In the U.S., 66% of adults are estimated to have at least one prescription, and the average person has nine filled annually. As an awake physician, one of the most depressing aspects of my work is seeing patients, especially the elderly, weighed down by numerous prescriptions that frequently do more harm than good.
For example, as I showed here, statins provide a negligible benefit (e.g., at best, taking them for five years extends one’s lifespan by 3-4 days) but create significant side effects such as severe muscle pain and cognitive impairment for 20% of users.
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This tragic situation is best demonstrated by a 2007 study which showed that simply discontinuing the least necessary prescriptions resulted in a 23% reduction in the death rate and an 18.2% decrease in hospital referrals. Sadly, since the trend in medicine is always to have people on more drugs, data like this has had no effect on the practice of the overprescription of medications.
Over the years, I’ve asked dozens of holistic doctors which widely prescribed drugs they consider to be the most unnecessary and dangerous, and in addition to statins, three frequently make their list:
•NSAID painkillers (discussed further here).
•SSRI antidepressants (discussed further here).
•Stomach acid blocking PPIs (the focus of this article).
Acid Reflux
Your stomach contains acid that it uses to digest food (primarily by turning on powerful enzymes that digest protein). When the stomach is digesting food, the acid should stay inside the stomach, but sometimes, it leaks back up into the esophagus (your throat) because the muscle that seals the top of the stomach (the LES) fails to fully seal. Since stomach acid is irritating, it frequently creates an unpleasant condition known as heartburn when it refluxes into areas like the throat that are not resistant to its acidity.
Gastroesophageal reflux disease (GERD) is a very common condition, estimated to affect 20% of adults (ranging between 18.1% to 27.8% of adults in the USA), is slightly more common in women, and those numbers have been gradually increasing globally.
In addition to overt acid reflux, another condition is silent reflux (laryngopharyngeal reflux), where minor reflux occurs without causing overt heartburn. It is often the root cause of a variety of other symptoms, such as:
•Allergies
•Asthma and reactive airway diseases
•Burning in the mouth or on the tongue
•Chronic sore throat
•Ear pressure and ear infections
•Frequently feeling like you need to clear your throat (and sometimes cough)
•Post-nasal drip
•Sensation of a painless lump in the throat
•Sinus issues
While most medical conditions are overemphasized to sell more prescriptions, silent reflux is not, and it is quite rare for me to meet an otolaryngologist (ENT) who recognizes this is the root cause of their patients’ symptoms. Fortunately, silent reflux is highly responsive to lifestyle changes (e.g., not eating at night), and those measures frequently produce profound improvements for patients.
Why Stomach Acid Is Essential for Your Health
Subtle distortions frequently occur in science, creating a false conception of reality that conveniently allows a profitable industry to exist. For example, stomach acid is largely viewed as unnecessary and thus frequently possible to justify eliminating with acid suppressing medications. In reality, it has numerous vital functions:
Protein Digestion: Amino acids, the building blocks of the body, are obtained from protein. Without sufficient acid, proteins can’t be properly digested, leading to significant nutritional deficiencies, impaired energy levels, mood or cognitive function, and food sensitivities from undigested foreign proteins entering the bloodstream.
Sterilizing the Stomach: Acid is a barrier to harmful microbes, preventing them from entering and infecting the digestive tract. Those with low stomach acid are thus at higher risk for severe foodborne illnesses and hospital-acquired infections.
For example, one study found that ventilated patients who received an acid blocking medication (which was not as powerful as the newer PPIs) were twice as likely to develop pneumonia and 60 percent more likely to die from hospital acquired pneumonia. Similarly, a Clostridium difficile infection is the leading cause of hospital-associated infectious diarrhea. It has a considerable impact on the length of a hospital stay and its costs—those on PPIs were found to be twice as likely to develop this condition. Furthermore, one large review of septic patients found those on PPIs were 4.3% more likely to die than those not on PPIs.
Note: the largest review that has been done so far of PPIs and COVID-19 found PPIs increased a COVID patient’s risk of dying by 77%.
Many of the issues with acid suppression are best illustrated by how they alter the normal bacterial flora of the gut. For example, to quote the manufacturer of one PPI:
Like other agents that elevate intragastric pH, omeprazole [Prilosec] administered for 14 days in healthy subjects significantly increased the intragastric concentrations of viable bacteria. The pattern of the bacterial species was unchanged from that commonly found in saliva. All changes were resolved within three days of stopping treatment.
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Nutrient Absorption: Many (myself included) believe one of the primary causes of all the chronic illnesses we see today are widespread deficiencies of vital nutrients. Much of this deficiency comes from:
•Industrial agriculture (which nutritionally depletes the soil)
•Chelating herbicides such as Roundup (which sequester essential minerals like manganese)
•Food processing (which removes many vital nutrients from food)
•Impaired absorption of the nutrients that remain.
Note: manganese deficiency is a root cause of many debilitating conditions, such as hyper-mobile connective tissue disorders (which make individuals much more sensitive to environmental toxins—for example, patients with ligamentous laxity are much more vulnerable to vaccine injuries). Fortunately, with appropriate manganese supplementation,& these conditions often significantly improve.
Poor stomach acid levels hinder the absorption of critical minerals and vitamins. Beyond making individual amino acids available, certain vitamins (e.g., B12) depend upon stomach acid for absorption, and many minerals bound to plants (e.g., iron) will only separate and become absorbable in an acidic environment.
Note: this is a key reason why stomach acid deficiency is particularly problematic for vegetarians.
Digestive Signaling: Acid stimulates the release of hormones (e.g., secretin and cholecystokinin) and enzymes necessary for digestion. These signals ensure that the pancreas releases the right enzymes to continue breaking down food and that the digestive system functions efficiently. Impaired acid levels can disrupt this process, leading to issues like indigestion and floating stools.
Why would Nature expend so much metabolic energy to provide each one of us at birth (and until at least age forty) with an ample supply of stomach acid and pepsin if it weren’t really necessary for digestion?” — Jonathan Wright MD
