Lecture on Acid Reflux and Proton Pump Inhibitors (PPIs)

Introduction

• Acid reflux, or heartburn, affects 10-20% of people in the Western world.
• Conventional treatment involves anti-acid medications, primarily PPIs and H2 blockers.
• PPIs are widely prescribed but come with significant risks, especially with long-term use.

PPIs and Their Mechanism

• PPIs reduce stomach acid production by inhibiting the hydrogen potassium ATPase enzyme (proton pump).
• Common PPIs include Nexium, Prevacid, Prilosec.

Short-term Side Effects of PPIs

• Headaches, nausea, diarrhea, constipation, abdominal pain.
• Potential for bacterial overgrowth due to improper digestion.

Long-term Side Effects of PPIs

• Nutritional deficiencies: B12, magnesium, calcium absorption affected.
• Risks: Dementia, heart disease, osteoporosis, infections like C. diff.
• Studies show increased risk of dementia and heart disease with long-term use.

Overuse of PPIs

• PPIs are often overprescribed due to lifestyle/diet issues.
• Many users do not benefit from these drugs, especially with long-term use.

Functional Medicine Approach

• Focus on root causes rather than symptoms.
• Causes include weak lower esophageal sphincter, obesity, high-fat foods, stress, poor diet, low stomach acid.

Strategies for Addressing Acid Reflux

Symptom Relief

• Use natural remedies: licorice root, slippery elm, aloe, melatonin.
• Dietary changes to eliminate triggers like processed foods, alcohol, caffeine, etc.

Lifestyle modifications

• Smaller, more frequent meals; avoid eating before bed.
• Manage stress to improve digestion.

Dietary Adjustments

• Emphasize whole, nutrient-dense foods.
• Avoid gluten and dairy initially; consider an Elimination Diet.
• Incorporate probiotics and fermented foods for gut health.

Conclusion

• Long-term reliance on PPIs is harmful; focus on lifestyle and dietary changes for relief.
• Treat the root cause of acid reflux for sustainable health improvements.