Let’s take acid reflux symptoms aka GERD/ heartburn/silent reflux as an example.
Many people feel these symptoms; how many might you ask? According to the National Institute of Health (NIH), up to 40 percent of the US population suffers from this and one out of five of these patients have silent acid reflux symptoms. One class of drugs used for this problem is known as Proton Pump Inhibitors or PPIs.
Over the past four years, Americans spent an estimated 60 billion dollars on this drug class! Does this sound like we are suffering from a problem of epic proportions? Since people have easy access to these drugs because they are available OTC, the prevalence of use has increased.
Some common Proton Pump Inhibitors are:
- Omeprazole (Prilosec, Prilosec OTC, Zegerid)
- Esomeprazole (Nexium, Nexium 24HR)
- Lansoprazole (Prevacid, Prevacid 24HR)
- Dexlansoprazole (Dexilant)
- Pantoprazole (Protonix)
- Rabeprazole (AcipHex)
- Esomeprazole/ Naproxen (Vimovo)
The commercials never say, “If you want to get better (or for some, reduce the size of your waist), reduce or eliminate fried foods, excess alcohol, sugars, soda, coffee,” which are additional risk factors. Obesity in and of itself raises risk of acid reflux symptoms. Commercials actually show a person suffering from a condition and taking a pill so they can get back to their life quickly and easily. But they continue to eat the wrong foods. Why?
Because Big Pharma is cashing in on this with a windfall, despite short-term benefits, and due to a lack of education about diet and lifestyle, we as a society continue to get sicker. I am not sugar coating these facts, folks, this is a serious problem! If you had a family dinner with your relatives and asked how many people are taking these meds, you might be astonished. I always say no one has all the answers, whether you practice functional medicine, clinical nutrition or standard medical care, but sure as the sun will rise tomorrow, we need to pay attention to this problem.
In Gut We Trust
Gastrointestinal (GI) health is paramount to your health. In fact, we are more bacteria than we are human cells.
Aside from GI symptoms like excess gas, bloating, diarrhea, constipation, cramping, pain, reflux disease (GERD, NERD) and many others, 70 percent of your immune system resides in your gut!
In one of my latest articles, I discussed the role of prebiotic fibers to help you grow a better internal garden in your gut. Taking copious amounts of probiotics without regard to your diet is one reason why many patients don’t see any significant results. Probiotics are dietary supplements. The word probiotic means “for life” as opposed to an antibiotic which means “against life.” The World Health Organization (WHO) defines probiotics as live microorganisms, which when administered in adequate amounts, confer a health benefit to the host.
Strain specificity is another important factor in why some probiotics work for some people and not others. The simple concept of “just buy a good product or keep it refrigerated” is a shotgun approach. Strain specificity implies that a specific organism such as Lactobacillus Reuteri must contain a number after it such as DSM 17938. The number is the specific strain that has been studied in the treatment of a particular health issue. I know, it gets complicated!
The microbiome is a diverse and complex composition of organisms that research scientists are just beginning to understand how important they really are. Many health conditions that have been a mystery in medical science are now turning doctors toward the gut and its microbiome. Autoimmunity is an example of this. When elevated, bacterial organisms such as Klebsiella, Citrobacter, Prevotella, and Proteus have been found to be autoimmune triggers in some patients.
Getting To The Root of Acid Reflex Symptoms
There are no shortcuts to fixing your gut. And while there is a time and place for acid reflux medications, even the Food and Drug Administration (FDA) and the manufacturers state they should not be taken for more than two to three months at a time. The issue is when you stop using them and the acid reflux symptoms return; well, it’s a no-brainer, you go back on them! Doesn’t it stand to reason that if you did not find the underlying cause of the acid reflux symptoms, which there are numerous reasons for, that in a large percentage of patients, the disorder will return?
Gastroenterologists typically scope your intestines (endoscopy for upper GI problems) looking for causes. Some patients have a hiatal hernia, which is a tear in the diaphragm that alters the position of the stomach. This can cause reflux. Other causes include bile acid reflux, which accumulates as a result of a pyloric valve weakness. Acid reflux symptoms can also be caused due to motility disorders, which regulate the movement of your stomach and intestines and changes in pressure from the lower esophageal sphincter (the flap that should close after food enters the stomach).
