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.]

This article by Dr. Ingrid Pincott, ND originally appeared in the North Island Midweek.

How is the school year going so far? If you are noticing bad or violent behavior in your children here are a few things to think about to help curb this disturbing trend.

  1. Is your child getting enough sleep? Often this relates to deficiencies of minerals and nutrients such as calcium, magnesium, vitamin D. It is also important to disengage from the mad rush of life one hour before bed such things as as avoiding video games and TV. This helps turn off noisy thoughts to get a good night’s sleep. It is recommended to read a book, take a bath or work on a hobby instead.
  2.  Brains are starving these days due to malnutrition and being exposed to excitotoxins prevalent in the food supply such as MSG and artificial sweeteners. Diet sodas are loaded with artificial sweeteners which have been shown to increase the cravings for sweet and increase the risk of obesity because of its effect on insulin. Fruit juices even though “natural” are not much better due to the sugar content. Instead learn how to make herbal iced teas using stevia or xylitol and show your children how to make them. To help with cravings for sweets make sure your child is getting enough B complex and protein.
  3. B complex is well known to help with irritability and is important at any age. The late Dr. Hoffer, a psychiatrist in Victoria, helped to popularize Orthomolecular Medicine and the use of high doses of niacin to treat psychiatric disorders including schizophrenia, attention deficit, anxiety, obsessive compulsive disorder, depression and bipolar disorder as told by Dr. Saul the co-author of Niacin: The Real Story.  These patients are beyond deficient, they are niacin dependent and must remain on high doses of niacin to remain well. This is much better than relying on pharmaceutical drugs for these conditions. In fact the modern symptoms of pellagra, deficiency of vitamin B3 (niacin) include anxiety, hyperactivity, fatigue, headache, insomnia and hallucinations.
  4. Omega 3 essential fatty acids (EFA’s) found only in  fish oils are known to change the levels and functioning of both serotonin and dopamine, both of which play a role in feeling pleasure. Omege 3 EFA’s increase the blood flow to the brain. People with depression often have compromised blood flow to a number of regions of the brain. There are many good tasting fish oils on the market including herring oil, sardine and anchovy oils as well as cod liver oil. Our brains need cholesterol to function properly so foods such as eggs, coconut oils and healthy animal fats including organic butter, should be part of the regular diet. Dr. Perlmutter a prominent functional medicine neurologist, advocates a high fat diet for the optimal functioning of the brain, providing that the fats are from healthy sources.
  5. Zinc deficiency is linked with angry aggressive and hostile behavior and is found in my customized popular B complex formula. Food sources include red meat and shellfish.
  6. Anxiety is often a component of bad behavior. The above nutrients are critical for the management of anxiety but I also recommend the use of homeopathic remedies. These are easy to take as they are mixed in a water bottle or taken directly into the mouth. Rubimeds are combination remedies that are very effective at balancing mental and emotional conflicts that are subconscious.

Taking enough of the above nutrients to be therapeutic is important so check with your naturopathic physician about optimal dosages for you and your family and inventive ways of getting your child or teenager to take them! Of course when you treat your child the whole family benefits!