Q: I had gastric ulcers a couple of years ago due to real bad heartburn. The specialist placed me on 40 mg of omeprazole each day and that has taken care of my symptoms. I would like to wean myself off of this medicine since it really doesn’t cure my problem and I know liver damage can happen. Is there anything I can do lessen the effects of taking myself off this medicine? I am working on not drinking coffee or carbonated beverages but I am really afraid that my heartburn will come back once I stop taking this medication.

A: A well-established BELIEF is that heartburn and related conditions are caused by excess stomach acid, which isn’t usually the case. Instead, the burning is caused by stomach contents that are in the wrong place, the esophagus, instead of where it belongs (sometimes a real hernia weakens the esophagus muscle allowing stomach contents to be pushed upward). The most common medical approach to the symptoms is to use a drug to block the production of acid, coupled with the belief that lower acid reduces esophagitis or heartburn. Yes, that’s a good idea for the short term. Even the package inserts for those drugs warn that they should only be used for a couple of weeks. Unfortunately, many people – and their doctors – end up swallowing the drugs for years.

Reducing stomach acid impedes digestion and breakdown of food. A common long term impact is lower mineral absorption and there have been numerous reports that thyroid problems are more common when there aren’t enough minerals available. Yes, long term use is also associated with damage to the liver (because the liver does the work of detoxifying the drug). Additionally, there are reports that chronic use of this kind of drug increases the frequency of gastric infection (C. Diff).

There are a few things that can help restore normalcy without using drugs. Consider adding acid (apple cider vinegar) before each meal and at bedtime. A tablespoonful in a glass of water before eating is helpful. Also, using a good digestive enzyme with meals can help make your food intake more nutritious and reduce the likelihood of developing deficiencies. Finally, use a good probiotic daily to repopulate the entire GI tract with good bacteria.