Any reason for PWME not to take protein pump inhibitors?

[Sasha]

I had a look at whether PPI might affect the gut microbiome - I'm anxious to protect mine - and this very recent paper suggests that they do, and for the worse:

http://www.sciencedaily.com/releases/2014/11/141125074656.htm

 

[Changexpert]

Sherlock is right on point. PPI is designed to suppress stomach acid level and it is very good at doing that. Within 3 days of PPI, your stomach acid level is reduced by more than half. This is a double-edged sword, even for h. pylori treatment. People who've had triple threat treatment report constant heartburn after the treatment because low stomach acid level creates a perfect environment for other pathogens to proliferate. Basically, you are harvesting other pathogens while killing h. pylori. There are numerous horror stories out there for h. pylori treatment. I know this because I used PPI for just one day for h. pylori eradication, and on that night, I had a mild heartburn along with severe dysphagia.

Most people who suffer from heartburn and other digestives issues are usually low in stomach acid, not high. One way to test this theory is to take supplements that either increase or decrease stomach acid level. One supplement that increase stomach acid level is Betaine HCL, and PPI does the opposite. Pathogens do not thrive in acidic stomach, so it is very important to keep your stomach acid level high (low pH).

One more note, esophageal valve is the guardian of stomach. When this valve is broken, the stomach acid travels in reverse, toward the throat, which results in heartburn. The valve can open or block the passage based on stomach acidity, meaning that low stomach acid level will give false safety for valve to open up. Once the stomach acid passes the valve, it can wreak havoc in the other parts of the body due to lack of protective coating.

 

[Sasha]

Thanks, @Changexpert - I'm seeking testing for low acid.

 

[jimells]

One more note, esophageal valve is the guardian of stomach. When this valve is broken, the stomach acid travels in reverse, toward the throat, which results in heartburn. The valve can open or block the passage based on stomach acidity, meaning that low stomach acid level will give false safety for valve to open up. Once the stomach acid passes the valve, it can wreak havoc in the other parts of the body due to lack of protective coating.

Well this is very interesting. I found a discussion on using Tagamet for improving ME symptoms due to its effect on T-reg cells (sorry, I don't really know what they are, aside from being immune cells). I have had occasional heartburn in the past, but nothing regular. After fooling with the Tagamet for ten days, I now have heartburn nearly every night. It's almost always late evening, a number of hours after eating - shouldn't the stomach be empty by then? The Tagamet didn't help my ME symptoms, and maybe made them worse, oh well.

Last night the heartburn came on earlier than usual and the Tums didn't really stop it, so I tried another Tagamet and it didn't help either. The theory of low acid causing early opening of the valve sounds plausible for me. I've been considering the idea of actually trying to get to the doctor's office, but now that doesn't sound like a good idea, since they would probably end up not helping.

I sure get tired of trying to be my own doctor. I sure wish I could find one that knows what they are doing...

 

[Mij]

@Sasha are you familiar with Pepzin GI? I've been taking this for the past 8 months and believe it healed my gut lining after so many years. I'm absorbing nutrients from food now, my iron levels etc. have gone way up. I bought it from iherb.

http://www.jwatch.org/jg201103180000002/2011/03/18/zinc-inhibits-gastric-acid-secretion

The human intervention study showed that oral zinc (with or without omeprazole) increased gastric pH compared with water or omeprazole alone for a period of 3 hours. The authors concluded that zinc produced a rapid and prolonged inhibition of gastric acid secretion and offers a potential therapeutic alternative to proton-pump inhibitors (PPIs).

 

[Sasha]

@Sasha are you familiar with Pepzin GI? I've been taking this for the past 8 months and believe it healed my gut lining after so many years. I'm absorbing nutrients from food now, my iron levels etc. have gone way up. I bought it from iherb.

http://www.jwatch.org/jg201103180000002/2011/03/18/zinc-inhibits-gastric-acid-secretion

The human intervention study showed that oral zinc (with or without omeprazole) increased gastric pH compared with water or omeprazole alone for a period of 3 hours. The authors concluded that zinc produced a rapid and prolonged inhibition of gastric acid secretion and offers a potential therapeutic alternative to proton-pump inhibitors (PPIs).

