Omeprazole (Prilosec), a proton-pump inhibitor (PPI) used to treat heartburn, stomach ulcers and gastroesophageal reflux disease (GERD), is the sixth most common drug prescribed in the U.S.1 Other PPIs include lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (AcipHex) and esomeprazole (Nexium) — and they’re often prescribed to reduce stomach acid,2 in a misguided attempt to relieve heartburn.
An estimated 113 million PPI prescriptions are filled worldwide each year,3 but it’s estimated that up to 70% of people taking them shouldn’t be.4 Fortunately, there are many natural methods for heartburn that provide relief without exposing you to the many side effects linked to these popular heartburn pills.
PPIs Are Intrinsically Taken and Should Not Be Used
Initially intended only for treatment of several serious conditions, including bleeding ulcers, severe acid reflux involving damage to the esophagus and Zollinger-Ellison syndrome,5 a rare condition that causes your stomach to produce excess acid, proton pump inhibitors (PPIs) were not meant to be used for everyday heartburn.
Further, they’re only supposed to be taken for a short period of time. Using them long-term can be habit-forming and dangerous, yet they’re commonly prescribed to hospital patients, who often continue taking them after being discharged, with no planned stopping point.6 In fact, up to 80% of patients are inappropriately prescribed a PPI at discharge.7 The consequences can be dire, as PPIs are associated with a number of adverse effects, including:8
Osteoporosis and related fractures
Clostridium difficile colitis
Hypomagnesemia, or low magnesium levels
Research shows taking PPIs for more than two years increases your risk of vitamin B12 deficiency,9 while the drugs are also linked to dementia, to the extent that researchers concluded, “The avoidance of PPI medication may prevent the development of dementia.”10
Why PPIs Cause More Harm Than Good
PPIs inhibit the proton pump in your body that produces hydrochloric acid. But excess stomach acid is rarely the primary trigger of heartburn and indigestion. On the contrary, heartburn is typically an indicator you have too little hydrochloric acid, which means if you add a PPI medication, you are only going to exacerbate the problem by decreasing your acid level even more.
Because hydrochloric acid (and pepsin) is necessary to break down protein in your intestinal tract, reduced acid levels affect your body’s ability to absorb nutrients. Without adequate protein breakdown, you also increase your risk of dysbiosis, an imbalance in gut microbiome between harmful and friendly bacteria.
As these undigested protein molecules ferment in your intestines, they become food for pathogens such as Candida, C. difficile and Helicobacter pylori (H. pylori). If you’re currently taking PPIs, be aware that you can develop both tolerance to and dependance on them. As explained in Gastroenterology & Hepatology:11
“The treatment itself may also predispose patients to a need for ongoing therapy. In suppressing acid, PPIs stimulate the body’s feedback loop that tries to reactivate acid secretion.
If the drug is removed, there is a potential risk of rebound hypersecretion, creating a sort of dependency on the drug because the body is acclimated to having acid suppressed. In addition, ongoing feedback stimulation creates a need for ongoing therapy to control symptoms.”
For this reason, it’s important to wean yourself off them gradually to avoid severe rebound symptoms. Do not stop taking PPIs cold turkey. Instead, work with your health care provider to gradually lower the dose you’re taking while simultaneously implementing the natural strategies that follow.
Once you get down to the lowest dose of the PPI, you can start substituting an over-the-counter (OTC) H2 blocker. There are many like Tagamet, Cimetidine or Ranitidine, but Zantac (famotidine) is by far the best and the safest. Then, gradually wean off the H2 blocker over a period of several weeks.
Famotidine is a potent serotonin antagonist and can help those who are taking SSRIs to come off them as they will help lower serotonin levels. Unlike most drugs, it is a relatively safe drug if used long term.
What Causes Heartburn?
One of the most common causes of heartburn is insufficient amounts of stomach acid. Your body needs stomach acid to properly digest food and absorb nutrients. If you don’t have enough, undigested food in your gastrointestinal tract can lead to indigestion and heartburn.
The leftover food in your gut can also cause bacterial overgrowth, including H. pylori, which is linked to gastritis, peptic ulcer disease and symptoms of acid reflux. As mentioned, if you use PPIs, they cause low stomach acid and, over time, may cause the glands that secrete acid in your stomach to stop working altogether.12
Hiatal hernia, in which the top of your stomach bulges through your diaphragm, is another potential cause of heartburn, as it allows food and acid to back up into your esophagus.13 Physical therapy and chiropractic care can sometimes be effective in resolving this condition.
Food allergies are another potential contributing factor, with caffeine, alcohol and nicotine among the top culprits. However, eating processed foods can also contribute, as it negatively alters your gut microbiome, encouraging the overgrowth of harmful microbes.
Increase Stomach Acid to Resolve Heartburn Naturally
A key strategy to resolving heartburn is to increase the acid content of your stomach. Taking a betaine hydrochloride (also known as trimethyl glycine) supplement, which is available without a prescription, is one way to do so. Take as many as you need to get the slightest burning sensation and then decrease by one capsule. You can also consume 1 tablespoon of raw unfiltered apple cider vinegar in a large glass of water to increase stomach acid.
