Proton pump inhibitor’s (PPIs) such as “the purple pill” are often prescribed to individuals for a variety of gastro-intestinal issues. Oftentimes, the patient is given the prescription with no set end date and remains on them for years. Current recommendations state that PPIs should only be used at the lowest possible dose for the shortest amount of time necessary.
The challenge for patients is not know when or how to stop taking a PPI. Always talk with the prescribing physician for recommendations. And keep in mind, stopping the use of PPIs abruptly is not recommended. The best way to discontinue is to taper down slowly while adding in digestive enzymes. This will reduce or eliminate the risk of some reflux symptoms while tapering (rebound acid hypersecretion). It is important to recognize this, know it is reversible and a shorter effect while going off the PPI. Make sure a clinician is supervising the tapering process.
Long term use of PPIs is associated with a number of health concerns including increased risk of intestinal infections, hip fracture, kidney failure, and pneumonia. Use of PPIs is also associated with a number of nutritional deficiencies, including B12, magnesium, calcium, zinc, iron and more.
Keep in mind dietary triggers for reflux. These include:
- Carbonated beverages
- Citrus fruits
- High-fat foods
- Spicy foods
- Others: consider IgG food sensitivity testing
Helpful lifestyle modifications include:
- FODMAP diet (https://www.monash.edu/medicine/ccs/gastroenterology/fodmap)
- Eat smaller meals
- Avoid eating within 3 hours of sleeping
- Overnight fasting (minimum 12 hours not eating)
- Elevate head while sleeping
- Sleep on the left side
- Stop smoking and alcohol
- Reduce weight