Proton Pump Inhibitors (PPIs)

Heartburn. Upset stomach. Indigestion. That feeling of pain in your lower chest comes from acid rising up into your throat. Most people don’t need powerful medications to deal with this problem. It may occur intermittently, or they can take an antacid once in a while, or they just choose less rich foods at their next meal. People who have heartburn a few times a week for a month or two, this could be a sign of GERD (gastroesophageal reflux disease), and they may need a PPI. Now what.


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PPIs are powerful drugs, not medication you want to continue using long-term. PPIs are the most potent inhibitors of acid secretion that we know and effectively reduce stomach acid production.


Commonly prescribed medications include:

  • Nexium,
  • Prilosec,
  • Prevacid and Prevacid 24-Hour, or
  • Protonix




Risks of PPIs

Taking a PPI for a year or less is probably safe but during this time you should make lifestyle changes so that you can reduce and hopefully stop taking the medication. Taking a PPI is linked to:


–  Increased fracture risks,


–  Increased risk of dementia,


–  Low magnesium levels (cause spasms, muscle cramps, and irregular heartbeat),




–  Pneumonia,


– Kidney damage,


– Disrupt gut flora,


– Increased risk of heart attack, and


– Increased risk of C. difficile infections that can cause chronic diarrhoea.





Controlling your heartburn

Your goal is to stop needing to take a PPI as soon as possible! Heartburn is exacerbated by pressure on the abdomen so losing weight will have a dramatic effect, in many instances. If you are overweight and suffering from heartburn it’s time to eliminate junk food, sugar, and high fat foods such as baked goods, cheese, yoghurt, and ice cream. For many peoplecleaning up their diet will stop the need for PPIs. Replace the junk and high fat foods with – you know it – fruits, vegetables, whole grains, and legumes.

Other things that will help are eating smaller meals, exercise, staying away from caffeine in any form, eating dinner early, and not laying down for a few hours after eating.

PPIs interact with other medications. And as with any medication, do not start using or discontinue use without the supervision of your physician. Your heart will thank you.


Dr. James Kneller treats atrial fibrillation, arrhythmia, and other heart conditions.  He is an internationally recognized authority on cardiovascular health and personal development.





Yepuri, G., Sukhovershin, R., Nazari-Shafti, T.Z., Petrascheck, M., Ghebre, Y.T., Cooke, J.P. Proton Pump Inhibitors Accelerate Endothelial Senescence. (2016). Circulation Research. 118(12):e36-42.

Treating Heartburn and GERD