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Paleo and long term PPI use

Answered on August 19, 2014
Created March 18, 2013 at 7:51 PM

Hi hackers

So, I have recently turned to paleo and have been steadily eliminating all my old, less than optimal, eating habits. One thing that concerns me though is my long term use of lansoprazole. I was prescribed this proton pump inhibitor for acid reflux almost eight years ago. The reflux was attributed to a hiatus hernia so modifying my diet has thus far not stopped the consistent heartburn from reflux. I take the lowest possible dose (15 mg) once a day and my heartburn just goes, it's a very helpful drug in that regard.

However I have been reading that due to the inhibiting action of the drug on stomahc acid production that some proteins will not be fully digested before entering the small bowel and can lead to food allergies.

I have started taking solgar digestive enzymes to help with this but I was wondering if there are any other paleo friendly tips from people in a similar position please?

Many thanks

C63b8a88c38822204a877a0610c76a3c

(0)

on March 19, 2013
at 08:44 AM

Thanks for these replies. In answer I have eliminated all grains and refined carbs except beer at the weekends, I guess I will have to work on this but social drinking at the weekend is my main 'get out of the house' being a youngish single chap. Weight isn't really an issue, I've always been fairly lean and I am now even more so with being paleo. Funily enough I have just started taking magnesium supplements in the form of citrate, is glycinate preferable for hiatal hernia? Thanks again for your replies.

3491e51730101b18724dc57c86601173

(8395)

on March 19, 2013
at 06:47 AM

One of the worst heartburn/reflux triggers for me is to drink a lot of water. Really and truly. I don't know why. I have to drink my water in small amounts often, because too much at once make me feel terrible.

C63b8a88c38822204a877a0610c76a3c

(0)

on March 18, 2013
at 08:14 PM

Well I did mention that the underlying cause of the reflux is a hiatus hernia and that I benefit from this drug in terms of reduction/removal of symptoms.

F5a0ddffcf9ef5beca864050f090a790

(15515)

on March 18, 2013
at 08:02 PM

PPIs is the WORST thing you can do for acid reflex. Just think about - what causes your acid reflex? It could be that condition that caused your acid reflex is exacerbated by PPIs. My only concern - WHY in the world all doctors prescribe it when there are so many cases when people get worse instead of getting better while taking PPIs.

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6 Answers

1
2b53550a397c86add263ca53707763d4

on March 18, 2013
at 11:36 PM

I too was on PPI's for about three years and also have a hiatal hernia. I haven't had much success treating the reflux or the hernia until very recently. I'm going to share with you what I've tried and experienced that has helped me a lot.

The most important thing is simple - drink more water. In the book "Your Body's Many Cries for Water(you can do a google search and grab the PDF)," the author explains that the classic symptom of chronic dehydration is a hiatal hernia. He also explains exactly why and how it happens. Now I'm not a disciple of this guy or anyone really, but I trust what I've experienced and the water has helped A LOT. Not to mention, folks with acid reflux are typically dehydrated. Understand however, that re-hydrating the body is not an overnight process.

In addition for the reflux, really listen to your body. Understand what foods it can and cannot tolerate. Eliminate(don't just scale back) grains and legumes and don't overeat. Also, CHEW YOUR FOOD. This one is huge but rarely talked about. Chew until a liquid consistency. Try bone broths and maybe even a short vegetable juice fast to give your GI system a break. Long-term PPI use decreases HCL/Pepsin production and likely contributes to small intestinal bacterial overgrowth since they aren't there to kill the bad guys. Some say bad bacteria can spread to the stomach, weaken it, and cause a hiatal hernia. I'll take the opportunity here and say you want to get off the pills ASAP. Bad news for many reasons. We want to treat the cause of your hernia/reflux, not the symptoms.

Also, I'd be shocked if you didn't have tons of tension at your solar plexus that needs to be released. The hernia restricts breathing and disrupts the natural wave of respiration(I'm willing to bet you breathe through your chest/shoulders and not your belly). I recommend standing comfortably, gritting your teeth, and letting out a shout/yell of frustration. Try and focus and make it come from your belly, where the hernia is. Another exercise I've found to be very helpful is to stand comfortably, take a deep belly breath in through your nose, and exhale forcefully through your nose. Forcefully. These may feel silly at first but don't overlook them.

I hope this helps.

3491e51730101b18724dc57c86601173

(8395)

on March 19, 2013
at 06:47 AM

One of the worst heartburn/reflux triggers for me is to drink a lot of water. Really and truly. I don't know why. I have to drink my water in small amounts often, because too much at once make me feel terrible.

0
C63b8a88c38822204a877a0610c76a3c

on March 20, 2013
at 07:42 PM

Thanks again for the replies. I have started taking probiotics, digestive enzymes, beatain hcl with pepsin and centaurium.

This is my second day without a ppi and I have to say I'm pleasantly surprised at how my reflux has been acting. I'm having a bit off and on but nothing like my pre paleo days where if I forgot to take the tablet I would have quite uncomfortable reflux by the afternoon. I've stopped taking coffee also, which has been harder for me stop than grains ever where but when I've come this far may as well continue.

So this is still early days in fairness and the results are promising so far, as someone said I will just have to be patient and see how things go, for now I'm doing all the right things, even down to chewing my food more.

Many thanks for your replies.

0
40de81eec0ef892797f3db0dec57cc9a

on March 19, 2013
at 02:43 PM

I had acid reflux but it went away when I went paleo. Have you tried a low dosage of probiotics first thing in the AM and a low dosage of digestive enzymes at meal time? Might help. In time your body will do what it's supposed to. Be patient.

0
75d65450b6ff0be7b969fb321f1200ac

(2506)

on March 19, 2013
at 11:49 AM

Although your PPI dosage has been minimal you might find it hard to stop cold turkey. You might want to consider switching to ranitidine (Zantac) which has a better safety profile than PPIs. Go with 150 mg twice daily, then reduce to 75 mg. In conjunction with advice from other posters you can devise a strategy for moving forward.

Best of luck.

_Lazza

0
F291857fa12a0291688ea994343156dc

(720)

on March 19, 2013
at 06:55 AM

Have you totally eliminated all wheat? Grains? Refined carbs? Beer?

When I did, my occasional acid reflux & chronic use of Tums both ceased. I've got a year old bottle of Tums... I used go through 2 or 3 large bottles per year.

I assume you've done the basics? Eliminated troublesome foods? Chew well? Don't eat within 3 hours of bed time? Lost weight?

Good Luck.

C63b8a88c38822204a877a0610c76a3c

(0)

on March 19, 2013
at 08:44 AM

Thanks for these replies. In answer I have eliminated all grains and refined carbs except beer at the weekends, I guess I will have to work on this but social drinking at the weekend is my main 'get out of the house' being a youngish single chap. Weight isn't really an issue, I've always been fairly lean and I am now even more so with being paleo. Funily enough I have just started taking magnesium supplements in the form of citrate, is glycinate preferable for hiatal hernia? Thanks again for your replies.

0
Medium avatar

on March 18, 2013
at 11:42 PM

Since your reflux was probably due in part to the esophageal sphincters not functioning properly as a result of a magnesium insufficiency, and since that medication actually depletes magnesium further, I'd say you should start taking 100mg of magnesium glycinate with every meal.

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