'Doorway drugs': The problem with heartburn medication

I have my own name for medications which indicate to me that a patient is entering a path of general health decline: 'doorway drugs': These medications pop up time and again at a junction (or doorway) in a patient's health journey - the junction arrives when a patient begins to suffer bothersome symptoms which are considered non life threatening, but are nevertheless very unpleasant - heartburn (acid reflux) is one of these. As a dietitian I wish for patients to heed the warning that their digestive system is giving through the heartburn, and to start making positive lifestyle changes instead of taking medication. This is especially hard to achieve when doctors are so keen to hand medications over and patients pressurise doctors to provide a solution, without looking inwards at the personal responsibility we hold in terms of maintaining our own health.

The specific heartburn medications which concern me are the proton pump inhibitors; more commonly known by the names omeprazole, lansoprazole, nexium, prilosec and more. Millions of people are being prescribed these medications as a first line defense against heartburn. These medications work to reduce the amount of acid being released by the stomach cells.

You were born to release stomach acid! Why turn it off?

I know only too well how horrible heartburn can be - it is certainly a symptom I experience when I am hit with a digestive flare up. I will not reach for the medications above for very important reasons and have cured it without them many times.

These medications treat the symptoms and not the cause. And beyond not treating the cause, they damage a vital part of the digestive process by ignoring the importance of stomach acid in maintaining our health. More and more research is pointing towards health problems (some resulting in death) where long term use of these medications may be a player.

Stomach acid is vital for:

1. Ensuring our immune system works efficiently: approximately 2/3rd's of the body's immune defenses are found within the gut. Long term use of these medications may put us at risk of conditions which are born of poor immunity or malfunction of the immune system.

2. Preventing bacterial overgrowth - the acid kills harmful bacteria coming into our bodies from our external environment. Having a good amount of health promoting bacteria in the gut is a vital contributor to good health.

3. Ensuring adequate nourishment - stomach acid helps to break down our food - without it we can become deficient in nutrients such as Vitamin B12 and calcium.

4. Strong bones - these medications may put people at risk of osteoporosis.

In the majority of cases, if you're experiencing chronic heartburn, your digestive system is communicating that your gut ecology (the balance of microorganisms living there) is out of balance, and your gut is irritated. This is likely due to your lifestyle choices. It is important to listen to these symptoms and start making changes, rather than silence them and put yourself at risk of poorer health further down the line. Remember: you were not born with a deficiency in proton pump inhibitor medication (much as the pharmaceutical companies would like to argue otherwise!)

A good dietitian can guide you through changes which can help to return your digestive system to an happier state. Some suggestions to try on your own:

- Eliminate caffeine

- Eliminate cocoa

- Eliminate fried food

- Cut back on alcohol

- Try digestive enzymes

- Take a good probiotic

- Lose weight to a healthy BMI/waist circumference

- Stop smoking

- Listen to your gut - is it happening during stressful times? Take ten, long, deep breaths.

- Have small frequent meals

- Have a high fibre diet

- Get frequent, pleasant exercise - go for long walks :-)

A key lesson in life is not to blame the messenger: heartburn in the majority of cases, is simply a message from deeper in the digestive system that all is not well. It is true that these medications may provide great relief in the short term, but in the long term curing the condition naturally gives a far better outlook for long term health: listen to your symptoms, change your behaviour and learn about the power of good nutritional balance.

Have a lovely week :-)