Reflux medication and your gut.

Have you suffered from reflux? Are you on medication for it? Have you ever wondered how they affect your gut?

Typical medications for reflux and related issues are called Proton Pump Inhibitors or PPI’s. Here's some that may sound familiar omeprazole (Prilosec, Prilosec OTC, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), esomeprazole (Nexium) and dexlansoprazole (Dexilant). PPI’s were an amazing find as they reduce the stomach acid and in turn reduce your reflux. What we now know is that long-term use of these PPI’s can also affect our gut community.


PPI’s are one of the most widely used over the counter drugs used worldwide. However, the lowering of the stomach acid has seen changes in microbiota communities of the mouth and gut that are associated with the use of PPI’s. The changes in the microbiota community seem to have a knock-on effect causing cycles of dysbiosis (gut community disturbance) and inflammation. Long-term use of PPI’s is also being associated with predisposing people to different types of cancers.


Sorry about the doom and gloom but it has also been noted that overuse of PPI’s reduces the diversity of your gut community, and promotes the growth of those bugs that aren’t so great for you. These bugs that aren’t so great for you create chemicals products that can damage your DNA so that’s not great news either. It’s not their fault, we’ve given them the opportunity to do that as we think medication fixes everything and we didn’t know much about our gut community before we all started using these medications.




Now don’t panic, I have a number of clients on PPI’s and their use can generally be reduced through changing your behaviour and diet. The side effects I mentioned above may not happen to everyone as we are all very different as you know. I am currently working on diets to help my clients reduce their use of PPI’s and because of their individuality no diet suits all. The idea is to increase the Gram-Positive bacteria in your gut community through prebiotic fibre and other foods to help with the reduction of inflammation. It’s a work in progress 😊.



References

Bruno, G., Zaccari, P., Rocco, G., Scalese, G., Panetta, C., Porowska, B., . . . Severi, C. (2019). Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified. World journal of gastroenterology, 25(22), 2706-2719. doi:10.3748/wjg.v25.i22.2706

Brusselaers, N., Engstrand, L., & Lagergren, J. (2018). Maintenance proton pump inhibition therapy and risk of oesophageal cancer. Cancer Epidemiol, 53, 172-177. doi:10.1016/j.canep.2018.02.004

Ferreira, R. M., Pereira-Marques, J., Pinto-Ribeiro, I., Costa, J. L., Carneiro, F., Machado, J. C., & Figueiredo, C. (2018). Gastric microbial community profiling reveals a dysbiotic cancer-associated microbiota. Gut, 67(2), 226-236. doi:10.1136/gutjnl-2017-314205

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