Are Acid-Blocking Drugs Safe?

Are Acid-Blocking Drugs Safe?
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Do the benefits outweigh the risks for acid-blocker drugs (proton pump inhibitors like Nexium/Prilosec/Prevacid)? What about baking soda?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Dyspepsia is the medical term for upset stomach. After eating, your stomach may hurt, or you feel bloated, nauseous, overly full, belching. “Despite the high prevalence of the disorder, there are no approved treatments for” it in the Western world. This leads people to seek out alternatives like baking soda, which the manufacturer promotes for use for “upset stomach.”

The problem is that “[i]t contains sodium bicarbonate and [therefore] has the potential for significant toxicity when ingested in excessive amounts,” potentially resulting “in serious electrolyte and acid/base imbalances.”

The labels were modified in 1990 to include the warning, “Do not administer to children under age 5,” because of reports of “seizure and respiratory depression.” Even just “a pinch” may be too much for an infant, and even just a few large spoonfuls could be fatal in a child.

Another new addition is the “stomach warning,” stressing the importance of not taking the product “when overly full with food or drink.” Why not? Well, if you’re familiar with scholastic science fair volcanoes, they’re baking soda and vinegar, right? Baking soda and acid, like what’s in your stomach. “This warning was added at the request of the [FDA] because of multiple case reports of spontaneous gastric rupture,” where people’s stomachs burst.

But, exploding stomachs aside, even just sticking to the suggested dose may still cause adverse effects. So, baking soda cannot be recommended, especially in “young children, pregnant women, alcoholics, and those who are on diuretics”—common blood pressure medications sometimes referred to as water pills.

What about acid-blocking drugs like Nexium or Prilosec? They work better than sugar pills, but not by much—helping 31% of dyspepsia sufferers, compared to 26% helped by placebo. In other words, 5% better than nothing. These so-called proton pump inhibitors “have…been extremely lucrative for the pharmaceutical industry,” raking in billions a year, but now that we have these massive computerized databases of patients, we can start to evaluate some of their “possible long term adverse effects.” For example: possible increased pneumonia, bone fractures, intestinal infections, heart disease, kidney failure, “and even all-cause mortality.” “The latest concern [to surface] has been the association between [the use of these drugs] and [the] risk of dementia.”

The problem with all these studies just showing associations, though, is that you can’t prove cause and effect. Maybe taking the drugs didn’t make people sick. Maybe being sick made people take the drugs. So, maybe it’s not that these drugs are the cause of these infections, fractures, death, and dementia; it’s just that they may instead be a marker for being sicker. But, there are potential mechanisms by which these drugs could have some of these effects. For example, here’s the death data. The longer people are exposed to these drugs, the higher their apparent risk of dying prematurely. But, like how could suppressing acid production in the stomach increase mortality, which is mostly like heart disease? Well, suppressing acid isn’t the only thing these drugs do. They may also cause a reduction in nitric oxide synthase, the enzyme that makes the open-sesame molecule that helps keep our arteries healthy.

In terms of dementia, a key event in the development of Alzheimer’s disease is the accumulation of these plaques of a sticky protein called amyloid beta. And if you just stick Alzheimer’s-like cells in a petri dish, and drip on increasing levels of the drug Prevacid, the cells start churning out more amyloid. And the same thing with Prilosec or Losec, Protonix, and Nexium.

Now, just because something happens in a petri dish or mouse model doesn’t mean it happens in a person. But, most studies to date have found this link between dementia risk with the use of these drugs—including the largest such study to date, involving tens of thousands of patients, that concluded that avoiding the chronic use of these drugs “may [help] prevent the development of dementia.” Though an alternative explanation of the link is aluminum exposure, which itself may play a role in dementia. So, maybe those using acid-blocking drugs have heartburn or something, and so are also using more aluminum-containing antacids, and that’s actually the real culprit? We still don’t know.

What we do know is that there’s “an almost cultish faith in [stomach] acid suppression” as some kind of medical panacea, which “has led to progressive escalation of…dosage and potency” of these drugs, all the while “mounting evidence” suggests these drugs may cause a variety of “adverse effects” and are “overprescribed.”

How overprescribed? “[T]he rate of inappropriate use of these drugs” is about half. Half the people on the drugs shouldn’t even be on them. “These rates are…worrying, because they mean that [these drugs] are prescribed for” things they shouldn’t even be prescribed for, meaning there aren’t even proven benefits to outweigh the risks.

Please consider volunteering to help out on the site.

Image credit: Mike Mozart via flickr. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Dyspepsia is the medical term for upset stomach. After eating, your stomach may hurt, or you feel bloated, nauseous, overly full, belching. “Despite the high prevalence of the disorder, there are no approved treatments for” it in the Western world. This leads people to seek out alternatives like baking soda, which the manufacturer promotes for use for “upset stomach.”

The problem is that “[i]t contains sodium bicarbonate and [therefore] has the potential for significant toxicity when ingested in excessive amounts,” potentially resulting “in serious electrolyte and acid/base imbalances.”

The labels were modified in 1990 to include the warning, “Do not administer to children under age 5,” because of reports of “seizure and respiratory depression.” Even just “a pinch” may be too much for an infant, and even just a few large spoonfuls could be fatal in a child.

Another new addition is the “stomach warning,” stressing the importance of not taking the product “when overly full with food or drink.” Why not? Well, if you’re familiar with scholastic science fair volcanoes, they’re baking soda and vinegar, right? Baking soda and acid, like what’s in your stomach. “This warning was added at the request of the [FDA] because of multiple case reports of spontaneous gastric rupture,” where people’s stomachs burst.

But, exploding stomachs aside, even just sticking to the suggested dose may still cause adverse effects. So, baking soda cannot be recommended, especially in “young children, pregnant women, alcoholics, and those who are on diuretics”—common blood pressure medications sometimes referred to as water pills.

What about acid-blocking drugs like Nexium or Prilosec? They work better than sugar pills, but not by much—helping 31% of dyspepsia sufferers, compared to 26% helped by placebo. In other words, 5% better than nothing. These so-called proton pump inhibitors “have…been extremely lucrative for the pharmaceutical industry,” raking in billions a year, but now that we have these massive computerized databases of patients, we can start to evaluate some of their “possible long term adverse effects.” For example: possible increased pneumonia, bone fractures, intestinal infections, heart disease, kidney failure, “and even all-cause mortality.” “The latest concern [to surface] has been the association between [the use of these drugs] and [the] risk of dementia.”

The problem with all these studies just showing associations, though, is that you can’t prove cause and effect. Maybe taking the drugs didn’t make people sick. Maybe being sick made people take the drugs. So, maybe it’s not that these drugs are the cause of these infections, fractures, death, and dementia; it’s just that they may instead be a marker for being sicker. But, there are potential mechanisms by which these drugs could have some of these effects. For example, here’s the death data. The longer people are exposed to these drugs, the higher their apparent risk of dying prematurely. But, like how could suppressing acid production in the stomach increase mortality, which is mostly like heart disease? Well, suppressing acid isn’t the only thing these drugs do. They may also cause a reduction in nitric oxide synthase, the enzyme that makes the open-sesame molecule that helps keep our arteries healthy.

In terms of dementia, a key event in the development of Alzheimer’s disease is the accumulation of these plaques of a sticky protein called amyloid beta. And if you just stick Alzheimer’s-like cells in a petri dish, and drip on increasing levels of the drug Prevacid, the cells start churning out more amyloid. And the same thing with Prilosec or Losec, Protonix, and Nexium.

Now, just because something happens in a petri dish or mouse model doesn’t mean it happens in a person. But, most studies to date have found this link between dementia risk with the use of these drugs—including the largest such study to date, involving tens of thousands of patients, that concluded that avoiding the chronic use of these drugs “may [help] prevent the development of dementia.” Though an alternative explanation of the link is aluminum exposure, which itself may play a role in dementia. So, maybe those using acid-blocking drugs have heartburn or something, and so are also using more aluminum-containing antacids, and that’s actually the real culprit? We still don’t know.

