Listen, I’m not totally against the use of ppi in general. I think they have their place in treatment, but are often totally overused and taken for way to long periods of time.
What is a ppi?
A ppi is a proton pump inhibitor. It’s medication used to reduce stomach acid production by blocking enzymes in the mucous membrane of the stomach.
Ppi’s are used to treat stomach and duodenum ulcers and conditions like GERD or ERD. It is, and i want to emphasize that, NOT supposed to be used to treat gastritis.
Nevertheless, doctors prescribe some form of it, if they suspect the patient having a gastritis without even knowing for sure by ordering a gastroscopy. Even worse, in Germany it can be bought over the counter in low doses without a doctor’s consent.
What counts as a ppi?
There are three major types of ppi. The most well known is pantoprazole, followed by omeprazole and esomeprazole. Rabeprazole and lansoprazole are lesser known.
Pantoprazole has gained popularity, because of it’s fewer reported side effects. Doses usually vary from 20mg up to 80mg a day.
Why should I be concerned?
1. Indigestion
Ppi reduce the stomach acid which is essential for digestion. Just think about it, normally there’s enough acid produced for the meal consumed at a certain time.
Taking ppi will reduce any amount, disregarding having too much, just enough or not enough acid, up to 90%, sometimes even 95%.
If the diet isn’t adapted and though stays high in hard to digest foods, the food will stay in the stomach longer and isn’t properly broken down.
Undigested parts will then move on to the small intestines and colon where the bacteria present feeds on them and produce gas or toxic metabolites. This leads to a vast discomfort, pain, diarrhea or constipation.
2. Vitamin 12 Deficiency
The parietal cells of the mucous membrane not only produce stomach acid, but also the intrinsic factor which is necessary for the resorption of vitamin B12. Over time this results in a vitamin B12 deficiency.
Consequences are insomnia, nervousness, problems with coordination or the cardiovascular system.
Vitamin B12 also plays a major role in the body’s effectiveness to absorb vitamin B6 and vitamin B9, hence interfering with the breakdown of toxic homocysteine.
A higher PH-level disrupts the calcium and magnesium as well as the zinc and iron absoption. If Vitamin D is insufficiently present, especially the loss of calcium can lead to osteoporosis.
3. Helicobacter & Microbiota
Stomach acid itself isn’t acidic enough to kill Helicobacter pylori, because HP build its own alkaline living habitat in the mucous membrane. But stomach acid can prevent overgrowth of this bacteria.
If there’s only a small amount of acid produced, HP will use this condition to proliferate. Sufferers of B-Gastritis will experience worse symptoms.
Because of the toxic waste products of pathogen bacteria, because of indigestion, the immune system is weakened , too. The microbiota will get out of balance , becoming a risk factor for getting a leaky gut or small intestine bacteria overgrowth or inflammatory bowel diseases.
4. Other organs could be affected
Especially liver health drops after months worth use of ppi. Kidneys could be affected, too. Specific organ values should be checked.
5. The by far worst side effect
The body adapts to the use of ppi, constantly trying to unblock the enzymes producing the stomach acid. More ppi is taken and more stomach acid is tried to be produced.
If ppi’s are stopped cold turkey, the result is painful heartburn and an inflamed stomach, again.Even if slowly reduced, the rebound effect is prominent. Patients reported even having a small rebound effect after only taking ppi’s for 2 weeks.
The reaction often will be taking ppi all over again.
As for my personal experience
I first took ppi for 3-4 weeks after being diagnosed with gastritis and GERD through a gastroscopy. The pain dind’t subside, so the doctor recommended taking it for another month.
This went on until I had my second gastroscopy which showed no sign of amelioration. Again, recommendation: even a higher dose of pantoprazole.
Nothing happened for two months. I even had worse side effects , such as prominent heartburn after eating, restlessness, over all feeling of nausea, loss of appetite, being full after only one bite and so on.
After my third gastroscopy I still had to take pantoprazole, meaning I took ppi approximately 5 months. I always lowered the dose fast to 20mg, taking it every other day and then every third and so on.
Going completely off of it was painful and hard. But because they didn’t help me at all, even made me worse, I disregarded the recommendation and tried to find a holistic approach .
In conclusion, ppi’s only mask the symptoms, but don’t fight the root cause.They come with a lot of unpleasant side effects and have a bad rebound effect. They should be used to treat ulcers and GERD. However gastritis has to be handled differently.
*This post is based on research and personal experience. All products (if any mentioned) are bought and tried by myself if not written otherwise.
2 Comments. Leave new
Hello Nirina!! Thank you for your awesome Post, it helped me answer some unanswered questions and link the dots. I have been having problems with my GI ever since I moved to Germany 4 years ago,after many Pantopranzole prescriptions from my doctor I ended up having the worst Syndroms 4 Months ago,so after convincing my Doctor to send me for gastroscopy ( he wanted to prescribe me with Pantopranzole again and call it a day) we found out I had H. Pylori. After 10 days of probiotics H.P was eradicated but I was left to deal with a wide range of symptoms that look like leaky gut-ibs.
With all the respect to Doctors out there but I find Germany’s Doctors robotic in their job, I acknowledge its half my fault,but a Doctor should have known better than prescribe Pantopranzole without any tests,and even declining any request of getting tested from my side.
I wish you only the best in your journey towards healing,and thank you again for shedding some light on my questions.
Mit freundlichen Grüßen
Olarasu Niko
Thank you so much for your comment!
Yes, I agree! Germany has one of the best health systems in the world, but doctors depend too much on the facts rather than viewing every patient’s situation individually. Sometimes I feel like they want to keep people sick just to make profit and keep costs low, because a gastroscopy and other medical tests aren’t cheap…
The triple therapy killed of all bacteria of your microbiome, so you have to rebuild it by eating loads of fermented foods, natural probiotics such as kefir and yoghurt, kombucha, prebiotics which feed the good gut bacteria cultures like root veggies.
Especially after an eradication I’d recommend taking supplements like a highly dosed probiotic and inulin just to help getting the microbiome started. I’d resist eating too much sugar, meat or fat as pathogens either feed on it or produce harmful toxins breaking these down. Just for a while at least.
I hope you’re feeing better now or soon. Thank you very much, I’m a lot better compared to when I wrote this post. Baby steps 🙂
LG,
Nirina