Why is stomach acid so important?
Stomach acid isn’t the enemy! Contrary to popular belief we need stomach acid, and lots of it. Stomach acid plays an important role in breaking down the food we eat, absorbing key nutrients, and killing off any bad bacteria that has dared to breach our defences. Therefore, without sufficient stomach acid we risk becoming deficient in essential nutrients, or falling victim to common infections such as h. pylori.
What are PPI medications and how do they work?
If regular indigestion, or it's associated symptoms such as acid reflux troubles you enough to go to the doctor, then the chances are you’ll be prescribed one of three types of medication. These are often one of the following:
Antacids - Antacid medications aims to ‘neutralise’ your stomach acid in a bid to reduce the effects of symptoms such as acid reflux or heartburn. Common types include Tums or Gaviscon and these are often widely available in pharmacies and supermarkets.
H2 blockers - A step up from the antacids, H2 blockers aim to reduce the amount of acid produced in the stomach. A common example of this type of medication is ranitidine.
Proton pump inhibitors – The strongest category of ‘acid blockers’ proton pump inhibitors or PPIs reduce stomach acid significantly, in a bid to reduce acid secretion and allow our oesophagus to heal if it’s had a hard time of it recently. Types of medication that fall into this category include omeprazole and lansoprazole.
What issues can be associated with these medications?
The first issue with many of these medications is plain and simple – we need stomach acid! Stomach acid is highly acidic and that’s exactly how we want it. See, it’s acidic for a reason; we need it to break down the food we eat into its simplest units so we can absorb the macronutrients for energy, and the micronutrients to support our health.
Acid reflux, often a symptom of indigestion, occurs when acid gets into the wrong place. Our oesophagus isn’t as sturdy as our stomach and so it can be painful if acid gets there. So, really we want to prevent acid getting to the wrong place by supporting the structure and functions of the sphincters (these act as entry and exit routes into our stomach) rather than necessarily reducing the amount that we produce.
Next, these medications were really only designed to be used in the short-term to help manage the healing process. However, there are some conditions, such as Barrett’s oesophagus, which require the long-term use of stomach acid suppressants. Also, the majority of people with heartburn and reflux should not be kept on these drugs long-term. As we now know, depleted levels of stomach acid can cause a number of problems long-term:
- More reflux! – unfortunately for us, the symptoms of low stomach acid are very similar to those that appear when we have too much (and mainly because both conditions can affect the functions of the lower oesophageal sphincter (LOS)). To learn more about the symptoms of low stomach acid click the link!
- A long list of other issues – PPIs can affect nutrient absorption and our ability to keep bugs at bay, plus the use of PPIs for a year or more has been found to increase our risk of bone fracture (1) (bone fracture may increase with shorter periods of use too). That’s not all though, it’s also been shown to lower our levels of magnesium, calcium, iron and B12. (2) It also puts us at higher risk of C. difficile, (3) and an increased risk of pneumonia in hospital patients.(4)
In naturopathic medicine we believe that long-term use of antacids actually makes the original reflux situation worse in the long run because it can risk weakening the sphincter at the top of the stomach which should prevent acid from refluxing into the throat.
This sphincter is toned by the healthy production of stomach acid so blocking it (although possibly useful in the short term) is not helpful.
How can you tackle acid reflux naturally?
If the medication you’re currently on isn’t helping you to manage your symptoms (or it may even be making your symptoms worse), then it’s time to take some action and try to manage your symptoms more effectively going forward.
Firstly, you should discuss with your doctor if the medication you’re on is still the best option. Next, there are some simple, but effective steps you can take at home:
1 – Don’t rush your meals
How you eat can really have an influence on your symptoms when it comes to stomach complaints. If we rush the food we eat, or don’t chew properly, your stomach won’t have time to prepare. This means the necessary juices may not be available in time to digest your latest meal properly and symptoms can soon crop up.
Aim to chew each mouthful at least 20 times and sit down and relax in order to enjoy your meals.
2– Don’t overfill
Eating huge portions can put extra pressure on your stomach, especially if you are short in acid already. Try to eat smaller portions at each meal and you can always have a small snack in between meals if you’re hungry, so long as you chew it well, that is.
Then there are also liquids to consider. As much as I’m a fan of ensuring you drink plenty of water, guzzling lots of liquids alongside your meals will only risk diluting your digestive juices. This will not only reduce the efficiency of your digestion, but can also make you feel more bagged up and bloated. My advice is to try not to drink anything for 30 minutes either side of food.
3 – Sort your posture
Not many of us consider posture when trying to improve our digestion but from my experience, it can have a real difference! Slumping over or eating on the move won’t give your stomach the space it needs to work at its best and this can give rise to troublesome symptoms.
4 – Manage stress
Again, we may not assume that stress and our digestion go hand in hand but that feeling of butterflies if you’re nervous is a vital clue - they’re very much in tune! Chronic stress, that is long-term stress perhaps as a result of busy schedules or persistent worrying, can eventually diminish digestive secretions and contribute to a host of unhelpful symptoms.
Then there are some remedies...
Then, after a couple of weeks of working on the factors above, with the OK from your doctor only of course, you may be able to start trying to decrease the dose of your medication, and can focus on using some herbs to better support your stomach instead. 
When it comes to managing indigestion or it's associated symptoms such as acid reflux with natural remedies, herbal bitters are the way to go. These can be taken with the medication initially, but if your hope is to come off it after chats with your doctor, they can eventually make a helpful alternative.
Take 20 drops of Digestisan, 3 times daily, before your meals to help manage the symptoms of indigestion or flatulence. Take in only a very small splash of water (5-10mls) so it tastes especially bitter in taste – this is best practice for sorting your stomach!
