Before I give my opinion on this, we need to get some background info. The most important aspect is digestion. Our body digests and assimilates food, and then there’s everything else. Digestion is an absolutely essential, critical, important, cardinal and crucial (sorry…ran out of synonyms, but you get the idea) of health. Without it, the rest of the body begins to break down.
So what slows down digestion? Age. As we get older, the region of our stomach that makes stomach acid wears down, just like our joints. This makes it almost impossible for someone over 50 to be making too much stomach acid (despite what they were told by their doctor). Next is stress. Our fight or flight response does not lend well to digestion. when you’re running away from a sabre toothed tiger, the body is not going to divert energy towards digestion (making stomach acid is an extremely energy-expensive process) and away from the heart, lungs and leg muscles.
Back in the 80’s an internal medicine resident by the name of Marshall proved that a little critter named Helicobacter pylori could greatly contribute to the development of ulcers and he singlehandedly changed the treatment paradigm. Unfortunately, we now view H. pylori as a pathogen that needs to be destroyed rather than a bacteria growing because the environment is ripe for growth (low stomach acid, absence of protective bacteria like Lactobacillus).
Add to the above, drugs like ibprofen (NSAIDs are responsible for some 20K deaths per YEAR due to bleeding ulcers) and you’ve got a nice mixture for the development of gastric problems (ulcers, gastritis, reflux).
Despite all the above factors that are fixable, we brush them aside and put people on acid suppressive drugs like Nexium and Prilosec for YEARS!! Read the label–this class of drugs was NEVER designed to be used longer than 6 months. If you’ve got a bleeding ulcer, guess what–you NEED them. Any other scenario and they are hurting more than helping.
What about reflux and esophageal cancer? Aren’t they needed? Nope. Don’t change the trajectory towards cancer so it must not be the acid (more on this in another post). What about heartburn and the discomfort? Besides proper dietary choices, supporting digestion rather than destroying it usually goes a long way towards helping symptoms. This means using apple cider vinegar or digestive enzymes to support digestion rather than destroying it with drugs.
So what if you’ve done everything right and even digestive enzymes aren’t helping? Should someone just stay on the drugs long term. Absolutely, positively without a doubt the answer is NO. The long term consequences of shutting down an absolutely essential part of your functioning is a very long list (cancer, inflammatory bowel disease, IBS, osteoporosis, depression, etc, etc, etc…).
This is the perfect time to consider surgery to help strengthen the lower esophageal sphincter and no longer need the drugs. Yes–there is always a time and place for surgery.