Heartburn medications for Heartburn Relief and the Health Effects of Long-Term Use
Are you the person who always has a stash of TUMS in your purse?
Most medications are designed to be used on a temporary basis, not long-term. But how many people do you know that take antacids at most meals for heartburn relief?
If you take any type of heartburn relief medication, prescription or non, you are causing long-term damage to your digestive health and opening yourself up to viral gut infections, food sensitivities, and nutrient deficiencies.
Is It Safe to Use Antacids for Heartburn Relief?
Are you the person who always has a stash of TUMS in your purse?
Most medications are designed to be used on a temporary basis, not long-term. But how many people do you know that take antacids at most meals for heartburn relief?
If you take any type of heartburn relief medication, prescription or non, you are causing long-term damage to your digestive health and opening yourself up to viral gut infections, food sensitivities, and nutrient deficiencies.
It’s true we do need resources for symptom relief when they arise. But the more important question we (and our doctors) are not asking is, why do you have heartburn in the first place?
Hi friends. I’m Hilary Beckwith, ex-dieter and holistic nutrition expert. Clients come to see me with signs of adrenal stress and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively, and fill in the gaps between what their doctor is saying, and what their body is saying.
In this article, you’ll learn:
the role of stomach acid
what causes heartburn (spoiler alert - it’s not typically caused by too much stomach acid)
three main types of heartburn relief medications
how to improve digestion long-term, without medications
what is stomach acid?
Stomach acid, known as hydrochloric acid, or HCl, is produced by cells that line the stomach, called parietal cells. It’s necessary to disinfect food and triggers the cascade of hormones and enzymes needed to further break down fats, proteins, and carbohydrates.
Additionally, HCl is needed to lower the pH (increase acidity) of the food you’ve eaten in order to trigger the next phase of digestion.
Think of it like the air conditioner in your home. You “set” a certain temperature that you want to maintain, and your thermostat monitors the temperature constantly and activates or deactivates the air conditioning as needed to maintain that temperature.
Digestion works similarly. In this case, the “thermostat” is monitoring pH levels of food in the stomach, and is “set” to somewhere in the range of 1.5-2.0. When the pH reaches 1.5, this triggers the opening of the pyloric sphincter, which allows food to pass through into the small intestine.
how stomach acid is produced
We’re about to get real nerdy.
The parietal cells in the lining of your stomach all have receptors for histamine, gastrin, and acetylcholine.
For the sake of this post, you do not need to understand what each of those is or does. Just know that when one or more of those factors interacts with its receptor on a parietal cell, this is what activates the process of stomach acid production.
Here’s how that works:
Hydrogen (which has a positive charge, and is therefore, a proton) enters the parietal cell by way of carbonic acid, which is what you get when water and carbon dioxide molecules combine.
Separately, bicarbonate within the parietal cells, is also being traded for chloride from surrounding blood vessels. The chloride is then transferred to the stomach.
When parietal cells are activated by way of histamine, gastrin, or acetylcholine receptor activation, this triggers an enzyme called ATPase to provide enough energy to pump hydrogen into the stomach, in exchange for potassium (potassium enters the cell, hydrogen leaves the cell), known as a proton pump.
When the hydrogen, now in the stomach, combines with the chloride, we get hydrochloric acid or HCl. This is stomach acid. (here is a really great video of how it is formed)
what causes heartburn?
While it can be true that one can produce too much stomach acid, one common cause of heartburn is actually not enough stomach acid, or HCl.
Taking heartburn medications and antacids when you actually don’t produce enough stomach acid can be harmful to your health, leave you susceptible to pathogenic infections like parasites, helicobacter pylori, candida overgrowth, and bacteria.
Additionally, taking heartburn medications regularly can lead to poor breakdown of foods, causing digestive symptoms like foul-smelling gas, bloating, constipation, and indigestion.
HOW LOW LEVELS OF STOMACH ACID CAUSE HEARTBURN
Refer back to the thermostat analogy I used earlier, and remember that food will stay in your stomach until it reaches a certain “set” acidity level of 1.5-2.0. Once that acidity level is reached, the pyloric sphincter relaxes and opens, allowing food to pass through into the small intestine.
If you don’t produce enough stomach acid to reach that “set” acidity level in a timely manner, but you do produce some stomach acid, imagine how that still-very-acidic food sits in your stomach, not going anywhere.
This not only causes damage to the lining of your stomach tissue by eroding the protective mucosal tissue, but also creates an environment for pressure to build, especially as you continue eating.
Eventually, the pressure builds enough that the still-very-acidic food begins to regurgitate back into your esophagus (the tube that connects your mouth to your stomach).
