Heartburn Meds Are Associated with Dementia, Part 2
Proton-pump inhibitors disrupt the gut microbiome, but you have options.
“With something like cancer, there is a feeling that you can fight it in some way or control your response to it, but with dementia there is the fear of losing control of your mind and your life.” —Kevin Whately
Last week, we talked about proton-pump inhibitors (PPIs), how they work and the problems they can cause. Among those problems is dementia. But there are other ways to deal with ulcers, and it’s a mystery why doctors don’t recommend them more often.
PPIs for ulcers
Most peptic and duodenal ulcers are caused by a bacterium named Helicobacter pylori. This microbe has a special talent for digging through the mucus coating the gut and then boring into the lining itself.
We have known about H. pylori for 40 years, and we know how to treat it. The protocol is to use antibiotics, along with a PPI, for two weeks. It isn’t simply palliative, it’s a cure. It is hard then, to understand why doctors and pharmaceutical companies still push long-term use of PPIs for ulcers.
Outside of ulcers, occasional heartburn may not be a good reason to use PPIs, because they can take up to four days to have an impact. There are older drugs, called H2 blockers, that are faster and may be a better substitute. These include Pepcid and Tagamet. But many cases of heartburn and acid reflux can be treated without drugs by eating smaller meals and not eating near bedtime. Losing weight can also help.
If you are taking PPIs regularly, you might want to review your dosage with your doctor. You might be able to lower the dose or eliminate them altogether.
What to do
Before your reach for a PPI, try taking better care of your gut. Many gut issues can be solved with a simple switch to a better diet. Rather than looking for pills to fix a dietary problem, why not circumvent the problem in the first place?
What kind of foods are good for you? The go-to diet is Mediterranean. It includes a wide variety of veggies, especially those high in prebiotic fiber. Prebiotic fiber is food for the good bacteria in your gut, which repay you by providing healthy substances like butyrate and feel-good neurotransmitters. The Mediterranean diet also includes a mix of different meats, especially fish rich in omega-3s, which have an anti-inflammatory effect.
The best microbiome is a diverse microbiome, and that is supported by a diverse diet. Try to eat as many different veggies and berries as possible. If you can’t get enough veggies, you might want to try a prebiotic supplement, especially a blend to support diversity.
Other foods to please your gut include ferments like yogurt, kimchee, sauerkraut, and kefir. Ferments supply a rich mix of both prebiotics and probiotics and are a valuable component of a healthy diet.
In short, PPIs have their place and are normally well-tolerated. But this new research indicates that long-term use may be a bad idea. Fortunately, you now know of some good workarounds.
References
Northuis, Carin, Elizabeth Bell, Pamela Lutsey, Kristen M George, Rebecca F. Gottesman, Tom H. Mosley, Eric A Whitsel, and Kamakshi Lakshminarayan. “Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study.” Neurology, August 9, 2023, 10.1212/WNL.0000000000207747.
Akter, Sanjida, Md. Rajib Hassan, Mohammad Shahriar, Nahia Akter, Md. Golam Abbas, and Mohiuddin Ahmed Bhuiyan. “Cognitive Impact after Short-Term Exposure to Different Proton Pump Inhibitors: Assessment Using CANTAB Software.” Alzheimer’s Research & Therapy 7, no. 1 (December 27, 2015): 79.
Yes, these techniques work! I stopped taking PPIs when I found prebiotics. Changed my life.
Left-Side sleeping also works well for me Scott. Diet quality and timing, along with sleep posture have made PPI usage extremely infrequent, bordering on never.