What we do know is that there’s “an almost cultish faith in [stomach] acid suppression” as some kind of medical panacea, which “has led to progressive escalation of…dosage and potency” of these drugs, all the while “mounting evidence” suggests these drugs may cause a variety of “adverse effects” and are “overprescribed.”

How overprescribed? “[T]he rate of inappropriate use of these drugs” is about half. Half the people on the drugs shouldn’t even be on them. “These rates are…worrying, because they mean that [these drugs] are prescribed for” things they shouldn’t even be prescribed for, meaning there aren’t even proven benefits to outweigh the risks.

Please consider volunteering to help out on the site.

Image credit: Mike Mozart via flickr. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

Stay tuned for my next video, The Best Diet for Upset Stomach (you had a sneaking suspicion that’s where I was going, didn’t you? :).

Surprised you haven’t heard about the potential downsides of popular medications. Here are some red pills to see how deep the rabbit hole goes:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

166 responses to “Are Acid-Blocking Drugs Safe?

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    1. This is a little off the subject, but a dentist told me baking soda was the best toothpaste any comments? I have in the past used it for indigestion, but since I’ve been on WFPBD I haven’t had the need to use anything anymore.

      1. I’m a dentist. Baking soda theoretically makes a good tooth paste because it is basic thus counteracts the acid produced by bacteria when they metabolize the sugars in your diet. However, you are not meant to swallow it.

  1. I take omeprazole as needed to relieve heart burn. I’d really like to not be dependent on it as a maintenance medication. What are some alternative solutions? Completely WFPB.

    1. Jim, I’m wondering why you even have heart burn. What in your diet causes this? I don’t even know what heart burn feels like.

      1. I’ve had persistent heartburn and gastric reflux for the past 6 years. It was pretty bad for 2-3 years and has heavily subsided after switching to 100% WFPB 4 months ago. I was taking (doctor prescribed) 40mg 2x a day in the worst of it. Now I’m taking 40mg once a day as needed, which is roughly every 3-4 days. I’m only on the high dosage because my prescription was just refilled. The typical OTC dosage is 20mg.

        I’ve had clinically diagnosed depression along with anxiety over the past 10 years. I’m not dealing with either of those as of the last 3 years though (at least not any more than the average person).

        I believe that I might be eating too fast/over eating. I think the WFPB switch has helped in that regard- I’m eating more filling food (so less over eating) and eating slower because all of the food takes more effort to chew. I used to scarf down my meals in 10-15 minutes in college and it became a bad habit of gorging myself quickly. I’m hoping I can ween off of the Omeprazole by continuing my diet and consciously eating more mindfully. No abnormal foods or significant levels of spicy foods that I think could be playing causing issues.

          1. Yeah, I have a friend who gets acid reflux when she eats tomatoes. I myself have experienced it when drinking strong ginger tea to empty stomach.

            1. Butch, I never had to quit, completely wish I had. but I did have to cut back a lot. I still drink a lot of beer, and some wine. The biggest things for me was processed foods, like white biscuits , rolls, and sweets , sandwiches meat, fried foods especially with salt. Replaced much of that with green smoothies, broccoli and Kell, spinach or greens, bland veggies like squash with a little bit of walnuts, and about 2-3oz of OJ for flavor. Add a few 1/4 cup or less, blueberries or strawberries 1-3 large too. Add lettuce or even a tiny bit of potato (cooked) and any other veggies in the fridge. I think the amount of the fiber has a major role in the heart burn. Also as constipation went up so did heartburn. Like vacations. It was so crazy to heartburn under control eat what I wanted for two days and on day 3 it would come back raging due to going out to eat, just over all huge decrease in fiber imo. So by day 3-4 would have heartburn then 4-5 constipation and excessive heartburn. 7-8 back on whole food and smoothies contraptions subsides, day 9 no heartburn. I didn’t take a vacation last year so I don’t know if I can make the adjustments necessary to make it through, but it’s a relearning how to eat. And yes, I still eat some meat, but it’s only about 3-4 days a week and usually only one meal a day, Not 2-3x per day.

              End

              1. Thanks, I no longer eat meat or dairy – lots of grilled fish and plants. I think tomatoes cause some of my problems. Gonna quit liquor an d drink a little beer. Trying to lose some weight – I think harder to do than getting off crack cocaine – although I have no experience in that area LOL! Gonna quit cigars, now smoking one per day. Just smoke one and checked my blood pressure – 177/98! Usually 140/85. I need to get my house in order. Thank you for the advice.

                1. Good job! Yes, it’s an extremely hard addiction to break . I gave up cigars easy for me but I started bicycling at the same time. It made sense for me. I wanted to be a better cyclist so psychologically it was only positive. But alcohol has been way way harder.

                  What’s funny is my wife gave up diet sodas about 6-7 years ago, and she had withdrawal symptoms for over two years. she would even wake up dreaming about them from time to time. If she Heard someone open one she would nearly melt down. Her health is a ton better for that too. But I think we are being deceived by the food companies, the pharma, media, and our culture. We have to take back our plates, and in taking back our plates, will keeps us from visiting Pharma imo.

                  End

                    1. I never liked the taste of diet soda. I always thought if I’m going to consume junk, I’m going to enjoy it.
                      To answer your question: I’ve quit all soda. :)

                    2. Yep me too, wasn’t hard to stop for me, however, from people who drink diet soda, and after I watching my wife go through drug like addiction withdrawals, I think diet sodas are more addictive.

                      End

                    3. I didn’t realize that diet soda was more or less addictive than regular soda. I hope everyone is alright with your wife now.

                2. And with tomatoes. For me I found out that canned tomatoes and pasta sauces would increase heartburn too, but so funny if I made it fresh from whole tomatoes- no heartburn. But it maybe different for you. You can try to see if there is a difference between them. At the same time I started eating a lot of cucumbers too, because they are some of the highest alkaline food that I could find. So about that time I was trying to eat a lot of highly alkalizing foods to keep from having heartburn. So good luck with all the positive changes it really seems to make a difference in our lives.

                  End

                    1. I never really add any oil to my pasta sauce it’s mainly tomatoes and garlic lots of Italian season with extra basil, parsley and if I’m feeling frisky little Chili powder or crushed red pepper. So, if people do oil to it, then yes. I do add a bit of olive oil to my pasta after it’s finished. And pasta is pretty al dente so it not as hard on the glycemic scale. If it matters.
                      On a side note if I do eat a lot of tomatoes raw or otherwise along with foods like lemons, I get fever blisters. Never really figured that out. I always thought it was excess acid accumulating in the body.

                      End

                3. Yeah, it was red wine and cigars in my case. I found it was much harder to give up cigars than alcohol, but got there in the end.

                  If you eat fish, standard dietary recommendations are to have several servings of oily fish per week. The more fish you eat though, the higher the risk of consuming excess mercury, PCBs etc. Canned fish may also be high in sodium.
                  https://health.gov/news/blog/2017/03/five-strategies-for-encouraging-seafood-consumption-what-health-professionals-need-to-know

                  Also, you mght want to consider steaming, poaching, boiling or microwaving your fish instead of grilling it because of the incrased cancer and cardiovascular risks associated with high temperature cooking methods like grilling, eg
                  ‘ Grilling (broiling) and barbecuing (charbroiling) meat, fish, or other foods with intense heat on the grill leads to formation of potential carcinogens.’
                  http://www.aicr.org/press/press-releases/2018/five-steps-for-cancer-safe-grilling.html

                  https://www.sciencedaily.com/releases/2018/03/180321162250.htm

        1. I think Jim already stated why he has heartburn. The cause is clearly an impact of his emotional state on his digestion. If you’re eating a WFPB diet and still refluxing you need to stop looking for answers in your diet. Start meditating, or start psychotherapy.

