Heartburn, medications and the role of your stomach acid

I have found myself frustrated lately at an advert for an over-the-counter heartburn medication. The drug, known as a proton pump inhibitor, is available in chemists, prescribed regularly in GP surgeries and clearly targeted at people who have similar music taste to ours. We are not aging rockers yet, but, as teenagers in the 1980’s, we are no spring chickens either and our music app clearly thinks we are likely to suffer with heartburn.

My issue with the advert is that it encourages the dietary behaviour that leads to heartburn and therefore the need for the medication in the first place. Smart advertising? Probably. Appealing to people’s desire to have it all, live fast, work hard, play well and feel great in the bargain? Yes perhaps.

The problem is that, after a while, people don’t feel well on these medications. The ‘proton pumps’ that the medication ‘inhibits’ are in the stomach and are responsible for pumping out hydrochloric acid. The stomach is the only area of the body that is made to cope with an acidic environment. It has a thick, mucous layer that the acid does not penetrate and therefore we generally feel no discomfort. The discomfort – the heartburn – starts when the acid travels upwards into the tube connecting the mouth to the stomach (the oesophagus) which is not made to withstand acid. It burns – literally – feels uncomfortable in the moment and overtime, can lead to a degeneration in the health of the oesophageal tract.

So people take a proton pump inhibitor to cut off the production of hydrochloric acid. The question to ask is why do we have this acid in the first place? The human body is an incredible machine, so it seems unlikely that the acid is produced to be a nuisance and cause heartburn. The fact is that hydrochloric acid plays an early and essential role in digestion. It deals with unwanted microbes that might be present in the food you eat. This is important. Our digestive tract is one of the few places where outside meets inside and we need it to deal with any nasties that might arrive on our food. But there is more to it than that. It begins the process of protein digestion, snipping the long protein molecules up into smaller sections to allow for easier digestion further down; it assists with the absorption of Vitamin B12, zinc and iron; and the acidic mixture that gets sent onto the next stage of digestion is responsible for stimulating the production of digestive enzymes and bile that prepare foods for absorption and use around the body. Without sufficient digestive ‘fire’, there is a negative knock-on effect, compromising digestion – bloating and gas are common symptoms – and bringing about nutrient deficiencies, low energy and more.

The advert that I alluded to at the beginning of this post suggests that with one pill a day, you can ‘start your day with a coffee’, have a ‘quick bit of lunch on the go’ and relax in the evening ‘with a cheeky takeaway’. I am a Nutritional Therapist with a heavy dose of realism and I also enjoy a takeaway at the weekends. But the fact is that throwing coffee into an empty system first thing, rushing or working as you eat a mindless lunch (what was in that sandwich?) and then having a take away in front of the TV at the end of a stressful day is not conducive to healthy digestion and would give many people heartburn. There are ways to fix heartburn that do not involve over-the-counter medications and the knock-on effects on our health. If you are taking one, have a look at the leaflet that comes in the box – they are not meant to be taken it in the long term and yet I see people in my clinic room on a regular basis who have been taking these for years and years. They feel sore, tired and depressed and often don’t even think that their digestion may be at the root of their problems.

If the advert that frustrates me resonates with you, think twice before you pop those pills. You need your hydrochloric acid. It just needs to be kept in the right place to work its magic. With a few dietary and habit changes, you won’t need the pills. Getting your digestion working optimally may just turn around your overall health and feelings of wellbeing – as well as getting rid of heartburn.  

(Speak to your doctor before stopping any prescription medications).