Does heartburn medication cause dementia?

A concerning report was released this week addressing the possibility of a link between gastric reflux medications (proton pump inhibitors such as Prevacid, Prilosec, and Nexium) and an increased risk for dementia. The study, which was conducted at the German Center for Neurodegenerative Diseases, looked at 73,679 people ages 75 and older and determined that regular users of PPIs had a 44% risk increase of developing dementia, compared to those that did not use PPIs. This was just an association, there is not a direct link between PPIs and dementia risk, but the association was strong enough that the researchers felt it deserves more attention.

PPIs have also been connected to side effects like magnesium and other nutrient deficiencies, increased risk of infection, heart disease, pneumonia, and chronic kidney disease.

The thing that is irksome about PPIs is that they stop your body from performing a natural process, and the effects are permanent. Once a proton pump is inhibited, it stays inhibited. And the more and longer you take a PPI, the more pumps you’re inhibiting. Why does it matter?

The Value of Stomach Acid

Hydrochloric acid, potassium, and sodium together make up your gastric acid, or stomach acid. This concoction is fairly misunderstood, and super important to your health. Here are the ways stomach acid assists our bodies:

  • breaks down protein from long, indigestible amino acid chains into shorter versions that our gut can absorb
  • pepsin, an enzyme that helps to break down protein, is activated by mixing with hydrochloric acid
  • kills microorganisms we don’t want entering our digestive tract (it’s our first line of defense!)
  • breaks our food down into chyme, which is then released into our small intestine for nutrient absorption.

In reference to that last point, enough stomach acid is important to break our food down into chyme that is the right size and ph. With too little stomach acid, the chyme sits in the stomach for too long, and pressure builds up. The valve at the bottom of the stomach (pyloric sphincter) only opens one way, to dump into the small intestine. But the valve at the top of the stomach (lower esophageal sphincter) will allow stomach contents to go both ways. The stomach has to relive the pressure building up with the partially digested chyme just hanging out, so the top valve will open, which typically results in some stomach acid escaping and burning the esophagus, the dreaded acid reflux.

Could the Problem be Low Stomach Acid?

Most people assume that acid reflux is caused by too much stomach acid, but there is now speculation that for a lot of people the opposite might be the issue. Without enough stomach acid, food is not properly broken down, the contents of the stomach don’t move out quickly enough (leading to acid reflux), and harmful microbes can be allowed to flourish. Also, large chunks of undigested food can contribute to the breakdown of the gut barrier, causing leaky gut, which leads to a host of health problems.

There are a couple different ways to test for low stomach acid at home, or you can go the medical route and ask your doc to test you. If you think you might have low stomach acid, there are also some natural remedies you can try to increase acid production. It’s a good idea to get your doc involved at this level if you’re on medications, and/or have serious gastric issues.


Listen to Your Body

I’m gonna go out on a limb here. I think that the majority of people the take PPIs had a moment in their life that their digestive issues started to creep in, and in all likelihood those issue arose from consuming foods that just didn’t agree with their systems. And, again in all likelihood, those foods were not the most nutritious. But sometimes even nutritious food can cause problems if your body just doesn’t like it.

As simple as this is, if a food bugs your stomach, DON’T EAT IT. Now if all foods bug your stomach, that’s different and something you need to seek medical attention for. But if a particular food, or just processed food, causes heartburn? Avoid it. It’s as simple as that.

It is still yet to be determined if PPIs are associated with increased risk for dementia, but what is for certain is these medications only treat a symptom, and not the underlying cause of why acid reflux is happening and peptic ulcers are forming. In most cases the root cause will be food, and avoiding the offending food will hopefully be the final fix.


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