Doctor explains why prolonged use of stomach acid reducers can be harmful: ‘Gut microbiome changes, infection risk…’
Struggling with frequent acid reflux can be more than just an everyday discomfort – when it becomes chronic, it may increase the risk of complications, including precancerous changes in the oesophagus linked to oesophageal cancer. To manage symptoms like heartburn, GERD, and ulcers, many people turn to acid-reducing medications such as proton pump inhibitors (PPIs). While these drugs can be highly effective in providing relief, long-term use may come with its own set of risks.
Dr Kunal Sood, an anaesthesiologist and interventional pain medicine physician, is shedding light on the potential risks associated with the long-term use of acid-reducing medications, particularly proton pump inhibitors (PPIs), and what prolonged reliance on them could mean for overall health.
In an Instagram video shared on April 17, the physician highlights, “Proton pump inhibitors can be effective, but long-term use changes how the body handles nutrients, microbes, and infection risk, which is why it’s important that the benefit outweighs the risk when taking.”
Nutrient absorption can be affected
According to Dr Sood, stomach acid plays a crucial role in extracting vitamin B12 from food so the body can absorb it effectively. It also helps maintain magnesium balance, meaning excessive use of acid-reducing medications can disrupt this equilibrium – while simultaneously impairing iron absorption.
He explains, “Stomach acid helps release vitamin B12 from food so it can bind intrinsic factor and be absorbed. Long-term acid suppression can reduce this process. Acid also supports magnesium balance, and prolonged PPI use has been linked to hypomagnesemia. Iron absorption may also be reduced since acid helps maintain it in a more absorbable form.”
Gut microbiome changes
Dr Sood highlights that reduced stomach acid can weaken the body’s natural antimicrobial barrier, allowing more oral and upper gastrointestinal bacteria to reach the intestines. He adds that overuse of PPIs has been linked to decreased microbial diversity and an overgrowth of microbes that don’t typically belong in the gut.
He notes, “Lower stomach acid reduces the body’s antimicrobial barrier. This allows more oral and upper GI bacteria to survive and reach the intestines. Studies show PPI use is associated with reduced microbial diversity and increased growth of organisms like Enterococcus, Streptococcus, and E. coli, which may contribute to dysbiosis.”
Higher infection risk
Low stomach acid can allow harmful microbes to pass through the digestive tract without being neutralised, enabling them to reach the gut alive. This, in turn, may increase the risk of infections and disrupt overall gut health.
The physician explains, “If fewer microbes are neutralised in the stomach, more can reach the gut alive. This aligns with observed associations between PPIs and enteric infections, particularly Clostridioides difficile. Randomised data show a signal for increased enteric infection risk with long-term use.”
Not all risks are equal
Beyond the risks mentioned above, Dr Sood notes that other widely cited concerns – such as dementia and chronic kidney disease – are largely drawn from observational studies and lack strong, conclusive evidence.
He explains, “Beyond the risks mentioned above, Dr Kunal Sood notes that other widely cited concerns – such as dementia and chronic kidney disease – are largely drawn from observational studies and lack strong, conclusive evidence.”
Why appropriate use matters
According to the physician, current guidelines advise using acidity reducers only when clinically indicated, at the lowest effective dose, and with regular reassessment – rather than continuing them indefinitely without a clear medical reason.
He concludes, “Stomach acid plays roles beyond digestion. Long-term suppression changes nutrient handling, microbial balance, and infection defense, which matters most with prolonged or unnecessary use.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. Tezzbuzz.com has not independently verified the claims and does not endorse them.
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