Proton pump inhibitors (PPIs), which are used to treat heartburn and other symptoms of acid reflux, are some of the most commonly consumed medications in the world—sales top $14 billion annually in the United States alone.
Over sixty million Americans suffer from acid reflux every month (and 25 million experience symptoms every day), so reaching for acid reflux meds has become worryingly normalized. PPIs such as Nexium and Prilosec used to be available only by prescription, but now they’re easily obtained over the counter. Unsurprisingly, this shift has dramatically increased PPI consumption, and has encouraged people to use them as casually as ibuprofen and other OTC medications.
As we’ve covered in past articles, OTC does not mean safe. Even commonplace meds can be much more dangerous than we think; ibuprofen and other NSAIDs, for example, have been linked with miscarriage, DNA damage, sudden cardiac arrest, and other serious health risks.
And proton pump inhibitors are as worrisome, if not more so. We already discussed in another article how a 2016 study found that PPI use can increase your risk of developing dementia by up to 44%.
Keep in mind, too, that PPIs already carry a long list of side effects, all of which are clearly spelled out in the OTC packaging: headaches, joint pain and inflammation, rashes and other skin problems, anxiety, dizziness, constipation, diarrhea, nutrient malabsorption, nausea, and more.
Fascinating how many stomach issues a stomach-treating drug can cause, isn’t it?
Now a new 2017 study has added another grave side effect to the list: an increased risk of developing chronic liver disease.
How acid reflux meds lead to liver disease
To understand why usage of proton pump inhibitors puts the liver at risk, it’s necessary to understand a bit about how these medications work.
The conventional treatment methodology for acid reflux and GERD (Gastroesophageal Reflux Disease, a chronic form of acid reflux) is based on a simple theory: symptoms can be controlled by reducing the amount of acid in the stomach.
While this approach does provide quick but temporary relief from heartburn and other symptoms of acid reflux, mounting evidence demonstrates that the underlying theory is entirely inaccurate. It’s actually insufficient stomach acid (not too much of it) that causes the symptoms in the first place, so acid reflux meds do nothing to fix the root condition (and in fact, they may make it worse).
Proton pumps are types of proteins (called integral membrane proteins, or IMPs) which help move protons across cell membranes. In the stomach, proton pumps are primarily responsible for modulating stomach acidity through secretion of gastric acid. It stands to reason, then, that inhibiting the action of the stomach’s proton pumps is a direct and efficient way to reduce overall stomach acidity.
Targeting one bodily mechanism without regard for the whole system can have grave consequences, though. Stomach acidity is critical not only for proper digestion and nutrient absorption, but also for microbiome maintenance. Gastric acid helps suppress the growth of harmful gut bacteria—when acidity drops, these bacteria are allowed to flourish.
The 2017 study mentioned above, which was published in the journal Nature Communications, found specifically that the bacteria Enterococcus grows aggressively in the intestines when levels of gastric acid are lowered by proton pump inhibitors.
Microbiome imbalance can adversely affect your health in a staggering number of ways, but what researchers focused on in this study was its effect on the liver. They observed that, when Enterococcus made its way to the liver, it worsened and even catalyzed chronic liver disease. They even found that colonizing mice with this bacteria was enough to trigger mild fatty degeneration in the liver, thus demonstrating that Enterococcus overgrowth is indeed to blame.
While further research is needed to determine a definitive link between PPI usage and chronic liver disease, this initial data is certainly conclusive enough to have researchers worried about the prevalence of these medications.
Treat acid reflux safely and naturally
If you suffer from acid reflux, know that there are better and safer ways to address it. First and foremost, you must examine your diet—research demonstrates that improper diet is one of the most prominent risk factors for acid reflux and GERD.
While overhauling your diet is admittedly more work than taking a pill every day, it’s the only way to heal acid reflux at its roots, and it will save you from the potentially severe side effects of proton pump inhibitors.
Start by cutting out the worst offenders that lead to acid reflux: processed sugar (especially in the form of sugary sodas and beverages), alcohol, processed foods, spicey foods, polyunsaturated fats like vegetable oil, and refined grains. Replace these gut-imbalancing foods with lots of organic vegetables (especially alkaline veggies like cucumber, and plenty of prebiotic-rich leafy greens), probiotic foods and drinks like kefir, kombucha, sauerkraut, and apple cider vinegar, healthy fats like coconut oil, and other stomach-supporting plants like turmeric, ginger, fennel, and parsley.
For acute relief from heartburn and other acid reflux symptoms, try natural remedies instead of OTC proton pump inhibitors. Papaya enzymes, magnesium (especially when dissolved in water), melatonin, and probiotics can work wonders. We also really have found these 2 products from Biotics Research to be effective in relieving discomfort without side effects: Gastrazyme and HCL Ease. While using dietary modification to heal the underlying condition is key, these natural medicines can provide relief during your healing process, and they carry none of the side effects and risks of OTC medications.