BLOGS Ask the Pharmacist Ask the Pharmacist – ACID REFLUX, ANTACIDS AND HEARTBURN

I have been reading about the consequences of long term use of medications for acid reflux. How can I stop taking my antacid?

The alarm bells are sounding and your health is at risk when you take antacids long term. Most definitely do not stop taking your acid suppressant without discussing it with your doctor AND do not stop taking it without weaning off slowly. The FDA has issued warnings about the overuse of these medications; and yet they are available to buy over the counter and advertised heavily as a solution to heartburn. Get out your reading glasses and go over the fine print of a package insert and you will discover that these drugs are not innocuous choices.

There are many types of drugs that are created to reduce stomach acid and treat heartburn, acid reflux, or GERD (gastroesophageal reflux disease). PPI (proton pump inhibitors) like Prilosec, Prevacid, Nexium or Protonix, H2 blockers like Zantac or Tagamet, and calcium carbonate like Tums or Rolaids, are all designed to be short term solutions unless certain serious underlying diseases are diagnosed. Most heartburn is not caused by too much stomach acid, but, in reality, too little acid is available to digest food or from acid being forced from your stomach into your esophagus. Go to and read the article “What you doctor didn’t tell you about GERD”. When the LES or lower esophageal sphincter isn’t doing the job, your delicate esophagus is damaged.

What are the long term consequences of suppressing stomach acid? A few examples are delayed gastric cancer diagnosis, atrophic gastritis, Clostridium difficile diarrhea, bone fractures, low magnesium, low iron, and vitamin B-12 deficiency. When digestion is hindered due to low stomach acid, the small intestine can get bacterial overgrowth and the delicate balance of the microbiome of the large intestine can be destroyed. Experiencing these complications can result in other symptoms that can then require more prescriptions and supplements and the cycle continues. If you read the post-marketing data from companies that make PPI and H2 blockers, you may find information that relates to you. It is a perfect opportunity to open a conversation with your health care professional.

If you consume a food and it causes heartburn, stop eating it. Find out why you are experiencing pain by getting to the root cause of your symptoms. Partner with your doctor and get an accurate diagnosis and plan treatment options. It may include an acid suppressant short term and education about how to digest food. If you are not benefiting from the plan more diagnostic work up may be needed.

How do I wean off these drugs?

Know that in a research study, subjects that had no symptoms of GERD, but were given acid suppressants for a few weeks as part of the experiment, developed acid reflux symptoms when the drug was discontinued. You must go slowly and allow your own parietal cells to produce acid again and your LES to become functional.

The most critical element in the weaning off process is to first adopt healthy eating and lifestyle habits. Over eating and night binging will weaken the LES and cause reflux. A trial elimination diet to determine which foods are causing irritation or food allergies is a perfect proactive step to take. Identify stress and make a plan to consciously reduce it.

Decrease the use of PPI slowly by using incrementally decreasing doses per day and using an H2 blocker or chewable antacid if pain returns. DGL (deglycyrrhizinated licorice) is a botanical choice as well as is mixing slippery elm powder in water and drinking daily. High quality sea salt (Himalayan), apple cider vinegar (Bragg’s) in water before meals, betaine HCL with pepsin in gradually increasing doses before meals and probiotics are all useful choices as digestive aids. Chris Kresser has a great e-book about GERD and heartburn.

Deidre (Dee) Kohley, Rph, works at Watkins Pharmacy, is a graduate of Ferris University and has lived all her life in Muskegon. She continues to find ways to reach women who genuinely want to get well or live an optimal life. Dee loves digging into research to find new ways to help people. She is married and has seven children and nine grandchildren who keep her busy. She loves the beach and spending time outside enjoying the seasons. You can contact her by going to her website or

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