The People's Perspective on Medicine

Show 1078: How to Have Good Digestion Without Heartburn Drugs (Archive)

Although some heartburn drugs are available without a prescription, at high doses they increase the risk for stroke. What are the alternatives?
Dr. Robynne Chutkan, The Microbiome Solution
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How to Have Good Digestion Without Heartburn Drugs (Archive)

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Millions of people take medicines like Prevacid, Prilosec or Nexium every day. But while such proton pump inhibitors may ease symptoms of heartburn, they can also lead to serious side effects. Dr. Philip Gorelick, spokesperson for the American Heart Association, describes the research linking these heartburn drugs to an increased risk of stroke.

Alternatives to PPIs?

What is the solution? Many experts recommend limiting such PPI use to acute situations where they are clearly necessary. Dr. Robynne Chutkan, a gastroenterologist, tells us how the microbes in our digestive tract affect our health. PPIs can have deleterious effects on our microbiota. She offers a number of other ways we can address digestive difficulties without wrecking the balance of bacteria in the gastrointestinal tract by taking heartburn drugs. How can you live dirty and eat clean for good health?

Remember: do not stop any prescribed medication, including heartburn drugs, without your doctor’s knowledge and supervision. Stopping a PPI abruptly can lead to rebound hyperacidity and troublesome heartburn for many weeks.

This Week’s Guests:

Robynne K Chutkan, MD, is on faculty at Georgetown Hospital and is the founder of the Digestive Center for Wellness in Chevy Chase, Maryland. She did her medical training at Columbia University and is board certified in gastroenterology. Dr. Chutkan is the author of three digestive health books: Gutbliss, The Microbiome Solution and The Bloat Cure. A frequent guest on The Dr. Oz Show and other media outlets, she’s one of the most recognizable gastroenterologists in practice today. Her websites are  and

Philip B. Gorelick, MD, MPH, FACP, is the medical director of the Hauenstein Neuroscience Center, Saint Mary’s Health Care in Grand Rapids, MI. He is also Professor of Translational Science and Molecular Medicine at Michigan State University College of Human Medicine. Dr. Gorelick is a spokesperson for the American Heart Association. The research he described was presented at the American Heart Association annual meeting on Nov. 15, 2016.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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After several discussions with my doctor, I decided to stop taking Prilosec. It took me seven months to completely wean off of it completely. Now I watch what I eat and if I have a little indigestion, I will have 1 or 2 tums. I feel much better knowing that I am off of this prescription.

How do you know that what is causing the heartburn, which in turn is getting people to take PPIs, isn’t what’s causing the adverse effects such as kidney failure? There are a lot of things put in our food.

I started drinking alkaline water and the surprise was that my acid reflux went away. It was due to gluten sensitivity, not totally allergic. Now I rarely have acid reflux due to gluten.

My Dr tried taking mo off Prevacid which I have been taking for acid reflux for many, many years
It was horrible! At first it was ok then I started with the worst acid reflux I have been had my entire life! Nothing worked to stop the acid! When it got so bad it was erupting into my mouth at night, even though I slept elevated we gave up! We tried everything natural to cure the acid and nothing worked, digestive enzymes, licorice, ginger, you name it I tried it!
It got so bad I lost my voice!
I had to go back on the Prevacid

PPI’s have also been linked to kidney disease. Rebound acidity is a big problem when trying to stop them. I used Gaviscon (an antacid), and famotidine (Pepcid) otc to ease the transition off of the PPI.

I’ve taken every purple pill there is. Had bleeding ulcer that nearly did me in. Reflux every night.
Now am on the “Eat Right 4 Your Blood Type” eating plan for Type O blood. (Dr. Peter J. D’Adamo and Catherine Whitney).

Within weeks I was off all gastric meds.
Asked new doc to re-check thyroid and she ordered ALL levels of thyroid tests–previously, male docs didn’t do them all.

About then I decided to give Lugol’s 5% solution a go (as per Adelle Davis–“Let’s Eat Right to Keep Fit ” and doc’s okay).

Adelle was right. Low thyroid–as per the deep dive tests, was what made me so tired. Two drops a week of Lugol’s and in a few weeks i could feel the difference.

