the stomach and small intestine leading to peptic ulcer disease and irritable bowel syndrome.

The Underlying Cause

Believe it or not, acid reflux is not typically caused by too much stomach acid but by too little.  Confused?  Well here is a little anatomy and physiology lesson.

Your esophagus is separated from your stomach by a ring of muscles called the Lower Esophageal Sphincter (LES).  This sphincter is responsible for keeping the contents of the stomach including food and stomach acid from entering back up into the esophagus.    The single most important determinant of the LES staying closed and preventing acid reflux into the esophagus is adequate levels of stomach acid.  When there is sufficient acid production in the stomach there is direct feedback to the LES which causes  increased tone and prevents the stomach contents from rising back into the esophagus.  If stomach acid is low when food enters the stomach, the tone of the LES is compromised and is not able to keep the stomach contents, including acid, in the stomach thereby leading to acid reflux.

So what causes low stomach acid production?  On-the-go, high stress lifestyles fool our body into responding as if we are being chased by a tiger instead of peacefully eating dinner.  This stressed state leads to a decreased ability to properly digest our food.   Your nervous system has two main states you are constantly oscillating between.  A sympathetic nervous state is when you are being chased by the tiger and need to move quickly and make fast decisions, a.k.a. “fight-or-flight.”  A parasympathetic nervous state is the “rest-and-digest” state.  One of the main underlying causes for acid reflux is people are eating when they are in a sympathetic dominant state.  This causes insufficient stomach acid production leading to laxity in the LES and regurgitation of the stomach contents into the esophagus.  Bingo.

So why are acid blocking medications dispensed like candy for acid reflux?  The answer is in order to experience relief it is much simpler and quicker to just eliminate the acid altogether than to try and change someone’s lifestyle and dietary habits.  When you take an acid blocker the tone of the LES plummets, but there is no acid left to rise up into the esophagus.  Once again, suppressing the symptom but not treating the cause.

The Real Solution

The following are some simple steps you can take to address the underlying cause of acid reflux and get off your acid blocker for good.

  • Practice good food hygiene.  Take a few deep breaths before meals to relax, smell your food, chew your food thoroughly.  These simple steps will signal to your stomach and pancreas that food is coming and dramatically reduce incidence of acid reflux and increase absorption of vital nutrients.
  • Eat smaller meals slowly and more frequently.  Overeating causes distention of the stomach and decreases LES tone.
  • Get analyzed for a condition called hiatal hernia syndrome (not to be confused with an actual hiatal hernia).
  • Avoid foods and substances which tend to decrease tone of the LES.  Citrus fruits, tomatoes, chocolate, mint, spicy foods, alcohol, caffeine, oral progesterone, refined carbohydrates and cigarettes have all been correlated with decreased LES tone.
  • Find a doctor who will work with you to improve acid production in your stomach.  For more severe cases it is sometimes necessary to use a tapered dose of hydrochloric acid with digestive enzymes until the stomach can produce enough acid independently again.

Conclusions

Acid blocking drugs are effective at temporarily relieving heartburn but when taken long term can lead to serious health consequences.  The real underlying issue with acid reflux is insufficient tone in the lower esophageal sphincter which is caused by stress, improper mealtime habits, and a poor diet leading to decreased stomach acid levels. Addressing the underlying cause of this issue is very important for long term health and wellness.

 

Ryan Sweeney, NMD

Naturopathic Medical Doctor at Root Natural Health, Flagstaff AZ

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17 responses to this post.

  1. This is really informative. Thanks

    Reply

  2. I am just curious…. why is the list of foods to avoid all acidic stuff, if more acid is what the stomach needs?

    Should a person with acid reflux not take Slippery Elm Bark, which lowers stomach acid?

    If the same person who has acid reflux also had ulcer spots in the stomach, what heals those…. more acid? Or is that a whole separate problem?

