Four Reasons I Don’t Recommend Heartburn Medication for IBS and How to Resolve Heartburn Symptoms Without Them
In my long, painful, 10-year IBS journey I found myself leaving the physician’s office with a heartburn prescription on more than one occasion. I’m sure this has happened to many of you as well. You go in. You tell them all about your boss, (ie your stomach). You tell them you can run super fast, but sometimes just not fast enough to make it to the toilet in time. You tell them other days you cry because your stomach hurts so bad and you wish something would come out. You also tell them you’re convinced you have cancer or maybe an intestinal blockage. But not once did you mention any symptoms related to heartburn, yet you leave with a heartburn prescription feeling confused. I’ve had countless patients come into the pharmacy with a similar story. I don’t know why this happens so often. I really don’t get it. But, whatever the reason I’m going to tell you why you should NOT take this heartburn medication for IBS symptoms.
Heartburn medicine is often prescribed to alleviate symptoms of acid reflux and gastroesophageal reflux disease (GERD). These conditions occur when stomach acid flows back into the esophagus, causing burning sensations in the chest and throat. By reducing the production of stomach acid or neutralizing it, heartburn medications can help relieve discomfort and prevent potential damage to the esophagus. There are several types of heartburn medications available to help manage symptoms of acid reflux and GERD. Notice how I said manage symptoms of acid reflux, not for IBS? Antacids like Tums and Rolaids work by neutralizing stomach acid and providing quick relief. H2 receptor antagonists such as Pepcid and Zantac reduce the production of stomach acid to alleviate heartburn. Proton pump inhibitors (PPIs) like omeprazole and esomeprazole are powerful acid reducers that can provide long-lasting heartburn relief by blocking acid secretion. What do they all have in common? Less acid.
Why don’t I recommend them?
Heartburn medications have potential risks and drawbacks that should be considered before use. Proton pump inhibitors (PPIs) and H2 receptor antagonists decrease your stomach acid. While this might sound great it is associated with multiple side effects and issues when taken long term.
Less stomach acid inhibits your ability to break down foods appropriately, which can exacerbate your IBS.
Acid is also essential for absorbing nutrients such as iron, calcium, and B12.
Less acid can also leave you wide open for infections including C. difficile infections. If you don’t know what C. dif is, look it up. You don’t want it, I promise.
Long term use of PPIs has been shown to increase risk of kidney disease and bone fractures. Use of H2 receptor antagonists are thought to cause confusion in the elderly.
The other problem here is that it can take weeks for acid levels to normalize after taking these medications. If you need quick relief, opt for a calcium carbonate tablet like Tums. These work quickly to neutralize the acid and don’t stick around long term.
It’s a Delicate Balance
We need stomach acid for breaking down food, absorbing nutrients, and protecting our bodies against pathogens. But too much stomach acid can damage the esophageous and cause painful symptoms.
If you have typical IBS symptoms like urgency, diarrhea, constipation and stomach pain, then heartburn medications will NOT help you. They will exacerbate your symptoms and lead to nutrient deficiencies.
If you have heartburn symptoms (burning in your chest or throat) then these medications might make you feel great in the short term. Wooohooo! You’re better! For now… You’re better until you start getting sick more often, start feeling fatigued, start having nutrient deficiency, and maybe even breaking bones if you’re clumsy. So, what to do? Suffer in pain? No.
To cure your symptoms you need to understand what is causing them. First, visit your doctor to ensure you don’t suffer from a more serious problem such as a peptic ulcer, Barrett’s Esophagus, or and H. pylori infection. If you’re in the clear, then it’s time to focus on healing these symptoms without medications. Heartburn is a sign of a damaged gut. Damage can be due to harmful gut bacteria or due to overwhelming your system with too many triggering foods. Sometimes people don’t realize how many acidic foods they consume and just a slight adjustment to their diet can make all the difference. The easiest place to start is identifying your triggers and and taking a break from them. Common triggers include:
Spicy foods
Fatty foods
Citrus
Tomatoes
Garlic
Onions
Chocolate
Coffee
Caffeine
Alcohol
Carbonated beverages
Nightshades
Processed foods
Artificial additives
Seed oils
Keep a food diary and take note of what you eat and when you have symptoms. If you narrow down a few things, then give your body a break from these for a few weeks and allow your acid system to recalibrate. After a few weeks of allowing your symptoms to resolve, then reintroduce these foods slowly. If your symptoms clear, then its probable you were just forcing your stomach to take on too many acidic foods.
If you’re symptoms don’t clear after this process then you likely have unbalanced microbiome and need more intensive healing. If this is the case, check out my book Guide Your Gut available on Amazon in June of 2024, to learn how to heal the damage and resolve your symptoms.