Reflux: I don’t eat or drink anything but water after 6 or 7 pm. No more reflux. No more allergy coughing and spitting.

If I have any discomfort from eating late, or eating the wrong foods, I sleep in the recliner and get a full night’s sleep. Dropped 7 ugly pounds from around my waist. Feel like a new person.

I did give up dairy, as per D’Adamo for my blood type, except for goat milk cheese, but it messed up Vitamin D and B2 which work with Calcium and Magnesium levels. So have to adjust for that –and added goat milk to my diet, hoping that will fix the imbalance. It’s an ongoing project to keep learning and keep everything balanced, but better than taking pharmdrugs. The two books are my bibles lately. Never felt so well. Now my only drugs are the food I eat and deep breathing.
SJ, I agree, chewing and eating slowly are very important. We need saliva to start the digestive process, so I chew even my morning smoothie–the full meal in a glass.

I had acid reflux for many years and took omeprazole until I realized how many negative side effects it could cause. I used techniques I read online and finally was able to switch to Zantac, which is less dangerous. My gastroenterologist then helped me stop that too. I make a simple drink of 8 ounces of room temp water and stir one tablespoon of apple cider vinegar (“With The Mother”)* into the water. SHAKE THE VINEGAR WELL each time you make the drink. Using a straw, I sip a little of this drink when I feel acid reflux coming on. The straw keeps the acid away from your teeth. This worked in about two weeks and now I only use it once or twice a day. I also have SIBO and maybe some IBS. Stress can make the acid reflux come back sometimes and will also sometimes make foods upset me that rarely cause me problems other times. But the vinegar works. I also make a salad dressing with 3-4 parts extra virgin olive oil and one part the vinegar. Do not add any spices etc. to it. It will keep at room temp. Shake it well and you can add any flavorings to the salad after the dressing is put on.

*”The Mother” means it is raw, unfiltered vinegar, which is essential. It is also unpasteurized and naturally gluten free. I buy it at my local grocery store and it is not expensive. It is a well known brand that has been around for years.

PPI’s also can make Plavix less effective. It would be interesting to see a study of racemic PPI’s vs active isomers – Lexapro certainly suppresses dopamine less than Celexa, some of these bad side effects may be different in PPI’s as well.
Personally, and for a good number of patients, getting elemental calcium out of diet, pills, and water eliminated my need for any stomach medicine. The Pepcid product which contains added calcium made me much worse in just a few days. CaCO3 is the cheapest binder for pills and is used frequently. A water softener helped and a water distiller for the very hard water where I lived did the most good. I am fine now with just a high quality water softener.

Dr Chutkin refers to a study in which people with inflammatory bowel disease improved with eliminating problem foods but required a sufficient amount of vegetable servings in order to get maximal benefit.

Do you have a citation for that article?

I have a hiatal hernia and reflux. I’ve taken a PPI for years. I want to get off the PPI but what will help the hernia?

Taking Nexium for 3 months 2× daily. Doctor told me to take it for shortest time possible. However, I wasn’t checking up until I awoke one morning 3 months later in pain with muscle weakness. I was sure my hip would break the pain was so bothersome. I called my doctor and made an appointment for next day, and I immediately stop Nexium. I have Osteoporosis so right about now I’m waiting for blood results but I’m sure the Nexum depleted the calcium in my body. The side effects are horrible

Thank you so much for sharing this conversation — it is very inspiring and informative. I was recently diagnosed with chronic gastritis (not caused by H. Pylori), and my G.I. doctor wants me to take 60 days of Dexilant 30mg. I am very wary of Proton Pump Inhibitors, but since it is for a short term use, do you think that will be safe? I want to heal my stomach, but I am also nervous about the drug causing SIBO or other issues. Any help would be extremely appreciated.