          1. Rick, re “stop looking for answers in your diet” might be something that comes from your own experience, but I found it far from the truth . For some people there are problems with some foods in wfpb. I am no longer taking meds, but at times it takes days of eating just cucumbers and drinking camomile tea. There can be a variety of reasons why people continue to suffer reflux or other painful inflammatory conditions while eating wfpb.. allergies is just one of them. The paddison program helped me https://doctorklaper.com/answers/answers07

              1. Uh, no, the camomolie tea is good. When my stomach is irritated about all I can drink is camomile tea, and eat bland watery vegies like cucumbers. Check out the paddison program.

        2. Jim,
          When I had this problem, I found the following helpful (two of which you mentioned): 1. eat smaller meals, 2. chew very well, 3. avoid oils or other highly fatty foods (I’ve read fat can relax the esophageal sphincter), 4. avoid eating at least 3 hours before bedtime, 5. tilt your bed so the head is about 6″ higher than the foot (cinderblocks can be used but there are bed length wedges on the market; do not just raise your upper body from the waist). A few years ago an ENT scared the daylights out of me claiming I was at risk for esophageal cancer from my GERD/LPR (larnygeal esophageal reflux syndrome), and he put me on some acid reducing medication. Fortunately my GE told me I should stop the meds but expect a rebound effect (which I had) and not worry about it. That relaxed me and I was able to quit the meds and get back to a normal life, at least in terms of stomach acid problems. It’s true, of course, that specific foods can trigger episodes, but which foods is highly individualistic. But in retrospect I am quite convinced my main problem was stress/anxiety related, exacerbated by overeating and wolfing down food. Practicing mindfulness and breathing exercises helped me control my stress and anxiety. I also exercise a lot everyday. These days I never have a problem although eating out is still a risk factor.

        3. Good for you improving your diet and manner of eating. May I recommend that you try an experiment for one month, or maybe just a week, and see if that helps. Eat like a saint, and I bet you know what I mean: that means no coffee, no sodas, no booze, no high acid foods like tomatoes, no spicy food, no greasy food, no overeating, no food that you know upsets your stomach even if it includes chocolate, no eating within 2 or better 3 hours of bedtime. Come on, it’s only a week or a month. I predict that you will feel better. You can reintroduce foods one at a time and see how you do, and then decide how you want to live. And you’ll save money, too! When I had reflux some years ago, even a few sips of red wine would do it. I care more about feeling good than I do about booze, so I drink very little now. Also, a sweet dessert after dinner, like cake or ice cream, is risky business for heartburn/reflux later. That’s when I end up taking a Pepcid Complete. (got off the Nexium and Prilosec) It’s all on me.
          Eat to live, don’t live to eat. Good luck and good wishes. It’s your choice, friend.

        4. Hey Jim. I work with gastroenterologists who frequently prescribe these ppi’s. Heart burn is not exclusively caused by what we put in our mouths. Stress is a very large cause for over production of acid in the stomach. These stresses include fluctuating sleeping and eating schedules as well as situational stressors like death, new jobs, domestic unrest…etc. Try to manage the aspects you have control of to reduce your heart burn.

      2. Rebound from taking the drugs long term. They create their own raison d’être. But he might also be drinking coffee or alcohol, known aggravates, or smoking. I found that my heartburn disappeared when I cut out animal products.

    2. Has anybody actually tested your stomach acid levels? My understanding is that the symptoms of too much acid and too little stomach acid for digestion are the same: stomach ache, reflux, etc. In my case, if I feel uncomfortable in the tummy (rare), I stir a tablespoon of vinegar into a glass of water and drink it down. That takes care of the problem.

      Many people taking those drugs seem to actually have too little acid to digest their food, so the stomach churns, trying to digest when it doesn’t have enough acid to break down the foods. As we get older we make less acid, so maybe your production has slacked off.

    3. Did you ever get tested for H. Pylori? That can devastate your gut system. It did to me. Consider reading Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD https://www.amazon.ca/Why-Stomach-Acid-Good-You-ebook/dp/B00AE1M1R0/ref=cm_cr_srp_d_product_top?ie=UTF8

      It was very helpful to me, and I no longer need acid blockers. Instead, I take supplements. Still working to get to the point I need to take nothing.

    4. I read in the old Prevention Magazine – when drug companies were the enemy- that as we age we produce less and less acid. They recommended Pepsin pills -acid! When my hubby began having “heartburn”, we bought some. 1 pill after meals and … no more trouble. After a year or so he no longer needed them, which the old article said. He did need a couple weeks of Nexium after an ortho insisted he had to take a strong anti-inflammatory which damaged his stomach lining.

      We also find plant-derived digestive enzymes solve minor burning after meals.

    5. Hi, Jim! I am sorry to learn you are dealing with heartburn. If you are overweight, losing weight is likely to reduce heartburn. Eating smaller, more frequent meals, chewing thoroughly, waiting at least two hours after eating to lie down, and sleeping with the head of the bed elevated may help. If you have not already seen this video, it may be of interest to you: https://nutritionfacts.org/video/diet-and-gerd-acid-reflux-heartburn/
      I hope that helps!

  2. I have suffered from acid reflux for many years even though I am a vegetarian. Sometimes the cause is physiological in that your lower esophageal sphincter (LES) doesn’t close as tight allowing acid to reflux. Sometimes its a hiatal hernia. No one knows why this is, and doctors just throw PPI’s at their patients. Find out which foods cause excessive bloating and avoid them. For me potatoes are a big culprit. Use a PPI only on an as needed basis for more severe reflux episodes. For more chronic use, I would recommend the British version of Gaviscon, which contains alginate. Alginate forms a raft in your stomach on contact with acid, preventing reflux. The US version of Gaviscon does not have sufficient alginate. I create my own following the instructions from here: https://fauquierent.blogspot.com/2016/11/make-your-own-gaviscon-advance-for.html. I take this at night about 30 minutes before I sleep. The most damage to your esophagus from acid reflux occurs at night when you are laying flat. So, for that reason I would recommend sleeping with a wedge pillow at night.

    1. Thanks Sidney MD for the links and suggestions. My husband was recently found to have a hiatial hernia so maybe this is an oportunity to get him onboard with wfpb eating.

    2. I’m in the same boat. WFPB diet for years but GERD nonetheless.I’ve been taking Ranitidine under the assumption that a link to dementia did not exist. Just to be sure I checked Pubmed and, to my surprise, found a study suggesting that certain analogs of the drug might actually TREAT Alzheimer’s. As a result my mind as well as my esophagus were relieved. Your comment re: Gaviscon is interesting. I take the Walmart Equate-brand equivalent for half the price. It is quite tasty so I’m going to try just adding a bit my alginate. Thanks for the tip.

    3. Sidney,

      I had that type of acid reflux once in my life. I honestly went to the ER because I wasn’t thinking of it as acid reflux which I had never had before and really haven’t had since, but it was terrifying. I had the sensation of not being able to breathe whenever I laid down to try to sleep and after a few days without any sleep, I became afraid.

      I think I read that you can get it after having a virus and that was what is was for me.

      I drank so much soda and coffee ate so much chocolate that I would have thought it would have stayed around, but it really only came for a season at the most.

      I bought a bed wedge, which I haven’t needed for years. I have an adjustable bed in my guest room but I don’t need one myself yet, but if I ever get it again I am ready.

      My friend has chronic problems where she has been on them for decades and they have looked at issues with her esophagus.

      The part that confuses me still is whether it is too many stomach acids or not enough stomach acids based on the other logic.

    4. Sidney,
      My understanding is that it is best to tilt one’s bed completely, not just raise the upper body from the waist. One could use e.g. cinder blocks under a frame to do this, or buy a mattress length wedge (I use the latter).

