Dr. Rakel discusses the long-term effects related to antacid use.
I think it’s one of the things we don’t realize is the potential dangers of long-term acid suppression. The normal pH of the stomach is about 1 to 3, the higher the pH the more alkaline, the lower the pH the more acidic. When we take a medicine such as a proton pump inhibitor or an H2 blocker, these are medicines that significantly lower the acidity of the GI tract.
Now again, if we touch base with nature, why did nature give us acid in the stomach? It allows us to absorb key nutrients and now the evidence and the research is helping us understand the potential dangers of long-term acid suppression. So just to go down a list we need acid to absorb iron and acid suppression can cause iron deficiency anemia.
We need acid to absorb our calcium and we are seeing that people who are on these drugs for a long-term have a higher risk of hip fracture. We need acid to absorb vitamin B12, the main vitamin that’s needed for our nervous system. We also need acid to keep the bacteria count low in the small intestine and we don’t want lot of bacteria in the small intestine, we want all of our bacteria in the large intestine.
If we have too much bacteria in the small intestine sometimes that can be aspirated up into our lungs and that we are seeing particularly in the elderly, an increased risk of community pneumonias on people who have long-term acid suppression.
So use those drugs short-term, if you have a bleeding ulcer or if you have a condition that really increases your acid, they are very good drugs but sometimes people start taking those over-the-counter and they use that to suppress their symptom but they never really ask the question, “Why am I having all this indigestion,” in the first place.
So we are suppressing our symptom but we are not healing the symptom or we are not getting it to resolve and that’s often a much more complicated system or approach that allows us to ask, what’s going on in your life? What stressors do you have? Are you eating on the run? What kind of foods are you eating? Are you exercising, which helps push things down and out so that it doesn’t come up?
So the medication gets in the way of the healing opportunity. Medication is very good for short-term use, sometimes long-term use but rarely do we need those medicines long term.
About Dr. Rakel, M.D.:
Dr. David Rakel, M.D., attended medical school at Baylor College of Medicine in Houston, Texas, and completed a family practice residency in Greeley, Colorado. He spent the next five years in rural practice as one of two physicians staffing a 14 bed hospital in Driggs, Idaho. As medical director for Grand Targhee Ski resort in Wyoming, he developed an interest in sports medicine and received his Certificate of Added Qualification in 1999.
Dr. Rakel completed a two year fellowship in Integrative Medicine at the University of Arizona from 1999-2001. He joined the University of Wisconsin Department of Family Medicine in 2001 where he teaches and practices, and is the medical director for the University of Wisconsin Health Integrative Medicine. Dave is board certified in family medicine, holistic medicine and sports medicine. He is also certified in Interactive Guided Imagery.