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Last fall I wrote a blog summarizing the potential effects of proton pump inhibitors (PPI) and cognitive decline. About 40% of the adult population in the U.S. reports some level of acid reflux. This explains why over-the-counter and prescription versions of omeprazole, lansoprazole, esomeprazole, rabeprazole, dexlansoprazole, and others are so very common. As a category, they are number three in popularity only behind psychotropic and statin medications. In dollars, that works out to about $10 billion a year.

We are used to hearing about serious problems with prescription medications, and PPIs are not an exception. Besides the increase in cognitive decline, problems are being reported for kidney disease too. A new article was published in JAMA Internal Medicine based on two population-based studies. The studies are observational, meaning that it is difficult to draw strict causal relationships, but the studies looked at fairly large sample groups (10,000 in one and 250,000 in the other), so this data cannot be ignored.

In the group not using PPIs, the rate of developing CKD (chronic kidney disease) was about 8.5%. For those using PPIs, the rate increased to 11.8%. In another group, the non PPI CKD rate was 13.9% versus 15.6% for the PPI-using group.

A disturbing part of this trend is that the kidney disease seems to be silent until it becomes a real problem. In other words, a person doesn’t get a lot of notice that kidney problems are imminent. It would nice to have a heads up.

The researchers suggested checking to verify that treatment is needed at all. Often a person is given a PPI in the hospital to help counteract the temporary meds, and then the prescription is automatically filled forever.

For those needing treatment for gastric reflux and heartburn, alternatives to PPIs like histamine-2 receptor antagonist (H2 antagonists) meds are available. Those drugs do not seem to have the same correlations to kidney disease as the PPIs. H2 antagonists are available as OTC (over the counter) and as prescription drugs. There are lots of them but you might recognize names like Pepcid, Tagamet, or Zantac.

Remember that acid reducers don’t just affect the stomach, but affect proton pumps around the body.

Since this is health blog focusing on natural things you can do, I can’t leave you with drug recommendations. The first task is to limit the problem as much as possible.

The first thing I can do is refer you to a recent blog discussing histamine intolerance: https://bit.ly/2IQXk6S. If you are experiencing acid reflux, you should begin by learning which foods in this group are not well tolerated by your body. Each person is different, and you will most likely find one or two foods on the list that your body doesn’t like and leaves you with acid reflux symptoms. For some it might be almonds and cheese, and in another it might be the tomatoes and avocados. It should only take a few weeks to sort this out as acid reflux tends to manifest with a few hours and then builds and builds in a not-so-subtle fashion.

I strongly recommend that you begin here to find a solution to your acid reflux. It has been the experience of many that histamine-reducing supplements and digestive enzymes can be a help on a scale of 1-10, these are probably a 2 whereas finding the offending food is a 9 or 10.

If you still aren’t convinced that you want to work to control your diet to help your acid reflux so you don’t need the meds that could damage your kidneys, drop in to a local dialysis center and talk with some of the staff and patients. See if you are okay with that being your future.