        1. Interesting. I’m not really sure what helped me but I suspect not eating for about 4 hours before bed and trying to not overeat at one meal has helped the most(I eat 5 or 6 smaller meals in a 10-11 hour window).

  3. I was diagnosed with severe GERD and prescribed ppi’s (finally pantoloc worked 40 mg /day). and told I would bo on them for life by ENT specialist. Switched to wfpb and simultaneously attempted to get off the ppi 10 years later. Took more than a few tries but did it over the course of 2 months. . Today I still have trouble (feels like an ulcer) especially around certain foods. Fat of any kind including olive oil will cause acid reflux. Chocolate, mint anything including toothpaste, tomatoes unless cooked, tea, alcohol in any form, vinegars, salad dressings, many condiments, fermented foods, kombucha, aloe vera juice, and many more cause pain.
    Tilting the bed didnt work for me, but not eating does.

  4. At the beginning of September I suffered severe abdominal pain following a jog. The pain escalated to the point of me calling an ambulance and Emergency room care, resulting in a CT scan and diagnosis of peritonitis and emergency surgery to patch a 2 mm perforation of the duodenum. The medical assumption is that this is caused by H. Pylori and I was held in the hospital for 7 days on IV wide spectrum antibiotics, PPI’s, and blood thinners 27/7. This was followed by a home prescription of antibiotics for 2 weeks and a prescription for Pantropazole Sodium for 2 months. The latter was presumably to reduce stomach acids to assist in the healing of the duodenal patch. After my first 3 weeks at home, I have discontinued the PPI’s due to possible side effects, against my surgeon’s advice. My question concerns the cause of this perforation. I have no obvious risk factors: don’t and have never smoked, don’t use NSAIDS, and don’t drink excessively, nor do I believe that I have high levels of psychological stress in my life (although stress is not considered a cause of ulcers any more). Also, I am physically fit, mostly plant-based and have never had digestive issues such as GERD. My surgeon asserts that it is just ‘bad luck’. Any thoughts on this?

    1. I’m reposting:
      I got H Pylori back in 2013. After my own personal research, I’ve concluded that we need our stomach acid, and acid blockers are very bad for you. I took it and it made things worse. It creates a welcoming environment for unwanted gut bacteria. I’ve learned to take supplements to address my gut issues instead. It’s not perfect, but it’s A LOT better than acid blockers, and I’m still trying to get rid of my problem 100%. Consider reading Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD https://www.amazon.ca/Why-Stomach-Acid-Good-You-ebook/dp/B00AE1M1R0/ref=cm_cr_srp_d_product_top?ie=UTF8

    2. What a tough experience. I sincerely hope you are steadily recovering. Most ulcers are caused by either the use of NSAIDS (including aspirin) or H. Pylori infection. When an ulcer is caused by H. Pylori, treatment with antibiotics for 14 days is highly effective and prevents recurrence in most cases. Diagnostic tests for H. pylori include blood tests for antibodies, breath test for high CO2, and stool tests. After you’ve received antibiotics, these tests may not be useful. The PPI does protect the stomach lining while the ulcer is healing, and two months is a reasonable course. Avoiding known triggers as you do is very important, and lifestyle is a great way to avoid future ulcers. Given you’ve had one with the serious complication of perforation, it would be reasonable to complete the two month course of the PPI if the symptoms you thought possible due to the PPI failed to resolve when you stopped that medication. The most important therapy was the two weeks of antibiotics, which is sounds as though you’ve completed. Best luck to you! -Dr Anderson, Health Support Volunteer

  5. I’ve read that PPIs also adversely affect the absorption of calcium and vitamin B12, and increase the chances of developing bacterial infections in the stomach.

  6. I have been taking these medications for over ten years – the day I stop, I get unbearable heart burn/acid relux at night. I am overweight and have had my gallbladder removed. What to do?

    1. Green smoothies worked for me. 2 large a day. try to get rid of sugar and salt from your diet, at least temporarily. Salt, especially the stuff they use in processed foods, killed me. Add ginger to your smoothies too.

        1. Good point. I never really tried to cut those down, but I guess did it inadvertently by increasing whole plant foods, and decreasing meat and dairy. Thinks happened so fast for me at that point, I certainly could be missing a couple good points like that. However, I still had to add about some oil, avocado and nuts to my smoothies, but I’m extremely active and can burn up to a few thousands of calories a day over my normal metabolic amount. So your probably right. Sugar, fat and for me salt. But after I depleted my salts, I had to add back some salt back in. But I can understand why we advise against it for less active people.

          End

          1. Avocado and nuts have never bothered me, so I’ve assumed it is just extracted oils that are problematic for me (feel like my food takes forever to digest). I also eat a lot of nuts/seeds because I burn the calories exercising.
            Cheers.

    2. ButchT, perhaps I can offer a suggestion? I tried many times but what worked was:
      Start not taking it 1 day per week, the next week, 2 days without (like a monday and wed), and keep adding 1 day per week (pause for an extra week if you really need too) until you are done. Continue eating wfpb (no dairy!) , beware of eating at restaurants, and choose bland and safe known foods for a while. Stand up or go for a walk after eating, and don’t eat within 2 or 3 hrs of going to bed. Good luck!

    3. Start with cutting out wheat. Give it a try, and read labels to be certain. Then a whole food plant based diet with no oil, and cut back on the nuts and seeds and avocados. That should give the needed weight loss.

      As one doctor told me: Reflux is an overweight problem and it’s a wheat problem. I was having a time with it a few years ago, so I cut out wheat and the problem disappeared almost overnight. Later I lost 40 pounds and I’ve never had reflux again.

      1. Live wire I’ve never been really overweight in my life. Except a year. And I had heartburn at my slimmest. It has very little to do with weight per se, tons to do with diet and possibly bacteria.

        End

    4. Hi, ButchT! If you have not already seen it, you may be interested in this video: https://nutritionfacts.org/video/diet-and-gerd-acid-reflux-heartburn/ Losing weight should certainly help with reflux. A low-fat, plant-based diet, eating smaller, more frequent meals, waiting at least two hours to lie down after eating, and sleeping with the head of the bed elevated may also be beneficial. I hope that helps!

  7. This text is in the description of the video: “(proton pump inhibitors like Nexium/Prilosec/Zantac)”

    However, Zantac is NOT a PPI; it is a H2 antagonist. As far as I know (and according to a gastro surgeon I saw), the side effects mentioned in the video have not been shown for H2 antagonists.

    The description should really be edited to delete Zantac.

    1. Zantec ? No it shouldn’t be removed . It will still rob you of iron and calcium, possibly b12. And no telling what else. It’s maybe ok for a short transition to a healthier diet, but I would get off that crap ASAP.

  8. Thank you DR Greger. This video touched a nerve with me. I was literally on Pepcid or tagement for nearly 10 years due to heartburn. Would take about a bottle a month. They seemed to work for me while taking them. But it’s funny when I started my 2 green smoothies a day and decreased my intake of processed food my heartburn went away almost immediately. I was able to stop almost overnight. I wish I had seen this years ago, but I don’t know what I would have done because, I didn’t know the link to diet and heartburn. I hope I’m not having going to have early dementia. And so glad to be off of the them. Are these studies looking at people who use prescription or the over the counter ppi’s too?

  9. I’ve been taking them for several years because I was diagnosed with Barrett’s Esophagus. I don’t really like the idea of taking them because of the heart issue. I also have a blocked coronary artery. I know the PPI’s aren’t good for heart disease but neither is esophageal cancer. What to do?

    1. Hi, Bill C. I am sorry to learn that you have been dealing with these issues. If you have not already seen it, you may be interested in this video: https://nutritionfacts.org/video/diet-and-gerd-acid-reflux-heartburn/ In addition to the advice in the video, eating smaller, more frequent meals, waiting at least 2 hours after eating to lie down, and sleeping with the head of the bed elevated may be beneficial. I hope that helps!

