Posted on May 23, 2012

Gastric Acid Reducers

Drugs that decrease stomach acid have the potential to affect absorption of a variety of nutrients. These drugs include proton pump inhibitors (PPIs), H2 receptor blockers, and antacids.

Proton Pump Inhibitors

· Esomeprazole (Nexium) · Lansoprazole (Prevacid) · Omeprazole (Prilosec) · Pantoprazole (Protonix) · Rabeprazole (Aciphex)

H2-Receptor Blockers

·  Cimetidine (Tagamet)

·  Famotidine (Pepcid) ·  Nizatidine (Axid) ·  Ranitidine (Zantac)

Absorption

Stomach acid is essential for absorbing certain nutrients like calcium, vitamin B12 and even thyroid hormone like levothyroxine, Synthroid, armor and nature-throid.

Cases of vitamin B12 deficiency have been linked to acid suppressor therapy (Journal of the American Medical Directors Association, March, 2008). Some Symptoms of this nutritional deficiency include fatigue, confusion, memory problems, peripheral neuropathy, constipation and depression. Vitamin B12 deficiency is a common deficiency among people with celiac disease.

These medications work by blocking acid secretion from the parietal cells of the stomach, but these cells also make a substance called intrinsic factor, which is critical for vitamin B12 absorption.  Proton-pump inhibitors such as Prilosec also reduce intrinsic factor secretion.

Vitamin B12 deficiency is serious because it can lead to neurologic disorders. The neurologic symptoms of vitamin B12 deficiency include numbness and tingling of the arms and, more commonly, the legs, difficulty walking, memory loss, disorientation, and dementia with or without mood changes. Although the progression of neurologic complications is generally gradual, such symptoms are not always reversible with treatment of vitamin B12 deficiency, especially if it has been present for a long time.

Calcium requires an acidic environment for optimal absorption. People who take an acid suppressor like esomeprazole (Nexium) can have reduced calcium absorption. People who take acid-suppressing drugs long term may be at increased risk for hip fractures

Drugs that suppress stomach acid–including over-the-counter antacids–may leave people at greater risk for food poisoning, experts at UC Berkeley say. The reason is that stomach acid normally kills many of the organisms that can cause food-related illness. Experts say this means that people with heartburn should be extra careful when it comes to preparing and handling raw poultry, seafood, and other foods.

According to a study published in the Journal of Gastroenterology, the long-term use of some acid reflux drugs may be linked to weight gain. In a small study, Japanese researchers found that patients who were on proton-pump inhibitors (PPIs) for several years were more likely to gain weight than people who did not take PPIs. Experts stress that PPIs are highly effective for most patients, but they say the study indicates that lifestyle modification and weight loss need to remain the backbone treatment for acid reflux.

Something else to think about is you need plenty of stomach acid to breakdown and sanitize the foods you eat. If you don’t, not only will your absorption be hindered, but also you are putting a great deal of stress on your small intestine to do the majority of the food breakdown. The food bolus from the stomach is more alkaline, instead of acid, increasing the likelihood of developing Candida, which also damages and depletes your good intestinal flora.

Heartburn / reflux is a symptom of a deeper problem. Most likely there isn’t enough stomach acid. Using a medication to suppress the symptom is not addressing the problem, and setting you up for far more serious problems down the road.