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GERD and Protein Pump Inhibitors: Seeking Alternatives

GERD and Proton Pump Inhibitors: Seeking Alternatives

Ingrid Pincott, ND

Proton  pump inhibitors (PPIs) are one of the ten most prescribed drugs in North America. PPIs are used in the treatment of acid reflux or GERD. I see at least one patient every week who is taking PPIs and wanting to get off them.

Bob, age 45, is a typical example. He has been taking PPIs for years and his GERD symptoms were not completely under control. He also had developed a rash he could not get rid of through conventional treatment so he is ready to try and improve his health. Certainly if a person is in severe gastric pain due to hyper-secretion of stomach acid, these drugs are useful to treat the acute phase. The side effects of long term treatment include: Decreased blood flow to the stomach, bacterial overgrowth in the stomach, hyperplastic polyp formation in the stomach, increased bile reflux and increased food allergy because food is not digested properly. Hypersensitivity reactions that can occur include urticaria, contact dermatitis, and drug rashes.

One of the reasons an MD might recommend a PPI for life is due to Barrett’s esophagus which increases the risk of developing esophageal adenocarcinoma (EAC).  However, in some recent research published by F. Hvid-Jensen, 2014, the risk of developing EAC increased with PPI use due to the increased formation of polyps while taking the drug!

Other complications of long term PPI use include: gastrin secretion increases, contributing to the risk of colon cancer, and esophageal adenocarcinoma; women taking PPIs have an increased risk of hip fracture, and reduction in bone density; there is also an increased risk of developing community acquired pneumonia especially in the elderly; and, finally, there is an increased risk to developing C. difficile as well as an increased risk of having a heart attack.

I recommended to Bob to come off PPIs gradually over six months to avoid rebound excess stomach acid. Some patients I have seen come off a lot faster than that because they did many other changes at the same time. For example removing wheat from their diet, eating a low carb diet, and eating food in proper combination helps a great deal to reduce GERD symptoms quickly. I put Bob on my candida program which addressed a lot of these recommendations in one protocol. The “yeast” killers help to kill off harmful bacteria and taking a strong probiotic away from the “yeast” killers helps establish a healthy microbiome. I told Bob this treatment program has helped many with chronic GERD.

I also have great success with a digestive aid containing  licorice, marshmallow and slippery elm that is aimed to heal the  stomach and help digest starches and fats without the use of protease, which can aggravate these cases in the early phases of treatment.

I saw Bob one month later. He was using the PPIs much less and was amazed. His skin was beginning to clear and he was much less itchy. He continued on the candida program for another two months and once he was off the PPIs I recommended a slightly stronger digestive enzyme. During this time I noticed on his blood work results that his liver and gallbladder were abnormal so I added a bile thinner and detoxifier for at least three months.

At the six month mark, Bob had lost 20 pounds due to the diet changes, his liver enzymes were back to normal and the only digestive aid he needed were the probiotics and the digestive enzyme. Often the symptoms of too much stomach acid are the same as too little stomach acid. The rest of his maintenance health program included B complex, vitamin B12, omega-3 essential fatty acids, vitamin D and a calcium magnesium complex. PPIs deplete magnesium and B12 so we had some catching up to do because he had been on them for so many years.

[A version of this article originally appeared in the Campbell River Mirror, March 25, 2016.]

Gut Feelings: Understanding the role of gut bacteria in regulating your mood.

by Dr. Kristin Schnurr, ND

Many of you may have heard the show, ““Bacteria in your gut affects your mental health.” which aired on the CBC on October 11, 2013. If you missed it, here is the link: CBC.

Listening to this show reinforced for me the importance of ensuring gastrointestinal health for myself, my family and for everyone I work with. We already know that healthy gut flora promotes health by strengthening immunity, improving our digestion and absorption of nutrients, and by promoting healthy metabolism and preventing obesity.

Too much of the wrong bacteria can make us ill and too little of the healthy bacteria can leave us vulnerable to illness. Symptoms of dysbiosis or an imbalance of good bacteria intestinally include: digestive upset, bowel irregularity, fatigue, allergies, skin conditions, headaches, autoimmune conditions, anxiety and depression.

Recently, there has been significant research emerging on the connection between gut flora and mental health. A recent study in the journal Gastroenterology shows that healthy gut bacteria play a major role in mental health and pain sensitivity. Scientists at UCLA showed a direct link between probiotics consumed and elevated amounts of the important mood regulating neurotransmitters: Serotonin and GABA.

Serotonin is a neurotransmitter primarily found in the gastrointestinal tract and the central nervous system. It regulates intestinal movement, mood, appetite, sleep, muscle contraction and cognitive function such as memory. GABA is the chief inhibitory neurotransmitter in the central nervous system. It plays a role in regulating neuronal excitability throughout the nervous system. People with low serotonin production typically suffer from depression. And, people with low GABA production typically experience anxiety.

This research is important as it points to the importance of addressing gastrointestinal health in the management and treatment of anxiety and depression. As Gregor Reid, PhD, a professor of microbiology, immunology and surgery at the University of Western Ontario stated, “There isn’t a drug on the market that can match probiotic bacteria for its far-reaching implications on health.

How to Cultivate Healthy Gut Flora

  1. Our first microbes are introduced in the vaginal canal after the natural birth process, and are delivered through breast milk. We inherit our gut flora from our mother at birth, where it settles in the baby’s sterile system and becomes the microbiome of the gut. Breastfeeding is another way the mother passes her beneficial flora to her baby. Bottle fed babies acquire completely different gut flora than those that are breastfed.
  2. Healthy digestive microbes come from ingesting uncooked and live culture fruits, vegetables, and dairy products that contain live probiotics. Routinely eating some fermented foods such as yogurt, kefir, sauerkraut, kimchi, miso or kombucha can also assist in replenishing healthy bacteria. It is important to ensure the products are guaranteed to contain live cultures since many brands destroy the essential bacteria with high temperature processing during the manufacturing process. If it’s in the fridge at the store it is more likely to contain live culture, if it’s on the shelf it has been pasteurized. Making your own yogurt, sauerkraut, kombucha or kefir assures an active bacteria content.
  3. For some people, the level of depletion of beneficial organisms in the digestive tract requires the consumption of a daily probiotic supplement in order to replenish beneficial bacteria. It is important to consider that infants, children and adults require different combinations of specific bacteria. And, it is important to be cautious with dosing in the treatment of skin and autoimmune conditions. A ND will help you determine the right bacterial strains and optimal dosing for your individual health.

Dr. Kristin Schnurr, ND is at the Sage Clinic in Victoria BC. www.sageclinic.com www.drkristinschnurr.com