    2. I am in the same boat as you, I did stop taking PPI,s three years ago when I started a WFPBNO diet which stopped all reflux. A few months ago I started I getting some discomfort in my stomach and my doctor suggested that acid was still leaking into my oesophagus. That discomfort has gone now that I am back on Omeprazole. I had a further gastroscopy which showed no worsening to the Barrett’s or the hiatal hernia in the last three years. Would like to reduce the PPI dose but wonder if I should.

  10. I have had severe GERD since my 30’s and had H. Pylori biopsy proven peptic ulcer disease since then. I progressed my diet to strictly whole food plant based. I avoid alcohol, smoking, and all illicit drugs. No candy, no sodas, no salt and no sugar/fat based deserts. My LDL of 53 indicates the seriousness of my diet and lifestyle. I eat my two main meals at 6am and noon with a small snack for dinner. I exercise and am not overweight. My mom was similar, but did eat meat, and spent one year in the hospital when I was 11 due to a perforated peptic ulcer with peritonitis which killed the majority of people with this condition in 1959(fortunately this occurred in Australia and we did not incur a hospital bill.). She also had severe essential hypertension which I do as well. I drink ginger/turmeric/pepper tea, Hibiscus tea. I meditate 1 hour/day. With my HTN, GERD and PUD, if I miss a few doses of medicine by accident, both the GI and hypertension quickly become out of control. I am well aware of epigenetics and with my diet and lifestyle have outlived by many years my severe metastatic prostate cancer and melanoma. But I think there are some people who just have too severe disease when genetics are strong as with my ruptured brain berry aneurysm and severe congenital spinal stenosis both of which have required 12 major surgeries with lasting neurological and pain issues. I just hope the WFPBD and approptiate medications with an active lifestyle just keep me going as I have already overcome some incredible odds. I would be interested in hearing about those who have done everything they can but still need medications.

        1. Hi Lida,

          I’m been taking them since 2017, and it’s treating my GERD way better than acid blockers, and with no side effects.
          This is NOT advice, but here’s my list:

          1) Betaine HCL
          2) Ulcetrol
          3) DGL
          4) Probiotic-10 25 Billion, veggie caps

  11. Another fantastic video. In the near future I am going to undergo a Hellers Myotomy due to Achalasia. My surgeon does not preform a fundapplication due to high failure rate. As a result i am told I require a PPI or Zantac to reduce damage caused by the acid possibility entering my esophagus. I already follow a plant based diet, but feel that increasing my greens is vital to ensure nitric oxide production is maximized . Also eating a lot of strawberries( from another one of your videos), is important. Will you be doing any videos that talk about alternatives to PPI’s?

    1. Yes. I’ve taken quite a bit of DGL and have found it to be effective.I usually combined it with other supplements but even by itself was good.Keeping the lining of the stomach in good shape is important and DGL helps do that.

        1. I don’t know if there have been any studies on long term effects. I took it for quite a while and had no problems. I believe it’s a safe supplement. Also, make sure you completely chew the tablet until it is liquid before swallowing for the best results.

    2. Yes, it’s a part of my supplments combination to battle GERD. It’s been working for me since 2017.
      This is NOT advice, but here’s my list:

      1) Betaine HCL
      2) Ulcetrol
      3) DGL
      4) Probiotic-10 25 Billion, veggie caps

      Consider reading Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD by Dr. Wright

    3. Hi, Lida! DGL stands for Deglycyrrhizinated licorice, and is produced by removing the glycyrrhizin from licorice root. While licorice root has been used traditionally to treat ailments affecting the digestive tract, especially ulcers and damage caused by aspirin, and is believed to increase production of protective mucus, it can affect kidney function, lead to dangerously low potassium levels, and increase blood pressure. Supposedly, the glycyrrhizin is responsible for these adverse effects, and so removing it is believed to make it safer. Licorice root is definitely not recommended for pregnant women, as it can increase the risk of preterm labor. You might be interested in this video: https://nutritionfacts.org/video/is-licorice-good-for-you/
      Everything on this site about GERD may be found here: https://nutritionfacts.org/topics/gerd/
      I hope that helps!

  12. Try probiotics people it works it’s call florastor great for all digestive issues and add sum digestive enzymes with that it will cure it

    1. Lavell, I am trying probiotics and enzymes but have read confusing information on whether they can be taken together or must be spaced apart.

  13. How I am successfully managing my GERD without meds

    Could not tolerate them and did not want to be on them.

    Lost 20 pounds- pain made this easy to do.
    Increased my activity
    Went on low FODMAP diet and hired a dietitian specialized in FODMAP foods. (See Monash University-FODMAP)
    Carry small amount of cooked oatmeal with me for flare ups and eat at something at least every 3 hours
    Elevated my bed 4 inches and use sleeping wedge
    Eat small frequent low acid, low fat meals and avoid all trigger foods
    Use Gaviscon as needed. I am down to 0-2 tabs per day.

    My doctor laughed when I said that small frequent meals are said to help, “who would do that long term?”, ME! because I have no choice! It’s that or GI surgery.

    A proud and healthy monthly supporter of Nutritionfacts.org

  14. Several years ago, a ENT I consulted for another reason told me following an endoscopic examination that I had “acid reflux.” I protested that I never feel any heartburn pain. He replied that the burns he saw were in areas not protected from stomach acid but areas which did not always produce pain. He called my condition “silent reflux.” When I dismissed the notion, he asked whether I recalled my father clearing his throat, especially in the morning. “Yes, I recall him clearing his throat often enough to remember it. He then went on to ask whether I did the same, especially in the morning. The answer was “Yes.” He prescribed my taking a 300 mg Ranitidine (generic for Zantac) every night before bed, and he explained it was safer than a proton pump inhibitor because the mechanism is uses to inhibit stomach acid was “H-2” histamine blocker. In the video, I gather that the researchers lumped the two mechanisms together, but I wonder whether there is nevertheless a distinction between the two mechanisms.

    1. Bruce, that is very interesting. My gastroenterologist knows I do not want to be on PPI’s so he recommended zantac for breakthroughs saying it was effective and harmless to use as needed. I hope Dr. Greger follows through with additional information.

    2. Bruce MacKenzie, have you ever spoken to your GP about allergies?… I only mention this because I see the same symptoms in my family, and while stomach irritation and acid reflux can occur at the same time, the throat clearing, tickling sensation, itchy ears in the morning proved for me to be allergies, not GERD. See Bobbi’s post above for diet info suggestions to try. My doc handed me the fodmap diet page, and said start eliminating from the top… I didnt have to go far. Dairy and wheat… though now I can tolerate some wheat . I tried Benedryl to see if it impacted my symptoms (it did) Just a thought.

    3. Bruce,
      Yes there is a difference. Dr. G will be covering H2 histamine blockers in another video. Stay tuned!

  15. I found that when I went off gluten(after 69 years), my acid reflux(the original reason I became a Vegan) simply WENT AWAY. This is also a documented circumstance in the literature: the link between GERD and gluten intolerance.

  16. I got H Pylori back in 2013. After my own personal research, I’ve concluded that we need our stomach acid, and acid blockers are very bad for you. I took it and it made things worse. It creates a welcoming environment for unwanted gut bacteria. I’ve learned to take supplements to address my gut issues instead. It’s not perfect, but it’s A LOT better than taking acid blockers, and I’m still trying to get rid of my problem 100%. Consider reading Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD https://www.amazon.ca/Why-Stomach-Acid-Good-You-ebook/dp/B00AE1M1R0/ref=cm_cr_srp_d_product_top?ie=UTF8

    This doctor promotes stomach acid.

