GASTRITIS, STOMACH ACID
Why Does Successful Drug Treatment of GERD Increase Cancer?
By Dr. Mercola
August 12 2011
See Dr. Pinna’s comments below…
A recent study found that medically treated patients with mild or absent GERD symptoms have significantly higher odds of a form of cancer, esophageal adenocarcinoma, than medically treated patients who still suffer from severe GERD symptoms.
Testing of more than 750 patients with GERD revealed adenocarcinogenesis in 122. The researchers found that severe GERD symptoms correlated with decreased odds of adenocarcinogenesis.
According to the study, as reported by Green Med Info:
“Patients taking proton pump inhibitors were 61.3 percent and 81.5 percent more likely to have adenocarcinogenesis if they reported no severe typical or atypical GERD symptoms, respectively, compared with patients taking proton pump inhibitors, who reported that all symptoms were severe.”
If you have heartburn, acid reflux, gastroesophageal reflux disease (GERD), peptic ulcer disease or any acid-related condition, chances are very high that you’ve been offered a prescription for a proton pump inhibitor (PPI) like Prilosec. The generic version of Prilosec is the sixth most-prescribed drug in the United States, and as a whole, this class of drugs is severely overprescribed and misused.
This is concerning for a number of reasons, which I’ll discuss below, but first it’s important to be aware of a new study that revealed a potential cancer link in a rather roundabout way.
PPIs May Mask Cancer Risk
New research published in the Archives of Surgery found that people with GERD who are treated with PPIs have an increased risk of a form of cancer called esophageal adenocarcinoma, and the extent of their risk appears to be related to whether or not they experience symptoms. The study’s intent was not to uncover this finding — rather it was to provide more information on the relationship between the severity of GERD symptoms and cancer risk.
But what they revealed was that patients with mild or absent GERD symptoms actually have a much higher risk of esophageal adenocarcinoma than patients with severe symptoms, and all of these patients were being medically treated with proton pump inhibitors.
The consequence of this is that people with few or no GERD symptoms are more likely to forgo a screening procedure for Barrett’s esophagus, a condition in which the lining of your esophagus is damaged by stomach acid and which can increase your risk of cancer.
The “gold-standard” treatment for GERD is clearly not doing anything to mediate this cancer risk, and, in fact, might be covering up a serious underlying problem by relieving symptoms while damage is still occurring. People who suffer from GERD for long periods are those most likely to develop Barrett’s esophagus and its related complications … and PPIs may therefore contribute to this risk by covering up symptoms without treating or healing the underlying problem. PPIs can even make your GERD worse, which I’ll explain below.
As principal investigator Blair A. Jobe, M.D., professor and director of esophageal research and esophageal diagnostics and therapeutic endoscopy, Department of Cardiothoracic Surgery, Pitt School of Medicine, told Science Daily:
“We are learning that the chronic and long-term use of PPIs may not be entirely without consequences and may lead to more insidious problems such as calcium malabsorption or cause one to be asymptomatic in the face of continued esophageal injury from GERD.”
Is the Standard Medical Treatment for GERD Making You Worse?
Typically, acid reflux is believed to be caused by excessive stomach acid production. So the “gold-standard” treatment is to prescribe a proton pump inhibitor, which works by VERY effectively block your stomach’s ability to produce acid. Problem solved, right?
This tactic misses the boat entirely, because acid reflux is NOT caused by too much acid in your stomach, it’s more typically caused by too little, as well as the acid flowing, inappropriately, out of your stomach and into your esophagus. GERD is commonly related to hiatal hernia — a condition in which the acid inappropriately comes out of your stomach, which is where it’s designed to be confined to.
After food passes through your esophagus into your stomach, a muscular valve called the lower esophageal sphincter (LES) closes, preventing food or acid from moving back up. Gastroesophageal reflux occurs when the LES relaxes inappropriately, allowing acid from your stomach to flow (reflux) backward into your esophagus.
In the early ’80s, Dr. Barry Marshall, an Australian physician, discovered that bacteria called helicobacter pylori (initially called campylobacter) causes a chronic low-level inflammation of your stomach lining, which is largely responsible for producing many of the symptoms of acid reflux.
One of the explanations for why suppressing stomach acid is so ineffective–and there are over 16,000 articles in the medical literature attesting to this–is because when you decrease the amount of acid in your stomach, you suppress your body’s ability to kill the helicobacter bacteria!
