Almost like a cult following, doctors are reaching into their white coat pockets and writing for proton pump inhibitors. Those are the medications like Prilosec, Nexium, Aciphex, and Prevacid prescribed for gastroesophageal reflux or GERD.

Often gastroenterologists tell my patients they have to be on these medications for the rest of their lives. Since they really do relieve symptoms, the unknowing recipient of the medications does not object. Doctors are aggressive with prescribing because of the long held notion that acid injures the esophagus and can lead to a condition called Barrett’s esophagus, thought to be a precursor of cancer. A recent study in May 2011, debunked that theory of association.

So, what’s the problem? The problem is that we do need stomach acid and cutting it out leads to all sorts of problems, which studies in major medical journals are now documenting. Without acid, digestion becomes more difficult and food actually stays in the stomach longer, which could lead to further reflux. Additionally, poorly digested food holds onto minerals and vitamins. Acid is also needed for the actual absorption of vitamins and minerals. This leads to the documented increase in osteoporosis among long-term users of reflux medications.

Another problem is that our small and large intestine needs acid to keep the proper balance of good and bad bacteria and/or yeast. Without the acid, an overgrowth of bad bacteria or yeast may develop. This can lead to gastrointestinal malabsorption or even worse life threatening infections. Studies have documented an increased incidence of Clostridia Difficile colitis among users of these medications.
Perhaps the most interesting phenomenon with the use of strong anti-acid medications is the increase in respiratory infections, such as pneumonia. Unbeknownst to us, we inhale and swallow microbes all the time. The normal acid environment in our stomach kills most. However, when the acid is low, we end up regurgitating and aspirating bad bacteria that can eventually lead to infection.

But, I know, it is so uncomfortable. So how can we treat GERD without leading to problems?

If you are diagnosed with an ulcer of the stomach or esophagus, then you should take the strong medications for about two months under doctor’s supervision.

You should let your doctor know of any changes you make in his or her recommendations.

If you develop breakthrough symptoms of indigestion despite the below regimen, you can try Pepcid Complete up to two daily or Tums.

The most important first line is dietary modifications.

• Decrease total fat intake
• Avoid large meals
• Decrease total caloric intake if weight loss is desired
• Avoid chocolate
• Avoid coffee depending on individual tolerance
• Avoid other known irritants - Alcohol, mint, carbonated beverages, citrus juices, and tomato products

• Maintain upright posture during and after eating.
• Stop smoking.
• Avoid clothing that is tight in the abdominal area.
• Avoid eating within 3 hours before bedtime.
• Lose weight if you are overweight.
• Sleep on your left side.
• Chew non-mint gum, which will increase saliva production and decrease acid in the esophagus.
• Elevate the head of your bed 4-6 inches by placing bricks under the headboard.

My patients and I have found the following regimen very effective at living without GERD symptoms:

1) L-Glutamine Powder 3 – 6 grams daily in divided doses
2) George’s Aloe Vera 2 ounces daily
3) DGL Ultra, German Chocolate Flavor by Enzymatic Therapy, Chewable 1 – 2, two – three times daily
4) Licorice Root, Nature’s Answer; 1 – 2 ml, one – three times daily (avoid if you have hypertension)
5) Digestive Enzymes, 1 – 2 with each meal
6) Zinc Carnosine as directed on label

Some people recommend Betaine HCL, but I only suggest this for people over the age of 65 who have difficulty producing their own stomach acid.

Certainly, other protocols exist and may help individuals. These modalities have worked consistently for others and me. In fact, one of my patients did not tell her gastroenterologist that she did not take the medication he recommended. When she returned a year later, her esophagus and stomach looked great and he told her to continue the medication forever!

Don’t always take your doctor’s advice as gospel. Do your research and don’t be afraid to question and challenge so that you get the treatment that is right for you.

Author's Bio: 

Charles F. Glassman, MD, FACP, has practiced general internal medicine, for over 20 years. Dr. Glassman specializes in personalized, patient focused care, with an emphasis on wellness and prevention. He approaches medicine in an integrative manner, looking carefully at all traditionally approved methods while recognizing the power of unconventional therapies. Dr. Glassman has repeatedly earned National and Regional Top Doctor and Patient Choice Awards. His new service, Coach MD blends the knowledge and experience of a caring medical doctor with the passion and guidance of a life coach. He is the author of the critically acclaimed book Brain Drain, which helps explain and fix self-sabotage. It is the winner of the 2011 Independent Publisher's Award and 2011 Eric Hoffer Award as the best Self-Help and Health book, 2010 Pinnacle Book Award for best Self-Help Book, and 2009 LA Book Festival Best Spirituality Book. To new subscribers on his website, he is now offering his free, new EBook, Destiny Diet. Weekly, Dr. Glassman hosts Medicine on the Cutting Edge, on, which gives a voice to pioneers in medical research and development. Dr. Glassman lives with his family in Rockland County, NY.