It seems almost like a daily occurrence, a patient stops in and states that they have been taking their proton pump inhibitor for 10 years and now they have either read that it can have some long term side effects or their prescriber tells them they need to stop taking it. Proton Pump Inhibitors such as Prilosec (omeprazole), Prevacid (lansoprazole), Nexium and others, are indicated for gastrointestinal symptoms and are to be used for 4 to 8 weeks and then should be stopped. However, there are several conditions that require long-term treatment with these medications. The hard part in trying to stop these products is that they can create a rebound acid secretion that reinforces the need to keep taking themThese Proton Pump Inhibitors as well as Antacids, such as Maalox, Mylanta, Tums, and H2 blockers, including Zantac and Pepcid, all come with short and long term issues we must be aware of.First off, they are some of the biggest offenders leading to nutrient depletions including; B vitamins, calcium, magnesium, vitamin D, iron, zinc and can cause disruption of healthy gut bacteria.Then there is altered pH. pH is a measurement of both acid and alkaline balance. Where a pH of 7 is considered neutral, the human digestive tract varies greatly in pH. Saliva has a pH between 6.5 to 7.5. The stomach where the secretion of hydrochloric acid (HCL) and pepsin takes place is much more acidic, between 1.5 to 4.0. We need hydrochloric acid to break down and absorb vitamin B 12, calcium, iron, as well as fat and proteins from food. This acidic environment acts as a first line of defense to various bacteria and viruses that can come through our foods.Our pH can become altered from the natural aging process, unhealthy dietary choices, or from the over use of antacids. If the pH becomes to alkaline in certain areas of our digestive tract, our good gut bacteria can be destroyed, and overgrowth of bad bacteria such as C. Defficile may ensue.When people come to me with heartburn or acid reflux, even though their body might need betaine HCL, this is not where I like to start. The reason being, they could have an active ulcer, which betaine HCL might only make worse, or they could have excessive irritation from years of reflux and heartburn, which the betaine HCL could irritate.The common therapy for heartburn and acid reflux is antacids. Where this might be appropriate for the short term, especially in the case of ulcers, as we mentioned, the long term can lead us down the path of nutrient malabsorption, losing our front line of defense against various pathogens, and altered pH.I like to begin with a product called Heart Burn Essentials from Pure. This can be added to current antacid therapy with the intention of weaning off the antacids, or by itself, if nothing has been tried yet.Heartburn Essentials provides natural ingredients and enzymes which are designed to support natural gastric secretion, enhance digestion, sooth and support the integrity of the digestive tract while offering relieve for occasional heartburn and indigestion. Stop by the pharmacy to see if we can help you with your digestion issues. Please visit my website at www.irsfeldpharmacy.com to find this and other archived articles in the blog section. Until next time, be vigilant about your health!!