Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

This week we’re going to be talking about PPIs (Proton Pump Inhibitors). 

PPIs is a special group of medicines that can be both good and bad for your health. 

It’s estimated that 70% of people that use these medicines don’t actually need them, or they simply stay on them too long. 

PPIs are one of the main medicines that I try to get people off of. 


What Do PPIs Do?


PPIs take almost all of the acid out of your stomach. They inhibit those cells that “pump” out acid into the stomach. 

There is no doubt that PPIs work well for certain conditions like Gerd and heartburn, as well as peptic ulcers and esophagitis. 

They are more potent than the first generation of acid reducers, which we call H2 Blockers like Pepcid, Tagamet, Zantac. 

There are quite a few PPIs out there. Here are some you may have heard of: 

  • Prilosec (OTC)
  • Nexium (OTC)
  • Protonix 
  • Dexilant 

Personally, I think they are overused. When a physician puts a patient on one, often the patient will stay on it without question for long periods of time. Plus, the availability of Prilosec and Nexium OTC makes overuse very common. 

God put acid in your stomach for a reason! Acid in your stomach helps with digesting your food and absorbing minerals. 

You also need acid in your stomach to kill bugs, bacterias, and viruses. 

When you inhibit all of the acid in your stomach it can lead to a lot of problems. 

  • Increased risk of Dementia 
  • Increased risk of Lupus 
  • Increased risk of having gut infections 
  • Increased risk of Osteoporosis (can’t absorb Vitamin D)  
  • Increased risk of Pneumonia 

There are not a lot of double blind studies and trials around the side effects of PPIs. These are all observational studies, but they make sense. 

My thoughts are that PPIs should not be used over two weeks unless instructed otherwise by your physician. 


Preventing Heartburn and Gerd 


We know that there are things that cause heartburn: 

  • Alcohol (red wine seems to be worse) 
  • Pepper
  • Garlic
  • Onions
  • Chocolate
  • Citrus
  • Coffee
  • Tomatoes 
  • Greasy foods in general 

As you know, we are all about prevention! There are some things you can do to prevent heartburn and Gerd. 

  • Wear loose clothes
  • Stand up straight 
  • Elevate your head when you’re sleeping
  • Don’t eat at night 
  • Eat small meals
  • Baking soda and water 
  • Ginger
  • Chewing gum after meals 
  • Apple cider vinegar 
  • Warm water with a little lemon and honey (aids in digestion) 
  • DigestShield (Co-Probiotic: Prebiotics, Prebiotics, and Enzymes all in one capsule)


Do you have enough acid in your stomach? 


You need some acid in your stomach. There are people who don’t have enough naturally, which could actually be the cause of their heartburn. NOT ENOUGH acid can be the cause. 

You can test this by taking a pill called Betaine. If you take one and don’t have heartburn, take another. And after the second pill you still don’t have heartburn or an upset stomach then you probably have too little acid in your stomach. 

It’s a cheap test you can do at home. It’s difficult to measure acid in the stomach! 

Note: Covid-19 gets into your intestines and your stomach. It’s been shown that you can shed the virus from your stool for long periods of time. It’s usually gone from your respiratory tract in a matter of 2-3 weeks, but can stay in your stool for months. When a Covid patient is on a PPI, I immediately stop it and put them on something less potent (if needed) like Pepcid. Remember, you need acid in your stomach to kill viruses. 


Final Thoughts


If you’re on a PPI, think about WHY you’re taking that PPI. If you don’t have a good reason, talk to your doctor about getting off of it.