Hello: I started taking dexilant on December 9, 2018 and on January 31, 2019 my blood tests showed a reading of .20 on my white blood cells which is extremely low. Upon investigation in November 6, 1918 my white blood reading as .45. On reading further on dexilant if you look into the side effects under RARE, you will find that dexilant decreases your white blood cells. My blood Doctor concurs with this finding, and since stopping dexilant my white blood started to improve. Gene BEWARE

I’ve gone off PPIs but now take H2 blockers. Plus I take prelief, started for interstitial cystitis. The H2s help my interstitial cystitis a lot. I’ve tried tapering off ppis and now h2 blockers very gradually, but get a lot of pain and horrible heartburn. At least the H2 blockers allow me to be ok without PPIs.

I watch my diet carefully and would love to eat foods like sauerkraut, the good kind, but it flares my interstitial cystitis. Too much acid. No cider vinegar for me, either. I do take a good quality probiotic pill. Low acid diet helps some.

This has gotten much worse with age. It’s easy to say it’s natural to have acid in our stomachs when one is young, but with aging many natural things go awry. Some of it is structural or built into our genes.

I am going to try the licorice, which I’ve never done. Keeping my fingers crossed.

I’ve been taking a PPI for 20 years (it’s the only medication I take) and have had no problems. I’d like to get off it to see if I still need it but no one ever talks about how to do that successfully without great discomfort. I’ve tried a number of times reducing the med slowly or using substitutes but without success. Any thoughts?

For Bobbie: took me most of 6 months after 20 + years on a PPI–very gradually cutting down on dose and taking one of the over the counter antacids if I felt I really needed to tame my stomach acid. My doctor still doesn’t believe the rebound acid report, by the way–so this was on my own. Before I finally was determined to succeed, I had several failed attempts–the misery of the heartburn drove me to resume taking PPI. The more I read about the drug and the possible side-effects, the more I wanted to stop it.

I wanted to get my 87 yr. old mother off PPI’s, and she certainly did go through the rebound effect – awful heartburn and sore throat every night. So I had her swallow 1 packet (about 2/3 of a TBSP) of regular yellow mustard. It’s ready right by her phone when she talks to me, and it works within 5 minutes or less. (I use it myself when needed.) And after using it for a year or so, she doesn’t seem to need it as often. It’s counter-intuitive, but it really works!

PPIs are potentially and actually deadly in conjunction with certain other drugs such as Metformin and can exacerbate or accelerate other medical conditions. I lost my best friend of 40 years, since high school, to PPI + Metformin + bad nutrition + near dead gut biome. He died.

The same thing nearly got my mother, but I found about the connection here at People’s Pharmacy, and I was able to get her to call her doctor right away to get her to look at this connection and her life was saved. She was quite unwell and her doctor didn’t understand why or why her minerals were so low.

Thank you People’s Pharmacy. You helped save my mother’s life.

I am also seeking any help I can get with repopulating my gut biome after antibiotics. The VA is medieval about this, mouthing the “eat some yogurt, hey” line and really believing it, knowing no better. FMT is out as it is only VA approved as a treatment for Clostridium Difficilis.

In my reading it only appears that 3 or 4 species of the thousand in the gut biome have been successfully recolonized by diet. I can make and eat fermented milk products and just bought the giant economy size jar of live Kimchee — which is a start. But there’s so little out there I can find that seems real.

Any advice backed by science is welcome.

I was diagnosed with GORD, hiatus hernia & Barretts Oesophagus some years ago. I get an occasional flare-up but generally manage by avoiding eating & drinking a couple of hours before bedtime. Foods that aggravates are: potato-chips with onion; biscuits; more than one beer; more than a few jelly sweets. Foods that help are: low-sugar yogurt; a little milk chocolate; meals with plenty of gravy or cooked sauces.

I took things for heartburn for years; finally, I used deglycyrrhized licorice tablets and chewed them up – took a while but I haven’t had heartburn for years now. I also used candied ginger.

The licorice works, but causes diarrhea after awhile for some people. I was one of them. Hope it works for you, though.

It all comes down to doing what is natural for the body. We need acid to digest our food, so why stop the acid production? People have to be more aware of chewing their food, eating slowly and not over indulging. The term “everything in moderation” fits with our diet and how much we should consume. There are natural foods and toppings that can help us digest our meals; apple cider vinegar is one. Also, our bodies were designed by our creator to move, not sit. As someone once said: “a body in motion stays in motion”.

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