Never heard of it - I'll take a look.

Glad you've done so well on it!

 

[caledonia]

Acid reflux is related to either high or low stomach acid which is related to the adrenals.

I've had reflux due to both low and high stomach acid.

For low stomach acid, take betaine hydrochloride with each meal and work on fixing the adrenal fatigue.

For high stomach acid, a PPI or H2 blocker can be very helpful along with working on lowering cortisol. Once the cortisol is lowered you can get off the med. I was on Dexilant (a PPI) for 6 months and my stomach was very touchy for several months after that. I believe this is the rebound effect mentioned.

I was recently on Pepsid (an H2 blocker) for 4 months and I started getting magnesium depletion despite being maxed out with magnesium supplementation. I researched it and the problem is the H2 blocker changes the nature of the parietal cells in the stomach so they produce less acid but it can also deplete nutrients.

So you basically have to wait for enough new parietal cells to grow back, which takes up to 52 days. Maybe this is what is happening with the PPI and the rebound effect too, not sure.

In general, for reflux, eat a bit lighter - you don't want to be overly full. Elevating the head of the bed 4"-6" can help whether you put some books under the legs, or use a wedge pillow. Wait at least an hour after eating before laying down in bed. If you eat a larger meal, two or three hours even might be better.

Anyway, the good news is that reflux is treatable and survivable, and you can get better without needing to be on medicine forever.

 

[Kathevans]

I'm a cautionary tale when it comes to taking these acid lowering pills. I took zantac for about eight years for reflux, often at only a half dose at night. After taking it for about six months I had more stomach bloating, more burping than I'd had. The doctor said I was swallowing air. I didn't think so.

I finally got off the Zantac, which was difficult because of its rebound effect, and slowly began to address the real problem, which was too little stomach acid. I began to sip lemon juice with my meals, and use sea salt, which helps with stomach acid. Unfortunately, more damage was done than I realized at the time. @Sasha's article from the Mayo clinic about the problems of absorption related to these drugs probably played a role in the deterioration of my health. A lowering of B12 would have been especially problematic, given my MTRR genetic snps.

As it happened, a course of antibiotics put me over the edge. Within six months I had fatigue, post exertional malaise, no muscle recovery, rashes on my chest and back, sensitivities to everything. And this has been my story for more years than I want to count.

I'm looking into Betaine now, hoping it might help now that the lemon juice, a few years of probiotics and sauerkraut have helped to strengthen my gut. But I'm not sure my microbiome will ever fully recover from the imbalance that the acid lowering meds created.

Still, I'm happy to have discovered PR and a community of people motivated by the Holy Grail of health.

I want to drink from that cup!

 

[maddietod]

I tried Prilosec for a few days and suddenly got such terrible intestinal pain that I threw up. I'm very sensitive to drugs, and am afraid to try PPIs. I also find that every drug seems to have side effects that aren't common but are reported, and I get all of them.

I've been researching, and one interesting thing I found was YouTube videos about hiatal hernias and reflux. If this is (all or partly) the issue, you pull the stomach down. I'm not interested in finding out if I have a hiatal hernia - it's much easier to do the exercises and see if I feel better.

This has helped a lot. My throat hurts from the acid, so I'm also eating/drinking a soft, non-irritating diet.

I'll only take PPIs as a very very last resort.

 

[Kathevans]

@madietodd I truly understand. I still sleep half-sitting up at the beginning of the night... I've never heard of these exercises you speak of, but the thing that finally got me off the Zantac was chanting with the local Buddhists. That is, in fact, a sort of exercise, right?! And I always feel emotionally better after chanting. I've even come across a scientific paper or two that report higher serotonin levels with chanting...