    Reply

    • Just because they are acidic foods does not mean they promote acid production by the parietal cells in the stomach. Classic apples and oranges scenario. Slippery Elm is very helpful for gastritis and ulcers as it promotes a healing of the gastric lining. I have never seen a source that says it lowers stomach acid levels. Perhaps you are confusing the soothing action it has on the gastric lining with lowering acid levels. Peptic ulcer disease is a more complicated situation and needs to be managed differently. Often h. pylori infection is an underlying cause that needs to be addressed.

      Reply

  3. Excellent post. I have acid reflux disease and am struggling with my heartburn. I will try your suggestions. Thank you

    Reply

  4. Posted by Sue Hallums-Barnes on May 23, 2012 at 3:32 am

    MY Husband has all the symptons of acid reflux without the heart burn,,he watches his diet,,,he is unable to take medicine cause he has colitis problems and the meds he has tried different meds smaller doses and his colitis flares up .. he tried licorise from the health vitamin store and his colits still flarred up we do not know what to do…sometimes he can hardly talk with the refluc symptons…

    Reply

  5. Posted by Hai Streams on October 29, 2012 at 10:50 pm

    Acid reflux can also damage the teeth so be careful with it and seek prompt treatment. ..

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    Reply

    • Thankfully, most people suffering from reflux are not at this level of severity, in which, acid travels all the way up the esophagus. Nonetheless, tooth decay from excess acid in the mouth is an important symptom that shouldn’t be overlooked.

      Reply

  6. Admiring the persistence you put into your site and in depth information you provide.
    It’s good to come across a blog every once in a while that isn’t the same outdated rehashed information.

    Excellent read! I’ve saved your site and I’m adding your
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    Reply

  7. Thank you, great article!

    Reply

  8. Posted by Ahmed Eichstedt on March 14, 2013 at 7:04 am

    In the past, irritable bowel syndrome has been considered a diagnosis of exclusion; however, it is no longer considered a diagnosis of exclusion, but it does have a broad differential diagnosis.[1] No specific motility or structural correlates have been consistently demonstrated; however, experts suggest the use of available guidelines can minimize testing and aid in diagnosis. ”

    Reply

  9. Posted by Frank G on April 11, 2013 at 12:42 pm

    Could you tell me where you got the information about LES tone plummeting with lower stomach acidity? I see this all over the internet but I haven’t been able to find a single source backing it up. It seems to make sense, as I get the worst heartburn ever if I take PPIs.

    Reply

  10. Posted by Craig Lowry on May 10, 2013 at 11:28 pm

    For the longest time I’ve had the feeling that Proton Pump Inhibitors were not the way to go. I figured there’s acid in my stomach for a reason and it has to be there because if it isn’t nothing is going to get broken down the way it should. This story just helps to support my theory. Good article!

    I do admit though that sometimes my reflux gets so bad that I cave and take an extra strength Zantac. As I get older I’ve thought more about my diet and my stomach and have included more fruits and vegetables and less processed foods (and sadly, less meat). However I live in America so it is more difficult as pretty much everywhere you go you’re going to get processed foods. We require things fast and on the go but there’s a price for that.

    Reply

  11. Posted by Annie Monteroso on June 28, 2013 at 6:41 pm

    this is very good for our health

    Reply

  12. Posted by acid reflux and pregnancy on July 5, 2013 at 7:30 am

    Burning Sensation in the Chest – chest pain is characterized by
    the feeling that your food could not move from behind your breastbone.

    An acid reflux pillow does not produce any side effects.
    Heartburn – this is the main symptom of acid reflux or
    GERD.

    Reply

  13. Posted by Pam Stefanic on August 24, 2013 at 1:51 pm

    I have been diagnosed with Acid Reflux, with my main symptoms being a feeling of having a lump in my throat or burning in the back of my throat. I am on Nexium 2x/day, and still get symptoms daily…but now it is more classic heartburn, and occasionally a burning in the back of my throat. I am slender, and watch my diet based on my doctor’s recommendations. What is my next step?

    Reply

  14. Posted by acid reflux medicine treatment on September 23, 2013 at 12:47 am

    Greetings! Very helpful advice within this post!
    It is the little changes tnat make the largest changes.

    Many thanks for sharing!

    Reply

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