This is heartburn.
While there is a place for heartburn medications in symptom relief, especially when peptic ulcers are present, taking heartburn medications and antacids long-term can actually make your digestive symptoms worse, and lead to other, more serious conditions.
The best option is to find and address the root causes of your heartburn symptoms, not just mask them. Later in the post, I’ll walk you through ways to improve your digestive health so you can ditch heartburn medications for good.
other health effects of low stomach acid production
prevents bile production from the liver, needed to break down fats and eliminate toxins
increases risk of pathogenic infection [2], such as h. pylori, candida overgrowth, parasites, and bacteria
increases risk of food sensitivities
increases inflammation by way of tissue damage within the stomach and intestines
increases fight or flight activation, due to tissue damage and unaddressed pathogenic infections
prevents conversion of pepsinogen to pepsin, the enzyme needed to break down proteins
vitamin B12 deficiency - HCl is required to stimulate the production and release of intrinsic factor, which is essential to the absorption of vitamin B12
other vitamin and mineral deficiencies - HCl is needed to properly digest food and absorb nutrients
foul-smelling gas - incomplete breakdown of proteins leads to fermentation, and consequently, foul-smelling gas
constipation
bloating
heartburn, GERD, ulcers, or indigestion symptoms
3 main types of heartburn medications
Proton Pump Inhibitor (PPI): Looking back to the diagram of how HCl is produced, you might recall the Proton Pump, which pumps hydrogen from the parietal cell into the stomach, where it combines with chloride to make stomach acid. PPIs are designed to stop the action of ATPase, the enzyme that powers the Proton Pump, thereby reducing the amount of HCl produced [1]. The less hydrogen we have in the stomach, the less HCl is formed.
Common names for PPIs include Omeprazole (Prilosec), Lansoprazole (Prevacid), Esomeprazole (Nexium), etc..
H2 Antagonist: Looking back at the same diagram, recall the Histamine receptors that trigger the production of ATPase when activated. These receptors are known as H2 Receptors, and therefore, H2 Antagonists block the receptor for histamine, preventing the activation of ATPase.
Common names for H2 Antagonists include Cimetidine (Tagamet), Famotidine (Pepcid), and Nizatidine (Axid).
H2 Antagonists, or H2 Blockers, are primarily used for relief from peptic ulcers.
Antacid (calcium carbonate): Calcium carbonate provides heartburn relief in two ways [3]:
Once in the stomach, the bond between calcium and carbonate is broken, and the carbonate binds to the free hydrogen, neutralizing it.
The influx of free calcium can stimulate peristalsis, or the mechanical movement of the stomach that works to push food into the small intestine.
Common product names include Tums, AlkaSeltzer, and Rolaids.
3 ways to improve digestion that you can start today
If you think these actions are too small to make an impact, think again. These three action steps are fundamental to long-term digestive health, and are often the first things I recommend to my private coaching clients.
Practicing these steps without also working to find and address root-causes to your digestive symptoms, isn’t going to get you very far. In many cases, we need to dig deeper, and that looks different for every individual.
If you want help figuring out what’s at the root of your heartburn and other digestive symptoms and want to ditch the heartburn medications for good, we need to chat. Click here to book some time on my schedule for a free consultation.
CHEW YOUR FOOD: Think this is too simple to be true? Chewing adequately supports the activation of your rest and digest nervous system response, and activates important salivary enzymes to begin breaking down food. There is no magic number - chew until your food becomes a smoothie-like consistency.
AVOID/MINIMIZE BEVERAGES WITH MEALS: Fluids, especially non-caloric fluids, dilute stomach acid, and prevent or slow the movement of your food through your digestive tract. If you feel the need to “wash down” your food, you may not be chewing enough.
EAT WITHOUT DISTRACTIONS: One of the most important steps needed for good digestion, is the activation of your parasympathetic nervous system, known as rest and digest. Eating while working, driving, doom scrolling, or multi-tasking, even if it doesn’t feel like you’re highly stressed, actually keeps your body in fight or flight, which inhibits digestion.
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BLOG REFERENCES
Shin, J. M., & Sachs, G. (2008, December). Pharmacology of Proton Pump Inhibitors. Current gastroenterology reports. https://pmc.ncbi.nlm.nih.gov/articles/PMC2855237/
Yibirin, M., De Oliveira, D., Valera, R., Plitt, A. E., & Lutgen, S. (2021, January 18). Adverse effects associated with proton pump inhibitor use. Cureus. https://pmc.ncbi.nlm.nih.gov/articles/PMC7887997/
Fritz, K. (2023, August 5). Calcium carbonate. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK562303/