Millions of Brits ‘hooked’ on medication to manage acid reflux that’s putting them at risk of dementia, a top pharmacist has warned.
Proton pump inhibitors (PPIs) are one of the UK’s most widely used drugs, with 73 million NHS prescriptions dispensed in England in 2022-23, at a cost of £190m.
The drugs, like omeprazole and lansoprazole, help to reduce the amount of acid inside the stomach, limiting the distressing symptoms of reflux, also called heartburn— including pain and difficulty swallowing.
However, studies have suggested that long-term use could increase the risk of developing dementia.
A 2023 US study published in the journal Neurology found that taking PPI medications such as omeprazole, esomeprazole and lansoprazole for more than four and a half years could make you 33 per cent more likely to develop dementia, compared to those who’ve never taken it.
The authors of the study theorised that the link could lie with the effect of PPIs on the body’s absorbtion of vital nutrients, such as vitamin B12.
‘This is essential for brain health,’ said Dr Thanu Jey, one of the researchers involved with the study. ‘PPIs may also lead to an increase in the formation of the protein beta-amyloid, which is linked to Alzheimer’s disease.’
Now, pharmacist Deborah Grayson, who has been working as a chemist for 25 years, has warned that, in many cases, the benefits of these drugs are not worth the risks.
Studies have found that those who take acid reflux medicine like omeprazole for long periods of time have a much higher risk of developing dementia.
She told MailOnline that they are often prescribed as a ‘panacea for varied digestive symptoms, without a clear clinical need to suppress acid production’.
Since there is no ‘exit strategy’ for taking patients off the medication, many are left ‘hooked’ for life — as long-term use can in fact make the symptoms worse, leaving patients more reliant on it.
‘We are sleepwalking into a significant culture of PPI addiction due to over-prescribing without clear reason and failure to give patients a clear exit strategy from the treatment,’ said Ms Grayson, who is also a nutritional therapist with Heartburn Cancer UK and runs her own clinic called Digestion With Confidence.
‘It only takes three days’ use of PPIs to be at risk of rebound heartburn, which can be five times worse than normal reflux.
‘This can mean patients inappropriately assume that the medication is essential as excess acid must have been the issue.
‘It is this rebound that leads to the inability to stop taking a PPI in many patients, effectively leaving them hooked.’
What’s more, up to 40 per cent of patients do not respond to a PPI, meaning they’re useless.
Pharmacist Deborah Grayson has warned that millions of Brits are caught in a ‘vicious cycle’ with acid reflux drugs.
Acid reflux, or heartburn, happens when stomach acid travels up towards the throat. If it continues over long periods of time, it’s known as gastro-oesophageal reflux disease, which is usually caused by a weakness in the muscles connecting the food pipe with the stomach.
Ms Grayson said that all too often patients are prescribed drugs instead of being informed about diet and lifestyle interventions that can relieve symptoms.
For instance, reducing stress and adopting regular eating patterns can help.
Most crucial is to take enough time to eat a meal, preferably at a dinner table.
Digestion starts in the brain with 20 per cent of stomach acid being produced in anticipation of food being consumed, according to Grayson.
‘This is known as the cephalic response,’ she said, explaining that before the invention of fast food, the preparation and cooking of meals triggered the same process, kick-starting the digestive system.
‘Modern lifestyles have resulted in many people deciding they are hungry, dashing into the nearest food outlet and eating food within minutes,’ Grayson added. ‘This means that the body has to play catch up and over-produces acid, exacerbating symptoms’
She advised – even if too busy to cook – to start the ‘anticipation process’ some 20-30 minutes before grabbing something to eat.
‘Think about what you are going to have, how it tastes and how it smells. This can trigger the anticipatory response in the same way that preparing it yourself would have done.’
Chewing is of equal importance.
‘Most of us are extremely busy and often ‘inhale’ our food,’ Grayson saif. ‘The chewing process reduces the burden on stomach acid.’
Each mouthful of food should be chewed until it’s soft, she added, while putting down your knife and fork between mouthfuls gives the stomach a much better chance of digesting the food you have eaten.
Grayson also warned of the many foods that can make reflux worse by relaxing the sphincter in the food pipe that lets acid travel.
Some with reflux suffer the ‘silent’ type, which is much more difficult to diagnose. Symptoms usually consist of dry coughing and frequent throat clearing.
These include coffee, alcohol, chocolate, peppermint, tomatoes and citrus fruits.
Spicy meals, fatty foods and large portions also cause the muscle to not function properly.
‘Avoiding these foods within three-to-four hours before bedtime can help massively,’ she said.
Her final tip is to add certain herbs to your diet, which can act as a stimulant for digestion, as well as protecting the system from damage from acid and bile.
‘Drinking chamomile or artichoke tea can help stimulate the digestive process in a similar way to bitter leaves whilst fennel can have a calming impact on digestion too.
‘Drinking tea containing marshmallow root or slippery elm can help to protect the digestive system from acid and bile.’
These two teas should be consumed one hour after medication to reduce the risk of impacting the absorption and function of any medication you might be taking.