How Do PPIs Work?
PPIs are a class of drug designed to inhibit the proton pump in your cells and reduce the amount of acid produced. They are among the most widely prescribed medications, ranking as the ninth most prescribed drug in 201515 with $14 billion in annual sales.16 However, PPIs are not specific to stomach cells and stomach acid is not usually the primary trigger in chronic heartburn.
Any cell in your body that produces acid uses a proton pump. This means that PPIs will inhibit the production of acid in all cells and not just those in your stomach. Scientists at Stanford University and Houston Methodist Hospital in Texas believe this may be the trigger behind the variety of dangerous side effects associated with PPIs.17 In effect, this hampers the ability of the cells to clear waste products and thus speeds damage and aging.
Cells use acid to clear end products of metabolism. When this acid is not present, a buildup of toxins results, which may lead to the development of significant health conditions.18 Dr. John Cooke, chair of cardiovascular disease research at Houston Methodist, calls this a "smoking gun."
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While PPIs reduce the amount of stomach acid produced throughout the day, it is not excess acid that is the cause of heartburn. Physiologically, the opposite is more often true. Low acid production may lead to bacterial overgrowth in the stomach.
This results in changes in digestion of carbohydrates, producing gas. Consistent gas buildup in your stomach increases pressure on your LES, weakening the sphincter and releasing acid into your esophagus and creating the symptoms of heartburn. Long-acting drugs such as PPIs may actually increase your risk of heartburn over time and often lead to greater rebound heartburn when you stop taking the drug.20
Early Testing Found PPI Promoted Gastric Cancer
Although the recent study has found an association between PPIs and stomach cancer, with or without infection with H. pylori, initial studies in 1985 on omeprazole (Prilosec),21 demonstrated an increased risk of gastric cancers in a rat model. In this study, female rats had a higher risk potential than males. At the time, this discovery generated some concern regarding the safety and delayed the development and approval of the drug.22
One developing pharmaceutical company, Astra, convinced regulatory authorities to continue with human studies, while two competing companies, Glaxo and SmithKline & French,23 stopped their PPI drug development programs as their tests also demonstrated a risk of gastric cancer in animal models.
Scientists determined prolonged therapy with PPIs led to hypergastrinemia, an excess amount of gastrin in the blood. This resulted in hyperplasia of enterochromaffin-like cells, an increased risk factor for gastric cancer.24 This hyperplasia was found in up to 30 percent of chronic users, especially prevalent in those infected with H. pylori.
Digestion Requires Acid
Digestion begins in your mouth and ends at your rectum. As food is broken into smaller pieces while you chew, it mixes with saliva, travels down your esophagus and into your stomach. Once in your stomach, it mixes with hydrochloric acid, which is required to break down food particles from which your small intestines can extract nutrients.
In other words, stomach acid is necessary for digestion. When you reduce the amount of stomach acid using PPIs, you increase your risk of heartburn, gastroesophageal reflux (GERD) and chronic indigestion. You may use a simple test at home to determine if your stomach acid levels are low, giving you the information needed to develop a natural plan to address your chronic pain. This will give you a rough indication of how much acid you produce.
Mix a teaspoon of baking soda in 8 ounces of cold water and drink it in the morning before eating or drinking anything else. The mixture of baking soda and hydrochloric acid in your stomach forms carbon dioxide gas, causing you to belch.
Time yourself for up to five minutes to determine how long it takes for gas to form. If you belch in two to three minutes, you likely produce adequate amounts of acid; earlier and repeated belching indicates excess acid. If you don't belch in the first five minutes, you likely don't produce enough acid.
