Patients taking acid blocking medications may experience adverse effects if those medications are taken long term. The medications are not recommended for long term use. This article will discuss the specific negative consequences of having deficient or no stomach acid.

What Are Acid Blockers?

Acid blockers aim to reduce the stomach’s production of hydrochloric acid (HCl).

Short term use, when appropriate is effective and safe. They are actually quite effective in multiple gastro-intestinal disorders including peptic ulcer disease (and associated bleeding), eradicating H. pylori, Zollinger-Ellison Syndrome, GERD and Dyspepsia [1]. The problem is when people take these medications for too long.

Long term use is considered both dangerous and ill-advised, even by the drug manufacturers themselves.

Acid is vital in protein digestion, mineral absorption and protection against pathogenic bacteria. Read more about the importance of stomach acid here.

The Consequences of Long Term Acid Blockers

When acid blockers are used long term, a wide range of associated conditions can ensue.

• Reduced mineral absorption [2]
  • Including magnesium, calcium, vitamin B12 – acid helps get these out of the food sources [1]
  • Some evidence shows these deficiencies are more likely in elderly and malnourished individuals [3]
• Increased risk of fracture
  • This is a consequence of reduced calcium absorption
  • Research has shown PPIs (one type of acid blocker) increased risk of hip fracture after only 1 year of use [1]
• Impaired protein digestion [2]
  • Stomach acid primarily breaks down protein, so we see lower amino acid in circulation [2]
• Depression [2]
  • Due to reduced protein breakdown, we see reduced tryptophan, tyrosine, and phenylalanine which can be associated with depression
  • Depressed mood occurs more often in those taking acid blocking medications [2]
• Increased potential for gastric adenomas (cancer) [4]
• Increased risk of gut infection [2]
  • Acid helps kill bacteria entering our digestive tract
  • Salmonella, C. difficile (and associated diarrhea), claustrum difficile, community acquired pneumonia [3]
  • Small Intestinal Bacterial Overgrowth (SIBO)
• Enterochromaffin-like cell hyperplasia [3]
• Parietal cell hypertrophy leading to rebound acid hypersecretion [3]

Can Acid Blockers Do Harm Long Term?

Acid blockers are known to have multiple serious long term consequences. If you’ve been on acid blockers for a long time (more than 1 year), consulting a naturopath would be helpful to get to the underlying cause of your acid reflux or GERD. Optimal gut function is possible, with the right investigation and treatments.