Acid reflux is one of the subjects that I am passionate about and my answer went beyond the usual scope of the Fast Tract Diet Q&A.
Question about drugs for acid reflux
“I am wondering why so many doctors are quick to prescribe drugs like proton pump inhibitors and H2 blockers, often both together for acid reflux and LPR. I am worried about possible side effects from these medicines, especially if I need to be on them for a long time.”
Here are some of the reasons I think many doctors overprescribe PPIs and H2 blockers for acid reflux and LPR:
- They are unclear on what really causes acid reflux and LPR (laryngopharangeal reflux).
- Both the medical literature and pharmaceutical marketing material promote these drugs as a complete solution.
- It’s easy and many people just want to take a pill and go back to their busy lives.
Since acid reflux and LPR both involve stomach acid getting into the esophagus (and beyond), blocking stomach acid makes sense to doctors. But like youself, progressive doctors are beginning to realize that this solution has serious flaws:
- These medicines fail to address the underlying cause, small intestinal bacterial overgrowth and intestinal gas, which I have proposed along with the evidence in the Fast Tract Digestion Heartburn book.
- 50% of patients prescribed these drugs continue to have symptoms, leading to mega doses, combination therapy and costly follow-up testing.
- Serious health risks associated with acid reducing drugs include:
– Reduced vitamin B12 absorption (risk of anemia), vitamin C (growth and repair of tissues throughout the body, including wound healing), folic acid (growth and repair) and likely other vitamins.
– Reduced mineral absorption including calcium (risk of bone fractures), magnesium (risk of serious cardiovascular, neurological problems and also bone health), iron (risk of anemia), and zinc (nerve damage and digestive tract issues).
– Increased risk of bacterial overgrowth in the small intestine and stomach since stomach acid is part of our bacterial control system.
– Increased risk of C diff and other GI infections because our acid barrier to outside pathogens is missing and our protective gut microbiota are altered.
– Increased risk of kidney disease.
– Increased risk of pneumonia likely from reflux of gut microbes into the lungs. Stomach acid protects against reflux of viable bacteria from our gut to our lungs.
The challenge for getting doctors to take another look at dietary control of acid reflux received a recent setback when the American Medical Association’s Continuing Medical Education (CME) program for doctors and gastroenterologists published a report that they no longer support any type of dietary intervention for treating GERD, stating: “Routine global elimination of food that can trigger reflux is not recommended in the treatment of GERD.”
Unfortunately, the report ignores new research that I cover in my book indicating that fermentable carbohydrates are driving acid reflux, and limiting these in your diet can eliminate or dramatically reduce your acid reflux and LPR symptoms. The approach also covers pro-absorption behaviors and identifying and addressing other underlying causes that are specific to individuals, in other words a functional medicine approach. The benefits of the Fast Tract Diet include:
- Addressing the underlying cause(s) of acid reflux and LPR
- A healthy approach that rates hundreds of foods using a point system (Fermentation Potential – FP) that essentially measures symptom potential of each food
- Avoiding the numerous side effects and health risks associated with PPIs and H2 blockers
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