Long-term use of PPIs and your gut health

supplements for IBS

During my 32 years of experience as a natural health practitioner specialising in digestive and gut health, the rise in stomach and digestive disorders and the increase in prescription medication being given to treat these disorders has not escaped my attention. Research backs up my observations on this subject.

A 2021 study surveying 73,076 adults across 33 countries found that 40% of those surveyed had a functional gastrointestinal disorder, which includes all the variations of irritable bowel syndrome, functional dyspepsia (symptoms of an upset stomach that have no obvious cause), functional constipation, and many more.

According to another survey of digestive health across Europe, gastrointestinal and liver diseases are responsible for over a million deaths each year in Europe across all ages, and the disease burden is likely to increase as the population gets older. This report also noted that the inflammatory bowel diseases, Crohn’s disease and ulcerative colitis, have increased significantly across Europe in the last 30 years, especially in the United Kingdom and the Scandinavian countries.

East Asian countries, including South Korea, Japan, and China, have also seen increases in gastrointestinal diseases as these countries continue to modernise, adopt Western dietary choices, and widely administer antibiotics.

Is there a common denominator?

The mechanisms behind digestive disorders are wide-ranging and individual to each person. However, what we can learn from extensive research over the last few decades is that environmental factors have just as much (if not more) to do with these disease outcomes than genetic predisposition alone.

For example, those with inflammatory bowel disease are often found to have low levels of beneficial bacteria in their gut microbiome as well as deficiencies in the metabolites produced by these bacteria, such as certain vitamins and gut supportive short-chain fatty acids like butyrate.

Toxic exposure to chemicals, pollutants, pesticides, pharmaceuticals and other hazardous substances in our water and air may also be contributors to digestive diseases. Your digestive system is among the first points of contact with these substances when you eat and drink.

The list goes on: inadequate nutrition in processed foods, high stress levels, traumatic experiences, even a lack of social support can all have a negative impact on gut health.

Prescription meds and gut health

Don’t get me wrong, I am not against the use of prescription medications, such as antibiotics to treat infections and serious illness. They are life-savers in many cases. Also prescribed with increasing frequency are proton pump inhibitors (PPIs), such as omeprazole or lansoprazole, and they can be an effective short-term treatment, for example, as part of a 1-2 week course to treat H.pylori infection in addition to antibiotics. Many people are prescribed a short course of PPIs to treat symptoms of acid reflux or dyspepsia, and if symptoms resolve, they can stop taking them. However, I have lost count of the number of people who have contacted me telling me that they are taking PPIs and have been doing so for several months, more often several years.

PPIs and your gut health

Some conditions may require longer-term use of PPIs include, and in these cases, the benefits outweigh the risks:

  • Severe oesophagitis, Barrett’s oesophagus, oesophageal strictures
  • Acid reflux
  • Dyspepsia or upper airway symptoms that improve with PPI usage but worsen when stopping PPIs
  • People with a history of upper gastrointestinal bleeding from gastric and duodenal peptic ulcers may need to be on PPIs long-term to prevent recurrence.

What we must not overlook are the risks associated with long-term use of PPIs. In recent years, observational studies have indicated associations with a variety of serious adverse effects from long-term PPI use. They include:

  • Clostridium difficile infection
  • Increased risk of bone fractures in susceptible populations
  • Chronic kidney disease
  • Dementia
  • Pneumonia
  • Vitamin B12 deficiency
  • Stomach cancer – this research was carried out over 5 years and showed that those who took regular PPIs had an increased risk

Whenever I am contacted by someone who has been taking PPIs long-term, I ask lots of questions about their medical history and always check that they have had their medication reviewed with their GP. In many cases, they need to stay on the PPI; in just as many cases, it is possible to come off it by looking at alternative ways to manage symptoms.

NOTE: The decision to wean off and stop taking prescription medication is a complex matter and one that should always be discussed with your GP.

Our gut health is unique to each of us, which means that some experimentation is required to optimise it, with diet and lifestyle changes, and a supplementation protocol that works for you.

Simple lifestyle changes include healthy eating, weight reduction, stopping smoking and avoiding factors associated with dyspepsia such as alcohol, coffee, chocolate and fatty food. Having your main meal well before bedtime (3-4 hours beforehand) and raising the head of the bed may help some people.

Supplementation protocol to support and optimise your gut health

While each person presents with their own unique set of symptoms, our Perfect Balance Kit will help kick-start a sluggish digestive system, enable you to get the most from your nutrition and assist in the elimination of bowel wastes, whilst at the same time, supporting your immune system.

Perfect Balance Kit

Our Perfect Balance Kit contains a powerful and effective combination of four natural supplements:

  • Live Bacteria probiotic capsules to get some good bugs back into your system
  • Natural Digestive Enzymes tablets to ensure your food is being properly absorbed and digested
  • Garlic tablets to ensure you have natural antimicrobials in your system to help fend off any opportunistic pathogenic bugs
  • Omega 3 capsules containing healing essential fatty acids to help dampen levels of inflammation in the body

The Kit comes with full instructions and you can learn more about it here, as well as read some of the amazing reviews.

I always ask that people get back in touch when they’ve almost come to the end of taking the supplements in the Kit to let us know how they’re feeling and report any changes in symptoms. We will then advise you further, with the aim of reducing supplements to a maintenance protocol to help prevent the symptoms from re-occurring.

It may take some time, but excellent gut health is absolutely achievable, whether you are looking to wean off long-term medication, heal from a digestive condition, or optimise your digestion for better overall wellness.

If you would like to know more about a supplementation protocol or have any other questions, please get in touch.