So suppressing stomach acid production tends to just worsen and perpetuate the condition.
Why You Must Get Informed Before Taking PPIs
Let me provide you with a simple yet powerful analogy. If the “check engine” light comes on in your car, and all your mechanic does is remove the light bulb from your dashboard, what would you think? You would probably realize that your car is still unfixed, as the mechanic only removed the warning mechanism for a potentially far more serious problem.
Well this type of approach is precisely what is happening with standard heartburn treatment with PPIs. If you’re taking a PPI drug to treat your heartburn you’re doing two things, but neither of them is actually beneficial to your health:
- You’re treating a symptom only; you’re not addressing the underlying cause
- By doing so, you’re exposing yourself to additional, and potentially more dangerous health problems, courtesy of the drug itself
As the study above showed, just because PPIs may cover up your symptoms, damage may still be occurring. Further, PPI drugs carry serious side effects, including:
- Bone loss
- Hip fractures
- Infection with Clostridium difficile, a harmful intestinal bacteria
- An increase in your risk of food poisoning, as reducing acid in your stomach diminishes your primary defense mechanism for food-borne infections
What you also should know is that these drugs actually CAUSE the very type of symptoms they’re intended to prevent if you stop taking them. In one study, more than 40 percent of healthy volunteers experienced heartburn, acid regurgitation and dyspepsia (pain and fullness in your abdomen) in the weeks after stopping PPIs; these were symptoms they did NOT have before!
It appears the drugs lead to “rebound acid hypersecretion,” which is an increase in gastric acid secretion above pre-treatment levels within two weeks of stopping the drugs. Essentially, because PPIs slam the brakes on the acid-producing pumps in your stomach, when you stop taking them that built-up acid can be unleashed with a vengeance.
This is why, in fact, you should not stop taking proton pump inhibitors cold turkey. You have to wean yourself off them gradually or else you might experience a severe rebound of your symptoms. Ideally, you’ll want to get a lower dose than you’re on now, and then gradually decrease your dose.
Once you get down to the lowest dose of the PPI, you can start substituting with an over-the-counter H2 blocker like Tagamet, Cimetidine, Zantac, or Raniditine. Then gradually wean off the H2 blocker over the next several weeks. While you wean yourself off these drugs (if you’re already on one), start implementing a lifestyle modification program that can eliminate this condition once and for all.
Natural Options to Eliminate Heartburn
Ultimately, the answer to heartburn and acid indigestion is to restore your natural gastric balance and function. So one of the first things you’ll want to do is to make sure you’re consuming enough good bacteria, while minimizing your intake of fructose and other sugars and grains, which can push your gut flora in the wrong direction. This will help balance your bowel flora, which can help eliminate helicobacter bacteria naturally. It will also aid in proper digestion and assimilation of your food.
Ideally, you’ll want to get your beneficial bacteria from traditionally fermented foods, such as:
- Fermented vegetables, like Kimchee and unpasteurized sauerkraut
- Kefir, fermented from RAW milk
- Yoghurt made from raw milk
Some health food stores might have the authentically fermented healthy foods but most likely you will have to make them yourself or purchase them from healthy organizations like Weston Price Chapters that hook communities up to sources of these types of traditional foods. If you are unable to find access to these traditionally fermented foods then it makes perfect sense to use a high-quality probiotic
The next strategies to implement to get your heartburn under control include:
- Eliminate food triggers — Food allergies can be a problem, so you’ll want to completely eliminate items such as caffeine, alcohol, and all nicotine products.
- Increase your body’s natural production of stomach acid — One of the simplest strategies to encourage your body to make sufficient amounts of hydrochloric acid (stomach acid) is to consume enough of the raw material.
One of the most basic food items that many people neglect is a high-quality sea salt (unprocessed salt), such as Himalayan salt. Not only will it provide you with the chloride your body needs to make hydrochloric acid, it also contains over 80 trace minerals your body needs to perform optimally, biochemically.
Sauerkraut or cabbage juice are also some of the strongest stimulants for your body to produce acid. Having a few teaspoons of cabbage juice before eating, or better yet, fermented cabbage juice from sauerkraut, will do wonders to improve your digestion as it can be made with high levels of Himalayan salt and the bacteria in the sauerkraut will help to heal your gut.
