PPIs won't heal you, but they can make you feel better
On my TikTok, I get a lot of q’s from people trying to heal their gastritis. They often ask me about the role of PPIs in my healing process. When I first suspected I had gastritis (they didn’t give me an actual endoscopy for an entire year), my doctor in Italy prescribed me a PPI (rabeprazole) for 2 weeks.
She told me I should be feeling better by then.
Those 2 weeks came and went, and while my symptoms were pretty much gone while taking it, they came right back when I stopped.
I wrote to her explaining this, and she prescribed me 4 more weeks of rabeprazole. I was happy to oblige to minimize my symptoms and essentially eat whatever I wanted again for another 4 weeks.
I had never dealt with serious health problems before, so I thought I would be healed at the end of the month. Clearly, I was wrong.
I stopped the PPIs after the 4-week cycle was up, and got the worst heartburn, anxiety, and nausea of my entire life. I wrote to my doctor again, and she told me that this surprised her and she recommended I get right back on the PPIs.
I did not refill the prescription.
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After a quick Google, I discovered that abruptly stopping PPIs can cause “acid rebound,” a condition where the stomach overproduces acid after stopping PPIs. I asked my doctor about this, and she said it was sort of a myth, that it doesn’t really work like that.
With my esophagus aflame, I decided to cut ties with that doctor and try to take matters into my own hands. That’s where this all started.
To the people who ask me about PPIs, I don’t discourage using them, especially because they do provide so much relief for so many people. However, my case and that of many people I’ve chatted with online is this recurring prescription of PPIs to stifle symptoms without addressing the root cause. PPIs can even worsen and cause new GI issues.
How do PPIs work?
PPIs (proton-pump inhibitors) are a type of acid reducer. They block acid-producing enzymes in the stomach, lowering stomach acid content. This can improve symptoms of heartburn, nausea, and burning as a result of GERD or gastritis.
Do they cure GERD/Gastritis?
Unfortunately, no. It’s not that simple. They do reduce symptoms of GERD and gastritis in some patients, but they are often prescribed for prolonged periods, which can lead to dependence and an increase in GI problems.
THEY DON’T FIX THE ROOT PROBLEM.
SIBO, bile reflux, and candida overgrowth can all be caused by prolonged PPI use.
The stomach is meant to be an acidic environment. Eliminating the stomach’s ability to produce acid means that foods are not properly broken down, and some pieces may get stuck in the GI tract, causing a variety of GI issues.
So why do doctors always prescribe them?
In my attempt to give doctors the benefit of the doubt, here’s my PC answer: Many doctors have a high caseload and don’t have the time to get to the root cause of each patient’s issues. Prescribing a PPI is a simple, short-term solution that can minimize symptoms immediately.
Sadly, the long-term effects are often not discussed.
What should I do if I’m taking PPIs but don’t feel any relief?
If you’ve been on PPIs for 4-8 weeks and you don’t notice an improvement in symptoms, you could be dealing with:
bile reflux
delayed gastric emptying
a weak LES
a hiatal hernia
functional dyspepsia
sibo
Hypochlorhydria
Get tested for any of the above that you expect could be the root cause. Then you can choose to slowly taper off the PPI and start addressing the root cause.