I also recommend swapping out processed table salt for an unprocessed version like Celtic salt. By consuming enough of the raw material, you will encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) naturally. Fermented vegetables are another dietary addition to focus on if you have heartburn.
Sauerkraut or cabbage juice is among the strongest stimulants for your body to produce stomach acid. It will also provide you with valuable bacteria to help balance and nourish your gut. Having a few teaspoons of fermented cabbage juice from sauerkraut before your meal will do wonders to improve your digestion. Fresh raw cabbage juice can also be very useful to heal resistant ulcers.
What You Eat and Drink Matters
Your diet, including beverages, also plays a role in heartburn symptoms. While processed foods should be avoided, consuming a Mediterranean diet, which focuses on fruits, healthy fats, lean meats and vegetables, may be as effective as PPIs in treating acid reflux symptoms.14
For occasional relief from burning reflux symptoms, alkaline water,15 due to its higher pH level than regular drinking water, may deliver soothing relief by neutralizing the acid in your body. One of the best ways to do this is to use 1 teaspoon of baking soda in 4 ounces of orange juice and stir.
Just make sure that the glass is only half-full as the reaction causes foaming that can cause the glass to overflow. This will help neutralize your stomach acid and ease the burn of acid reflux Another simple strategy is taking frequent sips of water, which can help in the management of GERD symptoms.16
Ginger tea is also useful, as it decreases pressure on the lower esophageal sphincter, helping to prevent heartburn and other gastrointestinal symptoms. Ginger also accelerates gastric emptying which, when impaired, contributes to heartburn,17 and helps suppress H. pylori. Add two or three slices of fresh ginger root to 2 cups of hot water and let it steep for several minutes. Drink it about 20 minutes prior to eating a meal.
The juice of the aloe plant is another natural remedy to help reduce inflammation, which may ease symptoms of acid reflux. Drink about one-half cup of aloe juice before meals. To avoid its laxative effect, look for a brand in which the laxative component has been removed.
Natural Remedies for Heartburn Relief
Getting regular sun exposure to optimize your vitamin D levels is critically important for gut health, as it plays a role in the production of 200 antimicrobial peptides that will help eradicate gut infections. Other remedies that may help you manage occasional bouts of heartburn and other minor reflux symptoms include:
• Astaxanthin — When compared to a placebo, this potent antioxidant was found to reduce symptoms of acid reflux, especially for individuals with pronounced H. pylori infection.18 “Significantly greater reduction of reflux symptoms were detected in patients treated with the highest dose of the natural antioxidant astaxanthin” compared to placebo, the study found.
Researchers concluded a daily dose of 40 milligrams of astaxanthin was effective for reflux reduction.
• Deglycyrrhizinated licorice root — Deglycyrrhizinated licorice (DGL) may also be helpful because it helps block inflammatory prostaglandins. One study found DGL protected gastric mucosa and relieved GERD symptoms better than acid-suppressive drugs.19
Licorice must be approached cautiously, however, because it contains the active metabolite glycyrrhiza, which at high doses can affect your adrenal glands, cause muscle weakness or numbness and raise your blood pressure.
Licorice is contraindicated if you’re on diuretics or stimulant laxatives. Women on hormone therapy, who have estrogen-dependent cancers or reproductive conditions like endometriosis, should also avoid it.
• Glutamine — The amino acid glutamine has been shown to address gastrointestinal damage caused by H. pylori. According to Susan Hagen, associate professor of surgery at Harvard Medical School, who’s studied the issue:20
“Gastric damage develops when the bacteria weakens the stomach’s protective mucous coating, damages cells and elicits a robust immune response that is ineffective at ridding the infection … Our findings suggest that extra glutamine in the diet could protect against gastric damage caused by H. pylori.”
Glutamine is found in many foods, including beef, chicken, dairy products, eggs, fish and selected fruits and vegetables. L-glutamine is widely available as a supplement.
• Papaya (papain supplement) or Pineapple (bromelain supplement) — Papaya contains papain, an enzyme useful for breaking down both protein and carbohydrates. Bromelain is a proteolytic enzyme found in pineapple, and like papain, helps digest proteins. Bromelain also promotes anti-inflammatory activity and helps you maintain regular bowel movements.
• Slippery elm — Slippery elm coats and soothes your mouth, throat, stomach and intestines, and contains antioxidants that may help address inflammatory bowel conditions.
Because it stimulates nerve endings in your gastrointestinal tract, it is useful for increasing mucus secretion, which has a protective effect against ulcers and excess acidity. Try mixing 1 to 2 tablespoons of slippery elm powder with water, consumed after meals and before bedtime.21
Other natural compounds, including curcumin, pectin and peppermint oil, have also been found to improve gastrointestinal symptoms and gut microbes while reducing the need for reflux medications.22 A dietary supplement containing melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine was also superior to omeprazole in the treatment of GERD.23
So, when it comes to finding relief from symptoms and support to address the underlying causes of most heartburn cases, there are numerous natural options at your disposal. These, combined with a whole food diet and limited processed foods, will help heal your gut and put an end to heartburn naturally.