Indigestion and heartburn are common digestive issues. Approximately 40% of people worldwide
suffer with functional gastrointestinal disorders (FGIDs) like indigestion, heartburn, IBS, diarrhoea
and constipation. I fully understand the frustration, confusion, and challenges that you may be facing
dealing with constant digestive discomfort that may be interfering with your job, relationships and
your quality of life.
Heartburn, also known as acid reflux, happens when stomach acid comes back up into the
oesophagus.
● Burning feeling in the chest
Indigestion also known as dyspepsia, can be caused by an excess in stomach acid but it can also be
the result of several different causes such as ulcers, gastritis, H.Pylori, Cholecystitis, gallstones and
biliary sludge, pancreatitis or gastroparesis.
● Burning feeling or pain in the stomach or abdomen
● Feeling full and bloated
● Feeling sick
● Belching and passing wind
● Bringing Up Bitter tasting fluids into your mouth
If you’ve been to the pharmacist or doctor about your heartburn or indigestion, you may have been
prescribed Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole or Rabeprazole. These
medications are also referred to as PPIs or Proton Pump Inhibitors. PPIs work by reducing the
amount of stomach acid produced by parietal cells in the stomach. This can bring welcome relief from
heartburn and acid reflux symptoms. However, what happens when PPIs are taken long-term?
Prolonged use of PPIs leads to a phenomenon known as rebound acid hypersecretion. However,
rebound reflux can occur after taking PPIs for as little as three days. This rebound effect can create a
cycle of dependency on PPIs, making it challenging to stop using them without experiencing severe
acid reflux symptoms.
NICE guidelines state that “PPIs should be used for the shortest time possible at the lowest dose
possible”. Why? That’s because long term use can result in significant reductions in magnesium and
B12. PPIs reduce stomach acid which means a reduction in symptoms, however the consequence of
this is that they also contribute to impaired digestion and malabsorption of numerous nutrients.
Normal digestion occurs when the pH (potential of hydrogen - a scale used to assess the acidity or
alkalinity) of the stomach is around 1.6 - 3.2. PPIs alter the acidity of the stomach making it more
alkaline, as a result you may struggle more to digest foods like protein. If food is not broken down
adequately, partially digested food starts to ferment and can lead to adverse digestive symptoms such
as bloating, abdominal pain and wind. Partially digested food may also pass through the gut into the
bloodstream which has the potential to trigger the immune system and contribute to food
intolerances and inflammation.
Stomach acid plays a crucial role in killing ingested bacteria and preventing gastrointestinal
infections. Long-term PPI use may increase the risk of bacterial overgrowth in the digestive tract,
leading to increased susceptibility to things such as: Salmonella, E.coli and C. difficile.
NICE guidelines recognise an increased risk of fractures in the elderly when taking high doses of
PPIs for over a year.
While PPIs provide effective short-term relief, they may not be the best long-term solution for
managing heartburn and acid reflux. Diet and lifestyle changes that may help include:
● Avoid triggers such as coffee, alcohol, tomatoes, chocolate, fatty foods or spicy foods
● Stop smoking
● Eating smaller meals
● Avoid eating 3-4 hours before bed
● Maintaining a healthy weight
● Elevate the head of the bed 10-20 cm while sleeping
● While Proton Pump Inhibitors may offer welcome relief from acid reflux, their long-term use
may pose various risks, including nutrient deficiencies, rebound acid production, food
intolerances, increased susceptibility to infections and other complications.
● Considering complementary approaches, such as diet and lifestyle modifications, can
provide effective long-term management while minimising potential side effects.
This blog is for information purposes only. You should never stop taking prescribed medication
without speaking to your doctor first. There are some conditions which make it necessary to
take a PPI long term.
If you’re struggling with heartburn or indigestion or you’re concerned about the long-term use
of PPIs, book a Digestion Rescue Call today. You’ll get a chance to talk about your symptoms
and how they are affecting your life. We can then make a plan and work out how we can work
together to support your digestive health long term so that you can enjoy FOOD FREEDOM
and greater overall health.