  17. I was hospitalized several years ago I had eroded esophagus, pre cancerous cells. Started taking Prilosec 40 mg per day, then 3 years ago increased to 40 mg twice per day. At that time I had started on Dr. Fuhrman diet after seeing PBS program, but then while on that diet I lost a lot of weight 50# or so. On that diet I was so happy with weight loss, but could not sleep in my elevated bed, had to sleep in recliner, sitting upright. That was when I found McDougall diet, found I could not eat potatoes as they cause bad reflux. Went on rice as a process of elimination found I could eat rice, all fully cooked vegetables, no raw. Oatmeal with mango, berries, bananas, . Thought I was doing well for 13 months, went off all PPI’s. One day after several bites of spinach and lentil soup, at a restaurant, it came back up with much blood. Hospitalized for 3 days, eroded esophagus for second time. Put back on Protonix, 40mg 2 a day. That was Jan: 12-15 th. Against medical advice I am taking 150 mg of Zantac before bed. Bought a hospital bed so I sleep with head elevated. My diet is not as good as I would like try to eat fat free, achieve perhaps 70-80 % as I am 84 and live in retirement home. They will fix me beans and rice every day, with non acid fruit and sweet potatoes, all other veggies have butter. Should I try to get off Zantac.? I can not even eat one bite of food without digestive enzymes. I also take DGL and Aloe Vera juice.

    1. If I were in your position, I would not stop the Zantac. It seems your symptoms are severe. Zantac is a H2 blocker, meaning its mechanism is to reduce acid production, not stop it completely like a PPI. H2 blockers do not have all the side effects of PPI’s.

  18. I notice that zantac (ranitidine) was mentioned as a PPI in the sub-title, but zantac was not mentioned in the rest of the video. Is zantac a PPI and if not, is it dangerous or safe?

  19. This video is is scaring me, and now my acid reflux is kicking, and oh man, I am scared to take omeprazole , and now my stomach is churning more. Better take my antacid, oh wait, that has a aluminum… more churning….. aaaahhhhhhhhhhHHHHHHHHHHHHHH!!!

      1. I realize cucumber is highly alkalizing but in your experience, what does eating a whole one do? Are you saying it can equal the effects of Omeprazole?

        1. I would suggest eating a half with a meal. through the day at meals that normally cause acid reflux.

          For me, I cut back on the amount of meat 60%, stopped dairy and by like 90% , and reduced wine and beer by about 35%. And I tried to eliminate all added sugar from my plate. It’s hidden in everything. I would say I cut it back by about 60% I don’t even put sugar in my oatmeal just some fruit. If my daughter is eating Iwill add honey. Stopped eating biscuits, flour tortillas, and French bread, and all white flour products for a while. I do have occasionally now, but it’s very hard on the digestive system.

          Increased all vegetables, but lots of the bland ones like cucumber, squash, broccoli , kell and radishes. Nuts, beans. For me I have to limit tomatoes especially canned and lemons/limes.

          I was taking a bottle or more of Zantac or such per month. I take maybe a few pills a year now. This year I think I took 2 pills so far this year.

          Also you may want to add glutamine to your diet as I read it helps build the stomach and intestinal lining back, although dr Greger advises against protein supplements.

          End

          1. I have no digestive problems during the day any more. I overcame chronic reflux by eating only very (emphasis) small meals but much more regularly as I’m retired and can do that. Its only during sleep that corrosive “mists” rise up and do their damage every single night! No medication or any other measure has been able to stop this happening, even though I have a seriously alkaline diet.
            Even Joel Fuhrman MD has been unable to resolve this condition.

            1. Seems like I read something about eating at night before bed, and if your eating meat for an evening meal especially with onions or alcohol, or anything that relaxes the esophageal sphincter may make it worse. But what you do through the day could help with the night. Try eating a part a cucumber before bed with no salt of vinegar. I’d certainly be looking for an alternative to pills everyday.

              It’s crazy how I got started drown this path. As a top level amateur cyclist I started not being able to breath and was told to take Asthma medication seemed to work till I found out how much it cost 300 a month without insurance. Wow, was not even possible so I started looking for alternative ways and found that ginger was very useful and the reduction in red wine, and low and behold I could go long periods with no symptoms. Was still having some other issues and kept digging and experimenting and trying an alkaline (mostly) diet. Low and behold my acid reflux went away too.

              Then I found this sight and found more answers and from sinuses being habitually inflamed with allergies to dust, to pain in wrist, knees, and ankles, constipation. Even running a constant low body temperature. I’ve pretty much self cured all of that. I feel better, look better, my cycling power and respiratory vo2max even improved enough to race again.

              So keep digging you’ll probably get there.

              End

        2. I guess Zanny I didn’t answer your question exactly. But cucumber will be digested, so you will have to eat more than one a day, but if you eat enough of the alkaline plants and grains and eliminate the hard stuff you will balance out fairly quickly like in weeks.

          End

  20. I personally believe I have been misdiagnosed with epilepsy caused by malabsorption issues caused from these kinds of medications. I’m still trying to find somebody to hear me out regarding the research I’ve conducted but I outright refuse to take them anymore and since taking a vitamin supplement I am now a year seizure free

  21. Hi. I’m a 25 year old male and have been experiencing a hoarse voice & moderate to severe throat pain for the past few years to the point where even speaking exacerbates the pain. I didn’t experience any real symptoms besides that, and a mild post nasal drip, but about 6 months ago i started experiencing painful burning/acid in my upper chest and throat. Since then i’ve been put on a bunch of PPi’s with only very mild relief from the burning at best, and have since had a allergy, barium swallow, motility, & endoscopy tests done that have all come back clean.

    My life has almost been on put on hold since i started having this issue, and doctors seem to not have any real answers besides handing out more prescriptions without a real diagnosis. To give some details I’m by no means overweight and if anything could gain a few pounds, I went WFPB over a year ago and I try to avoid most processed stuff & spices. Since going WFPB i feel better in some aspects, but it hasn’t seemed to really help my problem much. Overall I’m really unsure what i should do next, but I’d really like to try something different, and hopefully get off theses PPI’s as well. I really look forward to the next video, and hope maybe some folks here could recommend anything to try.

    I really appreciate any responses.

    1. Hey Zachary, I’m sorry to hear of your troubles. I’d suggest you start by getting a test for H.Pylori. It will probably be a blood test at first, and then all following tests will be breath tests.
      I’ve repeated it here several times, and am at risk of looking like a spammer, but perhaps you would consider reading Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD by Jonathan V. Wright.
      Personally, I no longer need and will refuse acid blockers. Instead, I take supplements. Still working to get to the point I need to take nothing.

      1. Thank you so much for the response Tan! I’m honestly stunned that this is the first time I’ve heard of H.Pylori, and I’ve been to too many doctors to name. It baffles me no one even mentioned this as a potential possibility despite me showing some of the symptoms for it. I’m definitely gonna see my general practitioner and demand I get this test done, even if I don’t have it It looks like something that needs to be ruled out.

        No need to worry about spam as well. I’m all for dealing with illness naturally if at all possible, and seeing as the book is rather inexpensive it looks like it could have some valuable information anyway even if it for some reason doesn’t have all the answers i need.

        Also I saw the list of supplements you take, and may end up giving them a shot. I’m just curious if is there a specific way you take them, or if you take them just as the bottle says?

        1. Zachary, I have read through the comments section today carefully, and wonderful suggestions are offered. I just wanted to say that if you have been scoped (endoscopy), then tney tested you for h pylori. They would have taken biopsies at multiple locations also. You dont have to request it, or just check by phone .. I had a follow up appt with the gastroenterologist to discuss it all. I cooled the flaming fire in my stomach the same way DArmstrong does it with alkaline foods.

    2. Zachary,
      I can relate to your problem as I’ve had a similar problem. In my case I had voice issues and shortness of breath. It turned out I had severe subglottic stenosis (scarring in my trachea just under my vocal cords). After GI tests, no evidence of reflux could be found but doctors were convinced I had silent reflux and wanted me to take the PPIs or H-2 blocker. It made no sense to me because as a dietitian I knew that my stomach was supposed to be acidic and I wanted to get to the cause of the problem. I had to find my solution.

