Written By: Dr Anitha Anchan | Updated : January 13, 2016 11:39 AM IST
The occurrence of acidity is rising steadily with changing lifestyles and eating habits. If you suffer from burning sensation in the throat or stomach, belching, sour taste and indigestion when you eat spicy food or when you eat outside you would most likely try natural remedies to get rid of the problem. And if these episodes become regular you might gulp down a sachet of antacid mixed in a glass of water or pop those over-the-counter acid suppressant drugs. Taking those medications may give you instant relief. But have you ever wondered what happens when you take them for prolonged periods?
When you think of stomach acid your conventional wisdom says that it is something nasty that burns the inside of our tummy. Well, the truth is that stomach acid is not something to be feared!
Stomach acid the elixir of good digestion
A healthy digestive system is important for overall wellbeing. The stomach is designed to produce the acid. Stomach acid (or gastric acid) the major component being hydrochloric acid is necessary for normal food digestion. It helps activate certain enzymes and break down proteins in the food. The breaking down of food allows its vital nutrients to be absorbed by the body. And a study has revealed that high levels of stomach acid also defend us against food poisoning. The acidity allows the stomach to act as a filter, effectively controlling which microbes can pass through the stomach to the gut.
It reduces the workload on the body s defenses too!
Did you know that the stomach acid helps knock out bad bacteria? The high pH of stomach acid makes an inhospitable environment for vast majority of bad bacteria that may be ingested with food or water. It helps protect the body by keeping the dangerous bacteria from growing and colonizing the gut.
Antacids and acid suppressants the consequences of low stomach acid
An excess production of stomach acid causes acidity with symptoms like dyspepsia, heartburn, gastric inflammation and ulcers in the stomach. Antacids and acid suppressants are used to treat conditions like acidity, GERD, gastritis, dyspepsia and peptic ulcer. Antacids are substances which neutralizes stomach acid. Acid suppressing drugs are H2 blockers and proton pump inhibitors. They reduce or inhibit gastric acid production.
Heartburn occurs when the acid (produced in stomach) comes up (flows back) towards the esophagus and thus causes an irritation in it. GERD is a condition when food substance flows back from the stomach into the food pipe (esophagus) when the muscle between esophagus and stomach fails to close after the passage of food from the esophagus into the stomach. Antacids and acid suppressants may give you instant relief but they fail to address the underlying causes! And long term use can have dangerous consequences:
1. Gastrointestinal infections
Consistent low stomach acid due to neutralizing or underproduction causes bacterial overgrowth in the stomach and the intestine. This not only leads to increased risk of inflammation and infection but also to indigestion and malabsorption. A weakened defense against bad bacteria makes you more prone to gastrointestinal infections.
2. Nutritional deficiency
As a result of inflammation (gastritis), the stomach is unable to produce the required amount of acids and enzymes to carry out digestion. Chronic gastritis may continue to affect your digestive system for a long time and can lead to malabsorption of important nutrients like iron, vitamin B12, etc. thereby leading to their deficiency [1]. If the condition becomes severe, it can cause bleeding from the stomach lesions.
3. H. pylori infection
Decreased amount of acid in your stomach suppresses its ability to kill the bacteria Helicobacter pylori. This causes colonization of the stomach by the bacteria and result in chronic gastritis. H. pylori have been recognized to exert profound and diverse effects on gastric acid secretory function[2]. Gastritis caused by the bacteria at furthest part of the stomach that connects to the duodenum increases acid secretion leading to duodenal ulcer. On the contrary, pangastritis (inflammation of entire stomach) caused by it markedly reduces acid secretion and increased risk for gastric cancer.
And there are other consequences too!
Depending on the type used, prolonged use of antacid may cause urinary tract infections, heart and kidney problems, muscle weakness and cramps, milk alkali syndrome, defective bone mineralization [3], etc.
References
1. Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013 Dec 11;310(22):2435-42. doi: 10.1001/jama.2013.280490. PubMed PMID: 24327038.
2. McColl KE, el-Omar E, Gillen D. Helicobacter pylori gastritis and gastric physiology. Gastroenterol Clin North Am. 2000 Sep;29(3):687-703, viii. Review. PubMed PMID: 11030081.
3. Woodson GC. An interesting case of osteomalacia due to antacid use associated with stainable bone aluminum in a patient with normal renal function. Bone. 1998 Jun;22(6):695-8. PubMed PMID: 9626411.
4. Biswas S, Benedict SH, Lynch SG, LeVine SM. Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis. BMC Medicine. 2012;10:57. doi:10.1186/1741-7015-10-57.
5. Lau YT, Ahmed NN. Fracture risk and bone mineral density reduction associated with proton pump inhibitors. Pharmacotherapy. 2012 Jan;32(1):67-79. doi:10.1002/PHAR.1007. Review. PubMed PMID: 22392829.
6. Cai D, Feng W, Jiang Q. Acid-suppressive medications and risk of fracture: an updated meta-analysis. Int J Clin Exp Med. 2015 Jun 15;8(6):8893-904. eCollection 2015. PubMed PMID: 26309543; PubMed Central PMCID: PMC4538134.
7. Chung EY, Yardley J. Are there risks associated with empiric acid suppression treatment of infants and children suspected of having gastroesophageal reflux disease? Hosp Pediatr. 2013 Jan;3(1):16-23. Review. PubMed PMID: 24319831.
8. Shah NH, LePendu P, Bauer-Mehren A, Ghebremariam YT, Iyer SV, Marcus J, Nead KT, Cooke JP, Leeper NJ. Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population. PLoS One. 2015 Jun 10;10(6):e0124653. doi: 10.1371/journal.pone.0124653. eCollection 2015. PubMed PMID: 26061035; PubMed Central PMCID: PMC4462578.
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