The information contained in this post is for educational purposes only and does not constitute medical advice. Please talk with you health care provider before stopping any medication or changing your treatment plan.
I was treated with high, daily doses of proton pump inhibitors (PPIs) for acid reflux disease for nearly 10 years before I learned that acid reflux symptoms are sometimes not caused by an excess of acid. Hypochlorhydria, which means a lack of stomach acid, actually causes many of the same symptoms as overproduction of acid.
I read Why Stomach Acid is Good for You by Dr. Jonathan Wright and came to understand the important role of adequate stomach acid in digestion and the implications of an underproduction of acid. At that point, I tried to stop my acid reflux medication but the “withdrawal” symptoms were horrendous. Even though I’d never had heartburn prior to starting PPIs, now that I’d been on them for so long the burning was nearly unbearable if I missed even one dose.
A holistically-minded MD who agreed with my assessment of the situation recommended that I supplement with apple cider vinegar at meals. I did, about 2 teaspoons in a glass of water, and it made a huge difference. I began to taper down the dosage of my medication very slowly and eventually I was able to stop taking PPIs altogether. And then, guess what? Not a bit of heartburn and no additional gastroparesis symptoms.
One year after I stopped the medication completely, I had a 24-hour pH/impedence study done at the Mayo Clinic. It showed no evidence of acid reflux. Not a single episode. I did, however, have non-acidic reflux. PPIs are notoriously bad at alleviating the symptoms of non-acidic reflux… specifically because the acid isn’t the problem! In fact, more problems may be created by the suppression of gastric acid (including delayed gastric emptying).
This certainly doesn’t mean that everyone with acid reflux symptoms is lacking in stomach acid or that nobody should be taking acid suppressing medications. Certainly there are times when that medication is appropriate and helpful. But it’s important to educate yourself, especially in the context of gastroparesis.
A 2012 study published in the Journal of Gastroenterology found that women with low stomach acid had significantly more symptoms of dysmotility and dyspepsia than those with non-hypochlorhidria. Given how many people are prescribed PPIs before or upon diagnosis of gastroparesis, this certainly warrants more attention.
If you’d like to learn more, I recommend starting with the following articles:
- Chris Kresser’s series of articles: What Everyone Ought to Know But Doesn’t Know about GERD
- Why Stomach Acid is Good for You summary and review from Weston A Price Foundation