      Dr. Jamie Koufman, a laryngologist, has done a lot of work with silent reflux and works with people that have voice issues. She has found that its the pepsin (an enzyme that digests protein) from the stomach that gets deposited in the back of the throat during silent refux. Pepsin gets activated by acid, whether its from the HCl in the stomach or from acidic food you eat. So when you consume something acidic it activates the pepsin in your throat, thus causing the damage. The solution is to avoid highly acidic foods or at least wash them down with a neutralizing food. Here is a link to her bio and books. https://www.goodreads.com/author/show/4159739.Jamie_Koufman. I hope this helps you.

      1. In my case I have found to date that nothing reduces or stops corrosive mists from rising up from the stomach when sleeping and causing burning pain, palet ulcers, and loss of sleep. Diet manipulation, medications and other measures too long to list here have not been able to improve these awful symptoms. Top university teaching gastroenterologists are at a loss as to what to do going forward. Serious daytime reflux is completely under control without medications due to my own discovery of eating very (emphasize) small meals throughout the day – I can do this as I am retired. However, nothing touches the mysterious stomach gasses getting beyond the LES which I’m informed can be more dangerous than the daytime reflux of stomach liquids. I have tried all the usual natural remedies I have knowledge of including Dr Koufman’s alkaline regime but still I wake up multiple times a night with seriously burning pain in the mouth and all northern extremities including the eyes which water until I wash then out. I have also lost all of my teeth and had move to full dentures. I did the Peptest twice which I had to send off to the U.K. and they returned showing that pepsin was present in areas it should never be. There is no such test in the U.S. but I gather Dr Koufman has produced one of her own which is awaiting FDA approval. I’m presently trying to wean off 20mg Famotidine (Pepsid) which I take just before sleep and am slowly introducing more and more Amla powder (Indian gooseberry) which Dr Greger covered in a recent video which one study showed was as good or better than some antacids. Watch this space.

  22. In honor of those lives lost in the horrific Pittsburgh shooting I am changing my name here from Lida to Tree of Life. May their memory be blessed.

  23. I was on 2 x 40mg Nexium and others daily for many years and eventually had to have the Nissen Fundoplication surgery. Following the surgery, I still had night time reflux which is still causing burning throat, mouth and tongue and a plethora of ulcers on the roof of my mouth which makes eating anything difficult. I’m informed by my gastroenterologist that these symptoms are caused by nocturnal corrosive “mists” that rise up whether I’m standing or sleeping on my 7″ higher raised bed head. No PPI’s, H2 Blockers or anything I have discovered helps these symptoms. Its thought they occur only when sleeping due to the fact that sleeping relaxes the lower esophageal sphincter allowing the “corrosive mists” to do the damage mentioned above. I have been a Nutritarian since its invention which has improved my health in multiple ways but this particular health issue I have yet to find a solution to. Just before sleep, I take 1 x 20mg Famotidine with Evamore alkaline water and I’m currently experimenting with 1 x 500mg capsules of Orange Burps but so far its not helping. Doctors have run out of ideas so if anyone has any suggestions I would be happy to hear them.

    1. Chinese herbal medicine might have something that would help. I recommend an experienced Chinese herbalist. They will need to do a constitutional diagnosis. There may be more going on than just the acid… mouth ulcers are more complicated in that system… good luck

    2. Have you tried sleeping on your left side? That’s said to be best because of the anatomy of the stomach and the manner in which the esophagus enters it.

      I had a similar problem a few years ago. In my case, I decided the primary problem was stress/anxiety from other health issues. This is not to say that overeating, eating oily meals or certain foods did not play a role, but I am convinced the underlying cause was psychological. But then I think many health problems, e.g., almost all lower back problems, are generally mostly psychogenic.

      1. As I mentioned previously, the symptoms occur whether I am standing or laying on an inclined bed so laying on the left side does not reduce or solve the problem but thank you for the suggestion as I know it works for many people. I don’t overeat, and as a Nutritarian I ingest no oils.

      1. As mentioned I am already taking d-Limonene in the form of Orange Burps (recommended by John Brisson). I only started taking this a few days ago and have not noticed any improvement but its early days in this regard. But thank you for the suggestion.

      2. May I ask how long you have been taking d-Limonene and how long before you noticed improvement? Additionally, do you know if it is safe to take this dose indefinitely?

  24. Try Yogi brand Comforting Chamomile Tea (brew fairly strong) good hot or at room temp. Settles stomach discomfort very well, all natural and caffeine free too. Crystallized ginger, cut a small piece let it desolve in your mouth great to take along on the go.

  25. I really empathise with everyone having digestive issues! I’ve had problems for the last 6 years. A year ago I tested positive for both dientamoeba fragilis and blastocystis hominis and was successfully treated according to a sensitive stool specimen check. The symptoms of gut/stomach ache, indigestion, feeling sick, loss of appetite, loss of energy, diarrhea, exhaustion, brain fog, and migraine continued. I asked for a sensitive stool specimen to be checked for Helicobacter Pylori and it came back positive. Faithfully followed a 7 day triple therapy regime of a Proton Pump Inhibitor, Clarithromycin, and Amoxycillin, and also took a good multi strain probiotic. For at least a week after ending this regime I felt completely exhausted, and my legs felt like lead. I wondered whether my iron stores had been affected, and if my B12 was low, so increased B12, and also took a sachet a day for 7 days of spring water which included iron in the analysis of minerals. My energy levels returned a little and my legs didn’t feel so heavy, but I still didn’t feel anywhere near 100%. Four weeks after finishing this protocol I re-tested a stool spec, and was declared free from Helicobacter Pylori and all other pathogens. Was feeling a bit better, but then gradually all the previous symptoms returned. Went back to my intelligent, listening Doc, armed with another stool spec to request testing (now awaiting results) and he told me that in fact although I’d been declared free from H. Pylori in the previous stool specimen, he had received more info from the lab and it was still present. Presumably the lab must have rechecked the original stool specimen. I have now studied H. Pylori in as many scientific papers as I can lay my hands on! It’s a nasty and persistent little bug, which can cause stomach/duodenal ulcers, which can lead to cancer. It can also be asymptomatic. It interferes with the intrinsic factor in the gut, affecting production of B12 and it also reduces iron stores. I have also learned that the triple/quadruple therapy unfortunately is not always 100% effective. One of the problems is antibiotic resistance which differs according to Country, and also that antibiotics cannot penetrate the outer layer/layers of the H. Pylori, so for antibiotics to be in any way effective, that outer layer/layers must be accessed/penetrated/damaged first. There has been some success using N-Acetyl-L-cysteine (NAC) to do this, followed by a triple or quadruple antibiotic therapy, including Proton Pump Inhibitor for 2 weeks, not 1 week. H. Pylori thrives on stomach acid, so Proton Pump Inhibitors are effective in this respect. A possible H. Pylori vaccine is also under investigation. Away from the scientific papers, anecdotally, people seem to be having some success using alternatives, and accordingly, I’m now following this regime of taking Mastic Gum (pistachio nut tree resin) which inhibits the H. Pylori from adhering to the stomach lining. DGL (liquorice), aged garlic powder, red grape skin extract, capsaicin (chilli) broccoli sprout powder(produces sulforaphane) , wild oregano oil (oregano vulgare), slippery elm, marshmallow root and aloe vera, the latter three to help heal the gut lining, and a multi strain probiotic, including Saccharomyces cerevisiae (boulardii). I eat live sauerkraut every day, and I’m also using N-Acetyl-L-cysteine (NAC). I’ll follow this regime for 4 weeks and then sensitive stool retest whilst still taking everything, and if H. Pylori still persists, then I’ll have to decide whether to use another round of a triple/quadruple therapy, but on the evidence so far, I’m not very enthusiastic about doing it! Just for the record, I’m a slim, active (dampened a little by “the bug”) 78 year old woman, eating 95% vegan whole foods and well on the way to being totally vegan! Good luck everyone, and thank you Dr. Greger and team for fantastic science info!

