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Stop Bellyaching!

I’m guilty. -Guilty as charged. I’ve been guilty for almost 30 years. Guilty of prescribing what I thought was an innocuous medication that now I think is so dangerous I never prescribe it anymore. It’s a whole class of drugs really … called proton pump inhibitors. Drugs like Nexium, Aciphex, Protonix, Prilosec, Omeprazole, Dexilant and others. These drugs are used to treat ulcers, acid indigestion, reflux, heartburn, gerd … its stomach pain with many different names. Now if you have a serious esophageal problem called Barrett’s Esophagus you should stay on these meds. You would only know if you had Barrett’s if you had an endoscopy … thats a procedure where they put a flexible periscope down your throat to look around. I highly recommend this test for anyone with longstanding persistent stomach troubles. What I don’t recommend is giving everyone with heartburn these medications. I used to prescribe these meds because they are very effective at eliminating symptoms and I thought they had no serious side effects, drug interactions etc. I now know better. Prescribing these drugs was easy … easy for me and easy for the patient but its just wrong.

The problem of indigestion is essentially a result of what you eat. Rather than treat the problem with a quick fix pill – it may be better to eat smart.

It has been an error in my thought processes which I think reflects my training in med school and beyond. I looked at the problem … indigestion and said what do we have to treat this with … I should have been asking what causes the problem. Its that same thought process that had me look at inflammation in the body and ask what antiinflammatory drugs do I have for this instead of asking what’s causing the inflammation.

Now I look at indigestion and ask what is the cause of the indigestion. The cause is 99% percent of the time what you are ingesting. You see those advertisements where people are going out to eat and intend to overindulge and they make it right by taking a pill. Thats, of course, the entirely wrong way to approach the problem. For almost 30 years I covered up the problem instead of working on the root cause —your dietary mistakes. Some foods that can cause indigestion are obvious … tomatoes, peppermint, carbonated beverages etc. Some may take some investigation to determine what is not right for you but that’s the right approach. If you have indigestion it’s your body trying to tell you that you have eaten something bad for you! It’s just that simple. Don’t try to cover it up … get to the bottom of it by making dietary changes until the problem goes away.

Now, again, for any persistent stomach issues see your doctor and get a scope done because you have to check for cancer, pre cancer (Barretts), and or an infection called H Pylori which can cause ulcers. Once you know it’s nothing serious you can do the detective work to find out what is bothering your stomach and eliminate it from your diet. How many ways can your body try and communicate with you? You aren’t getting text messages or following your stomach on twitter. When you have pain there is a reason and instead of treating the pain find out the cause and let your body heal itself.

Avoiding foods that cause your indigestion is a better solution to the problem than a pill that provides a quick fix and a variety of side effects.

Ok, but what’s wrong with the PPI’s (?) … or the Proton Pump inhibitors I listed earlier? Well, it’s very very clear that those drugs affect your absorption of Vitamin D and Vitamin B12. They clearly have been implicated in osteoporosis which is thinning of the bones leading to increased fracture risk. There are also reports from the European literature that these drugs may be implicated in increased risk of stroke and dementia! How is that for a side effect! Also there was a recent study reported in the British Medical Journal of 350,000 men followed for approximately 5 years. In this large study men taking PPI’s regularly had a 50% percent, that’s right 50% increase rate of death! How many of you out there have been blithely taking these meds for years!

Finally … these drugs work by impairing the proton pumps in the cells. Not just the cells we thought they worked on in the stomach but also in the cells in the rest of the body. These drugs affect the powerhouses in your cells called the mitochondria. So when you inhibit the acid secretion in your stomach you also inhibit activity in all your cells and that doesn’t sound like a healthy thing to me.

Of course, work with your health care provider … but work with them to get off these meds and get to the bottom of your indigestion which I remind you is almost certainly that you are eating something wrong ! Look at you … it’s probably not just one thing but multiple things that you should avoid because they are not good for you.

One easy way to check your stomach symptoms is to do a three day rice diet. Nothing but white rice for three days. Billions of people live on essentially this diet all the time. I am asking you to go on rice only for three days. You could alternatively fast instead of the rice but I know you and fasting is something you don’t think you can do. If you eat rice and nothing but rice for three days all your stomach problems should go away. If they don’t, it’s not your diet, and you should have further investigation. If all your symptoms go away, and I suggest that they will indeed all go away for the vast majority of you … you then know it’s your diet and you can start cleaning it up. Not as easy as popping a pill but in the long run much healthier for you. That’s what’s important … getting healthy and staying healthy for the long run.

Why haven’t you had this conversation with your healthcare provider? You and they should be focused not on covering up the problem with medication but solving the problem with your diet. I can, and do, make the exact same argument for diabetes … we can keep throwing more medications into you or we can finally correct your diet and improve your diabetes naturally!

Dr. Barry