A Word on ANTACIDS & H.Pylori

How many of you suffer the occasional bout of heartburn?  Judging by the sales of Rennies, Gaviscon and other over the counter antacids, the answer is probably quite a few.  A large meal with rich food will often bring on such a bout, so many people keep antacids in the bathroom cabinet.

But here’s the thing, antacids were intended to be used short term, certainly no more than three times a year, yet many people take them habitually, unaware that in doing so they’re altering the pH of their stomach, making it more favourable for the gut bacterium H.Pylori.   This mostly harmless gut bacterium co-exists with many of us, causing no symptoms, so we’re unaware of its presence.  We pass it on via saliva and when sharing utensils.  So it may be that after millions of years adapting to the harsh acidic conditions of our stomach, H.Pylori is simply a strategic member of our normal microbiome.  However, because its role in gastritis and peptic/duodenal ulcers is well established, (and it also raises risk of stomach cancer), when symptoms of chronic acid reflux occur it’s sensible to investigate.

Chronic heartburn and GERD (gastroesophageal reflux disease) is an unpleasant condition to live with and the accompanying inflammation (from rising stomach acid) can be very damaging to the oesophagus, so sufferers understandably reach for the antacids.  However it’s worth investigating if H.Pylori is a factor, rather than just taking antacids ad infinitum.  When a virulent H.Pylori infection with adverse symptoms has been diagnosed, a GP will prescribe an antacid alongside two antibiotics.  However, such treatment need not be generalized to all H. pylori positive subjects, when there are no symptoms.

My concern about the casual long-term reliance on over the counter antacids is because H. Pylori bacteria prefer a slightly higher pH and so will thrive when the pH of the stomach is frequently raised. People generally fall into one of two camps: ‘regular users’ of antacids, or ‘never user’ of antacids.  Clearly when their use becomes ‘regular’, the antacid is not resolving the root cause of the problem. By providing a temporary bandaid, these antacids may temporarily soothe heartburn, but you may also be inadvertently encouraging a bacterium to proliferate that’s capable of causing much more serious conditions.

Regular users of antacids should also be aware of the nutrient deficiencies that result from regularly reducing stomach acid.  Studies have shown an association between low stomach acid, H. pylori infection and iron deficiency anaemia, while the absorption of some vitamins such as vitamin B12, vitamin A, vitamin C, folic acid and Vitamin E are also affected.

So – prevention is always better than cure – when you next drop by the chemist for your antacid, consider instead alternative heartburn remedies, try Slippery Elm, and Aloe Vera juice instead, which taken on an empty stomach will soothe and reduce inflammation, without altering the pH of the stomach.  Then once inflammation has subsided encourage healthy levels of stomach acid by supplementing digestive enzymes and starting meals with bitter dark green salads, watercress etc, which stimulate production of stomach acid.  By optimising digestion you’re more likely to keep H. Pylori in check.

Foods containing plant flavenols like apples, cranberries, onions, garlic, celery, and tea inhibit growth of H.Pylori. Also foods rich in B vitamins and Calcium like dark leafy greens, beams, almonds, whole grains and sea vegetables.  And of course, eat smaller meals, and more modest portions of protein in the evening, because protein is harder to digest and hangs around in the stomach for longer, making reflux in a relaxed prone position more likely. So eat earlier – avoid eating late at night if you can.  Don’t drink litres of water with or straight after a meal – you’ll simply dilute your stomach acid.  Stomach acid not only digests food – it helps to keep the stomach free from parasites and bugs!

[1] A Talebi & B Abadi (2014) Helicobacter pylori: A Beneficial Gastric Pathogen? Front Med (Lausanne).1: 26

[2] Mei Zhang (2015) High antibiotic resistance rate: A difficult issue for Helicobacter pylori eradication treatment. World J Gastroenterology 21(48):13432-7.

[3] Chuah SK et al., (2011) A new look at anti-Helicobacter pylori therapy. World Journal of Gastroenterology. 17(35):3971-5.

[4] G Vitale et al., (2011) Nutritional aspects of Helicobacter pylori infection. Minerva Gastroenterol Dietol 57(4):369-77

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