    1. Very informative. what is the science behind…NAC. If you don’t mind.
      I have no problems, but have been wondering a bit, if a vegan diet suffices in all the specific regards like amino acids to provide optimal nutrition. I would not go back to eating meat or dairy, as that is a ethical thing, but vegan supplements are available for things like aminos.

      1. Hello Mostly Vegan ron in New Mexico!

        In response to your query about NAC (N-Acetyl-L-cysteine), I can give you the sources of some of my information, but I really haven’t studied it enough to be an expert! I do know it’s used in cases of paracetamol (acetaminophen) overdose, and to loosen thick mucus in individuals with cystic fibrosis or COPD (chronic obstructive pulmonary disease)

        I would think that a good vegan diet should give one all the amino acids needed, but I’m trying to get rid of a specific bacteria, Helicobacter Pylori.

        Here are the links:- https://universityhealthnews.com/search-results/?q=Helicobacter+pylori, The article I read was written by Kathleen Jade ND, and she does give refs.

        The other article I read came from https://www.fxmedicine.com.au/blog-post/nac-persistent-infections and tthey also give refs.

  26. If baking soda is so terrible to injest than should we even be using it in actual baking to help rise foods? This is very concerning!

    1. It’s also worth remembering that baking soda is very high in sodium. Just half a teaspoon of baking soda delivers 1250 mg of sodium. The US dietary guidelines recommend that adults consume less than 2,300 mg of sodium per day

      1. Mr Fumblefingers, I use less baking soda than recipes call for when baking, with no problem. e.g., I make a whole grain sourdough waffle with 1/2 the amount of baking soda (which is 1/4 teaspoon for three Belgian waffles, and I may try less) and no salt (the recipe calls for the same amount of salt as baking soda; I know that salt is important for “strengthening” the gluten, but is it the sodium or chloride that is necessary? I suspect sodium), and I get beautiful waffles: crisp on the outside, moist on the inside. Oh, and the recipe has no oil or eggs, and I use soy milk (unfiltered).

        I wish I knew more about the chemistry of baking. And cooking. It would help in adapting recipes. Currently, it’s trial and error.

  27. That’s nice to know, I suffer from chronic pain. I’m taking ginger and turmeric with black pepper everyday to try and help with it. I take codeine paracetamol and ibuprofen. The ibuprofen causes stomach upsets and I was prescribed Nexium to deal with that… Great! I’m doing the predominantly whole plant based diet vegan thing. My father died of dementia and used to take antacids all the time and I’m starting to feel a little paranoid as I’m at the age where he started to go downhill.

    Can someone please tell me that Alzheimer’s and dementia is caused by animal originating foods especially oxidised cholesterol which can cross the blood brain barrier causing plaque in brain arteries leading to the cause of of Alzheimer’s and dementia.

    If I want to sleep at night, I need to take pain medications, which lead to taking Nexium. Which is worse for me, not sleeping and/or having poor sleep, or should just sticking to paracetamol with codeine (staying away from ibuprofen). Or do these have equally bad side effects as well?

    1. Hi andiness, I broke my T7 at age 11. My back pain of 48 years faded away after about 6-9 months after going whole plant based with no added salt, oil or sugar. No longer do I eat paracetamol or ibuprofen (both with codeine).

    2. andiness (interesting “name”), you say you suffer from chronic pain. Where, all over your body? In your joints?

      Folks like you are a medical doctor/Big Pharma’s dream. Rather than concentrating on prevention or cause, they want to douse you with pills; if those pills don’t seem to work, they’ll happily prescribe others.

      If I were you, I’d first want to know WHY you continue to have this pain. Get to the source instead of slapping bandaids (drugs) on yourself. This could be due to several reasons, including daily stress, coping with a miserable relationship, allergies, or various psychological reasons.

      Maybe you could be hypnotized to find out why. Woo-woo moi would say this could be a carryover from another lifetime; hey, y’never know! I’m now reading MIRACLES HAPPEN (from library) by Brian Weiss, which goes into this subject more deeply.

    3. andiness,
      So sorry that you have to deal with chronic pain. There are many factors involved in Alzheimer disease. If you have already been doing WFPB for at least a year then you might want to consider a clinic such as True North; they do medically supervised fasting to heal chronic diseases and inflammation causing pain, then transition you to WFPB. They call themselves “the last resort.” Here’s a link to learn more about it. https://www.healthpromoting.com/

  28. This was my reason for changing my diet 3.5 years ago.

    I knew that taking drugs forever was no way to treat my reflux.

    I am better now. No OTC, no Rx, no problemo.

    You and your health are what you eat. It’s a joyous when you get it right. Thanks Michael and friends.

  29. Wait, I thought there was a video here suggesting using baking soda in our water to make our water more alkaline. I’ve been doing that for the past year to help avoid interstitial cystitis flare-ups. Is that something I should now stop?

  30. Hi GR0508,

    I am a volunteer for Dr. Greger. Thanks so much for your question.

    Here is the video Dr. Greger has on baking soda to make water more alkaline: https://nutritionfacts.org/video/alkaline-water-a-scam/

    Use it with caution, however, as too much can be harmful (as shown in the video under which this thread is). For things like interstitial cystitis flare-ups, I am not aware of any evidence that suggests that baking soda helps, but you should use a combination of listening to your body and checking base with your physician.

    I hope this helps to answer your question.

  31. While reading along with the video, I found the large number of typographical errors disconcerting. Didn’t anyone proof read? I hope this is not an indication of the attention to detail of the author.

  32. Does anyone know of a way to get off of Prilosec. I have Barrett’s esophagus and I take it once a day. I wonder if I could take it every other day. GI Revive is a supplement recommended to help, but I still got reflux on the 2nd day without omeprazole.

  33. Patients get this way due to the highly processed and highly calorie dense western diet. Populations that eat unprocessed plants (think farm to mouth with no machine in between) rarely if ever suffer from your condition. Have you tried eating an unprocessed plant diet? Even with this there are possibly trigger foods in some people such as black pepper and citrus. I used to have GERD. As soon as I switched to a WFPB diet, my GERD was cured.

    Dr. Ben

    1. Hello Dr. Ben, it’s excellent that you no longer have GERD. Unfortunately, not all GERD symptoms are caused just by eating a poor diet, and not all GERD symptoms will disappear by eating a WFPB diet, even if avoiding “trigger” foods. In the case of Helicobacter pylori, a much more aggressive form of treatment is necessary, whether it be allopathic or alternative or a combination, because no amount of WFPB alone will kill this persistent bacteria. In the case of chronic gastrointestinal pain and discomfort, I think it’s advisable not to second guess the cause, but to undertake appropriate testing, including a sensitive faeces specimen test (PCR) which at the moment appears to be the most accurate for detecting pathogens, and also a faeces occult blood test. Armed with that information, we have a better knowledge of what we’re dealing with, can order further appropriate tests and at least have a fighting chance of finding an appropriate remedy, and of course, a WFPB diet will continue to support recovery. Sending happiness and sunshine from Australia!

  34. H. pylori is ubiquitous: 50% of the entire world human population is infected with it, yet 50% of the population does not have GERD. What you’re referring to holds true in a gastric environment of consumed refined carbohydrates, refined fats and animal products, which are all high fat and/or high caloric density, and none of which we evolved to eat. The highest risk factors for GERD as documented in unbiased peer-reviewed clinical studies as reported by Dr. G, are high fat foods, and high caloric density foods. This can all be avoided by simply eating what we evolved to eat: unprocessed plants.

    Sending Aloha from Hawaii.

    Dr. Ben

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