Acid reflux symptoms can also be caused due to bacterial overgrowth in the stomach ( H.Pylori) and various other organisms that can grow in your small intestine and change the composition to an unfavorable balance known as dysbiosis. This contributes to how your intestines move and absorb nutrients. We develop excess gas and bloating from these imbalances and they too increase our prevalence of reflux disease.
As you can see, there are no simple shortcuts to this problem and just because the drugs help reduce symptoms, doesn’t mean they’ve cured you of the condition even remotely. At best, a short course of these medicines can bring symptomatic relief and reduce the irritation and inflammation of the affected tissues.
So, what’s so bad about continuing on these meds? Here are the real associations that have been found. If you take these medications on a prolonged basis, there are increased risks of dementia-related illness, kidney disease, bone fractures, heart attacks, pancreatitis, B12 and Magnesium loss, and more.
Not a pretty picture! We have to do better, and that means we have to look for other ways to treat this beast and what personal responsibility we can take to improve our lives.
Looking At Things Through A Different Lens
Two specific tests that I utilize in practice that help identify some of the causes of acid reflux symptoms are the Hydrogen breath test (or SIBO test) and the GI-Map test.
SIBO stands for small intestine bacterial overgrowth. When the bacteria that live in the small intestine (small amount) become more like the bacteria in the large intestine (large amount) we develop SIBO. Gas, bloating, cramping, and either constipation dominant or diarrheal dominant presentations are the main symptoms — they’ve also been directly linked to Irritable Bowel Syndrome (IBS).
However, reflux can develop from this disorder, along with rosacea, hives, and anything from acne to ulcerative colitis. The list can be exhaustive, and the reason stems from some of my opening remarks and previous blog. The microorganisms in our gut play a pivotal role in our health. We have to live symbiotically with them. They outnumber all the cells that make us up as an organism by a factor of 10! They talk to each other and they speak to all of our biology.
The SIBO test is a noninvasive breath test we provide to you, to perform at home.
The other test called the GI-Map test is a stool test. A fecal sample is submitted to the lab and through the advanced technology of DNA-PCR identification, they can tell us remarkable things about what’s growing in our poo. For instance, you can learn who the good and bad bacteria are. A digestive analysis is provided, so you will learn whether you are producing enough enzymes for digestion, absorbing fats, and detoxifying properly in your gut. The test also provides markers for inflammation, immune response, and gluten sensitivity as opposed to celiac disease. Pretty strong data to help catch the culprits!
If your symptoms are serious, don’t wait; see a doctor. If the only approach to your reflux or GI symptoms is the continuous administration of PPI meds, see a functional medicine doctor like myself.
Lastly, we have to wake up about our lifestyles and desire to be healthy people. We have to understand that food is medicine that serves as molecular information, and should be regarded as something enjoyable that provides sustenance for life. We have to realize that over-processing our foods, altering their genetic makeup (GMOs), and growing them with an onslaught of chemicals and hormones is not a sustainable practice aligned with health.
Slow down for a minute and contemplate this thought: Organically grown foods provide more sustenance and nutrient density. Animals raised to eat grass and not grains improve the nutritional composition. We need to stop rushing through our meals, appreciate what we have, and pay homage to how amazing our bodies are.
So, if you really want to be a healthier person, you have to shift from herd mentality to individualism — a path that will help you live a better and hopefully a longer healthier life.
Dr. Loren Marks is a chiropractor, board-certified clinical nutritionist and functional medicine practitioner. Dr. Marks is the founder of Integrative Assessment Technique (IAT), an assessment methodology embracing, nutritional biochemistry, emotions, and structural neurology. In 2018 he was the first chiropractor to ever present to the New York County Psychiatric Society on Methylation defects, mineral imbalances, and their role in mood, behavior and mental health. You can learn more about Dr. Marks at DocMarks.
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