Proton pump inhibitors (acid blockers) are top sellers. Since the drugs for stomach protection no longer have to be prescribed by the doctor, but are freely available, they are considered harmless and used for various stomach complaints. But it is precisely long-term use of these drugs that can cause considerable side effects.
Proton pump inhibitors (PPI) are drugs that greatly reduce the production of gastric acid. They are therefore colloquially referred to as acid blockers or “stomach protection”. Examples of PPI are omeprazole, pantoprazole (pantozole), lansoprazole (Agopton), rabbeprazole (Pariet) and esomeprazole (nexium).
PPI are used to relieve various symptoms. For example, reflux diseases (reflux esophagitis) and heartburn, gastritis, or a Helicobacter pylori infection. PPI are also prescribed in combination with certain painkillers (e.g. diclofenac, ibuprofen) as their ingredients can attack and damage the stomach lining. Hence the term stomach protection.
PPI change the pH value in the gastrointestinal tract and thus impede the absorption of nutrients.
But the long-term use of proton pump inhibitors is not without risks. By reducing the acid production in the stomach, the pH conditions in the digestive tract change with consequences for the nutrient supply and the intestinal flora.
Poorer mineral uptake, vitamin B12 deficiency and altered intestinal flora.
The bioavailability of the minerals calcium, zinc, iron and especially magnesium is significantly influenced by the pH situation in the stomach and intestines. If acid production decreases, the pH value in the gastrointestinal tract increases (the environment becomes less acidic). As a result, mineral compounds dissolve less readily and are absorbed to a lesser extent (bioavailability decreases).
The result is an impoverishment of minerals. Osteoporosis (calcium deficiency), iron and magnesium deficiency and zinc deficiency are possible consequences.
Proton pump inhibitors increase the risk of vitamin B12 deficiency by 65%.
Vitamins are also affected. Vitamin B12 needs the so-called “intrinsic factor” to be absorbed into the body. This protein is produced in the supporting cells of the stomach. It binds vitamin B12 from food and transports it safely to the lower intestinal sections, where vitamin B12 is then absorbed into the body. The body needs gastric acid to bind to the intrinsic factor. The use of acid blockers increases the risk of vitamin B12 deficiency by 65%.
Lower acid production by stomach cells also has an influence on digestion, such as from proteins in food. Normally the protein is denatured by gastric acid and can therefore be better digested in the intestine.
More than 50 % of users of proton pump inhibitors have a bad colonisation of the intestinal flora.
However, if undigested protein reaches the lower intestinal segments, the composition of the intestinal flora changes. A putrefactive flora can develop. In more than 50 % of PPI users a SIBO (Small Intestine Bacterial Overgrowth) is detectable, in non-users the figure is 6 %.
The shift towards the unfavourable bacterial species (SIBO) increases the probability of intestinal complaints, intestinal diseases, allergies and food intolerances.
Fewer side effects through careful use and targeted supplementation
Proton pump inhibitors (acid blockers) are usually not used against the cause of increased acid production, but only to combat the symptoms.
In any case, it would be important for the physician to clarify the underlying causes. Sometimes measures to reduce stress, a change in diet (more vegetable, less meat), an alkaline cure or the use of omega-3 fatty acids instead of pain-reducing drugs such as ibuprofen, diclofenac & Co. can help.
If the proton pump inhibitors are nevertheless necessary, the targeted additional supply of the affected minerals zinc, magnesium, iron and calcium and the vitamins, especially vitamin B12, makes sense. A probiotic preparation with several favourable bacterial cultures in high dosage can stabilise the intestinal flora and counteract a SIBO.
