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Indigestion and proton pump inhibitors

High levels of gastric acidity are necessary for  healthy gastric function. This is because stomach hydrochloric acid destroys ingested pathogens and helps digestion by liquefying ingested food into chyme, which can pass downwards through the stomach and onwards into the intestine rather than regurgitating into the oesophagus or lodging in the stomach and causing stomach ulcers.

Proton pump inhibitors (PPIs) such as omeprazole (Losec), lansoprazole (Zoton) and cimetidine (Tagamet) relieve acid indigestion by blocking natural production of gastric hydrochloric acid. Side effects of PPIs include vitamin B12 deficiency with macrocytic anaemia and unnatural tiredness, impaired intestinal absorption of calcium and magnesium with osteoporosis, impaired zinc absorption with immune system weakness and impaired protein absorption with impaired healing. Insufficient stomach acid also results in putrefaction of incompletely digested food in the intestine  with inflammatory bowel disease. Other side effects of PPIs include headaches, skin reactions, paraesthesia, dizziness, somnolence, insomnia, arthralgia, myalgia, an increased incidence of kidney and heart disease, stomach cancer and antibiotic resistant infection.

The primary cause of acid indigestion is erosion of the stomach lining, which renders it hypersensitive to physiological amounts of stomach acid. Stomach lining erosion is caused by stress (worry and exhaustion), alcoholic drinks, poorly tolerated foods (particularly gluten), and by non-steroidal painkillers such as aspirin, ibuprofen and diclofenac.

How to cut down on PPIs

PPIs are most effective when taken sixty to thirty minutes before breakfast. It is best to cut them down gradually. For example, try reducing the dose of lansoprazole from 30 mg to 15 mg and of omeprazole from 20mg to 10mg.

Indigestion associated with cutting down on PPIs may be alleviated by taking  an antacid such as Gaviscon, by thoroughly chewing one's food, by eating small frequent meals, by avoiding poorly tolerated foods, by leading a less stressful lifestyle and by taking a nutritional supplement designed to heal the damaged stomach lining (1). The initial goal should be to reserve PPIs just for the occasional heavy celebratory meal.

1. Pepti-Guard (SF 734) from Thorne (Health Interlink) – contains deglycyrrhizinated liquorice, slippery elm, marshmallow extract and aloe vera.


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