- Take a hydrochloric acid supplement — Another option is to take a betaine hydrochloric supplement, which is available in health food stores without prescription. You’ll want to take as many as you need to get the slightest burning sensation and then decrease by one capsule. This will help your body to better digest your food, and will also help kill the helicobacter and normalize your symptoms.
- Modify your diet — Eating large amounts of processed foods and sugar/fructose is a surefire way to exacerbate acid reflux as it will upset the bacterial balance in your stomach and intestine. Instead, you’ll want to eat a lot of vegetables, and high-quality biodynamic organic and preferably locally grown foods.
- Optimize your vitamin D levels — As I’ve mentioned many times in the past, vitamin D is essential, and it’s essential for this condition as well because there’s likely an infectious component causing the problem. Once your vitamin D levels are optimized, you’re also going to optimize your production of 200 antimicrobial peptides that will help your body eradicate any infections that shouldn’t be there.
As I’ve discussed in many previous articles, you can increase your vitamin D levels through appropriate amounts of sun exposure, or through the use of a safe tanning bed. If neither of those are available, you can take an oral vitamin D3 supplement.
- Implement an exercise routine — Exercise is yet another way to improve your body’s immune system, which is imperative to fight off all kinds of infections.
Finally, remember that there is virtually always a better, safer option than PPIs for GERD and similar problems. For instance, the antioxidant astaxanthin was found to reduce symptoms of acid reflux in patients when compared to a placebo, particularly in those with pronounced helicobacter pylori infection (best results were obtained at a daily dose of 40mg).
Ginger has also been found to have a gastroprotective effect by suppressing heliobacter pylori, and a dietary supplement containing melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine was found to be superior to Prilosec in the treatment of GERD, promoting regression of GERD symptoms with no significant side effects.
Even water has been found to be more effective than acid-inhibiting drugs, so while I realize that GERD can have painful symptoms that you want relieved now, you may want to consider the long-term consequences of PPIs, and the safer and more effective strategies and alternatives, before resorting to them as your form of treatment.
Dr. Pinna says…
This is an excellent article and covers all the aspects
of the hyper-secretion of acid in the stomach.
HOWEVER, THE TOPIC IS NOT AS SIMPLE AS DR.
MERCOLA WOULD LEAD US TO BELIEVE…
One simple remedy, not mentioned, is a teaspoon
of vinegar in a glass of water. Vinegar, like all the
acidic foods mentioned, is acetic acid, the result
of fermentation. Fermented carbohydrates produce
acetic acid. All the foods mentioned by Dr. Mercola.
Natto, Kimchee. etc., simply have acetic acid or
Acetic acid is a weak acid. It combines with
hydrochloric acid (HCL) and semi-neutralizes
the HCL. The resultant pH is 3.0 which is a
mild acid. This known as “buffering” a strong
Stomach acid is a common disorder and the OTC sales
of omeprazole are in the millions.
The real culprit, however, is the HELICO PYLORI
If the symptoms are severe, these must be eliminated. There are numerous treatments which require three or four antibiotics
taken twice daily and the use of a PPI taken twice
The time for the treatment is one to two weeks.
Before and after the treatment you must be tested,
a breath test, for the H. PYLORI.
The success rate is between 85 to 95 percent.
Almost any doctor can test for H. Pylori and
prescribe the treatment.
A Gastroenterologist will almost always “SCOPE”
the esophagus and the stomach to verify that there is
no cancer. This procedure costs several hundred
dollars if you have no insurance.
The use of good bacteria found in “Probiotics”
such as yogurt, will generally reduce the quantity of
the H. Pylori, but not totally eradicate the bacteria.
Today, most doctors eradicate the H PYLORI
with antibiotics if the symptoms are severe.
However, the recurrence rate is
high, since most people harbor this bacteria and
re-infect each other.
Families, in particular, have
high rates of H. Pylori because they eat the same food
and share the same utensils.
According to the National Cancer Institute, most
experts DO NOT recommend testing for and eradicating
The reason for this conclusion is that H. Pylori
reduces some types of cancer in the esophagus,
although it increases some in the stomach.
Thus, we have a mixed bag of opinions concerning
My opinion is that if the acid is refluxing badly,
treat the infection with antibiotics. If the case is mild,
treat with vinegar and avoid alcohol and coffee as
much as possible.
Here is the link to the National Cancer Institute
where H. Pylori is discussed: