Understanding the impact of PPIs on gut health
Diverticular disease and diverticulitis are common digestive conditions that affect many people, especially as they age. The exact cause of diverticulitis remains unclear, but there are several factors that can contribute to it, including chronic constipation, blockages in the colon, and inflammation. While lifestyle factors including diet and exercise also play a role, recent research, such as the findings outlined in this paper suggests that certain medications, particularly proton pump inhibitors (PPIs) and antacids, may also increase the risk of developing diverticular disease or worsen existing symptoms.
PPIs, widely prescribed to manage acid reflux and heartburn, can potentially lead to bacterial imbalances and compromised gut integrity over time. I am frequently contacted by people trying to manage their diverticular/diverticulitis symptoms, many of them taking a cocktail of different medications but unaware of the link between these medications and the impact on their gut health. Understanding how these medications work is essential for anyone looking to manage or prevent their diverticular flare-ups effectively.
The role of PPIs in gut health
PPIs work by reducing the production of stomach acid, which can provide relief from conditions like GORD and acid reflux. However, stomach acid plays a crucial role in maintaining the balance of gut microbiota, which are essential for digestion and immune function. Long-term use of PPIs has been linked to dysbiosis – an imbalance of gut bacteria – which may weaken the gut wall and increase susceptibility to infections including diverticulitis.
According to this study in the World Journal of Gastroenterology, while PPIs are generally well tolerated, prolonged use may promote bacterial overgrowth and alter gut flora, raising the risk of diverticular disease in vulnerable individuals. Therefore, it’s essential to evaluate the long-term use of these medications, especially if you are managing diverticular disease or other gut-related conditions.
Other medications that may worsen Diverticular Disease
In addition to PPIs, there are several other medications that may contribute to diverticulitis flare-ups or complications. These include:
- Opioids: Known to slow gut motility and cause constipation, opioids have been associated with more severe diverticulitis complications like abscesses and bleeding.
- Steroids: Used for conditions like arthritis, steroids can increase the risk of diverticulitis, particularly in older adults.
- Iron supplements: Often prescribed for anaemia, iron supplements are notorious for causing constipation, which can exacerbate diverticular symptoms.
- NSAIDs (e.g., ibuprofen): Frequent NSAID use has been shown to increase the risk of diverticulitis, as these drugs may weaken the gut lining and provoke inflammation.
- Antihistamines: These can lead to constipation, further aggravating diverticular disease symptoms.
Reducing the risk of Diverticular Disease
When anyone contacts me for advice about their diverticular symptoms, I always stress the importance of diet and lifestyle adjustments to help avoid long-term reliance on medications that can negatively affect gut health.
- Diet: A diet rich in high-fibre foods such as lentils, leafy greens, and whole grains can help maintain regular bowel movements and reduce the risk of constipation, a major trigger for diverticulitis flare-ups. This study from the European Journal of Nutrition found that individuals consuming at least 30 grams of fibre per day have a significantly reduced risk of diverticular disease compared to those with a lower intake. If you’re not eating enough fibre-rich foods, then consider taking two of our high-Fibre tablets half an hour before lunch and dinner with a glass of water.
- Gut health: Supporting the gut microbiome through probiotic-rich foods, and supplements such as our Live Bacteria capsules, can help reduce long-term PPI use and help restore healthy gut flora. I also recommend regular colon hydrotherapy treatments – its cleansing effects can enhance liver function and improve overall digestive health, which may lead to fewer gastrointestinal issues and less need for acid-suppressing medications like PPIs.
- Supplements: If you are getting regular diverticulitis flare-ups then consider carrying out our 5-day Charcoal cleanse to help clear out any nasty bacteria and microscopic bits of trapped food in the diverticular ‘pockets.’
- Stress management: While stress does not directly cause diverticulitis, it can lead to poor eating habits and gastrointestinal discomfort. Incorporating mindfulness, exercise, and relaxation techniques can promote better overall health and digestion.
You can find more comprehensive information on managing diverticular disease in our free downloadable Diverticular Disease Fact Sheet. If you have a question about a gut and digestive health issue or would like to know more about our range of supplements, please get in touch.
