Proton pump inhibitors (PPI’s) are a class of drugs that reduce how much acid the stomach makes. These drugs are prescribed to assist with gastro-oesophageal reflux (GORD/Gerd), gastric and duodenal ulcers – which are often caused by Helicobacter Pylori infection.
The common PPI brand names sold in Australia are Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Losec), Pantoprazole (Somac), Rabeprazole Sodium (Pariet).
When digestive problems occur, the first two stages of digestion – generous chewing of one’s food and the digestive process within the stomach – are often overlooked. Once food enters the stomach, the hormone Gastrin stimulates the release of hydrochloric acid (HCL) from specialised secretory cells termed parietal cells.
The pH of HCL is a very acidic 1.5 to 3.5; vehicle battery acid is pH 1.0. Apart from its role in commencing the breakdown of solid foods, HCL creates an acid barrier to prevent oral bacteria from passing through to the small intestines, whilst also neutralising pathogens (harmful bacteria) in any contaminated food.
This essential facet of the digestion-absorption process is fundamentally blocked (1) by the taking of PPI’s – which when taken regularly for extended periods – can have potentially harmful effects on one’s digestive and overall health.
The initial adverse effects of PPI’s are a premature emptying of the stomach before consumed foods have been fully broken down by HCL. Because the stomach’s acid barrier is diminished, PPI’s increase the amounts of oral (ie: mouth) bacteria entering the bowel and essentially altering the gut biome (Leech: 2023).
This may then result in a SIBO (small bowel bacteria overgrowth) and gut dysbiosis further along the gastrointestinal tract – with resultant nausea, diarrhoea/constipation, bloating/flatulence or abdominal discomfort.
A 2024 study (as reported by Dr. Zain Hasan) found longer-term use of Omeprazole (Losec) increased beta-amyloid plaque in the brain – commonly found in the post-mortem brains of dementia patients.
PPI’s increase the risk of Clostridium Difficile Infection (CDI) in the colon (2). Osteoporosis is associated with long term PPI use (> one year) because it reduces calcium (3) and iron absorption. Vitamin B12, Magnesium and Zinc absorption is reduced with regular PPI use.
PPIs are also known to reduce the efficacy of Statin drugs (such as Rosuvastatin), which are prescribed to aid in lowering the harmful cholesterols.
Their long-term use can increase the potential risk of immune-related adverse skin conditions and skin hypersensitivity (Review study: The Journal of Cosmetic Dermatology) as well as chronic kidney disease (CKD) in predisposed individuals.
Alternate interventions:
Assessing gut health and function is a wise 1st step for those wishing to withdraw from PPI medication following long-term use.
Assessment is via a faecal test Complete Digestive Stool Analysis (CDSA) which assesses total gut function: protein, carbohydrate and fat malabsorption, pancreatic enzyme adequacy, faecal pH, microbiome balance or the presence of excessive pathogen/parasite numbers.
‘Next generation’ shelf-stable probiotics can now be targeted to a person’s individual health concern; Probiosis-5 from Spectrumceuticals (4) is the probiotic of choice to aid in reducing the adverse effects of PPI’s and as a natural, probiotic alternative for reflux, GORD, or upper GIT (5) pain, burning or bloating.
Always discuss your intention to withdraw or cease any prescribed medication with your doctor or medical specialist.
- Regularly taking a PPI over five days will reduce stomach acid production by 65%.
- Clostridium Difficile Infection (CDI): a spore-forming bacterium causing watery-diarrhoea, pain, fever and nausea. It’s estimated 20% of this infection is associated with antibiotic or gastric acid suppressant (PPI) drug use. C. difficile can be a fatal disease if severe or left untreated.
- PPIs may make it more difficult for the body to absorb enough calcium; the US FDA warns that PPIs may increase one’s risk of hip, wrist or spine fractures.
- Probiosis-5 is a ‘Practitioner only’ dispensed probiotic and not available OTC.
- Gastro-intestinal tract.
Copyright Anthony Pearce 2025