Medications: Unmasking the Harm to Your Digestive Health

In our pursuit of better digestive health, it is essential to recognize that some medications intended to help may actually cause harm. With abundant information, conducting thorough research is crucial before making significant changes, particularly regarding medicines that affect your gut. While recommendations can be helpful, what works for one person may not work for another, and some common digestive medications can easily harm or worsen your health.

Here Are Several Digestive Medications That Can Harm Your Health:

Antacids (e.g., Tums): These medications neutralize stomach acid, temporarily relieving heartburn. However, raising the stomach’s pH can worsen reflux over time, as the LES is regulated by gastric pH and signals to close when the stomach pH is low (acidic). Antacids do not address the underlying causes of heartburn.

Proton Pump Inhibitors (PPIs): Medications like Prilosec and Prevacid stop stomach acid production by blocking the enzyme system responsible for its secretion. While they are safe for occasional, short-term use (no more than two weeks), long-term use of PPIs can lead to numerous problems. These include vitamin B12 deficiency, bone fractures, an increased risk of C. difficile infection, magnesium deficiency, food allergies due to improper food digestion, and Small Intestine Bacterial Overgrowth (SIBO). The primary concern is that PPIs only mask symptoms of Gastroesophageal Reflux Disease (GERD) rather than address the underlying issue. Prolonged use diminishes the stomach’s intrinsic factor, weakens the lower esophageal sphincter (LES), and decreases bacterial colonization from food ingestion, which can worsen SIBO. Additionally, stopping PPIs after long-term use may lead to severe rebound reflux as the body attempts to upregulate stomach acid production.

H2 Antagonists: Examples include Pepcid AC and Zantac, which lower histamine levels in the stomach and reduce stomach acid production. Though considered safer than PPIs due to their shorter duration of action (about six hours), long-term use can still result in problems similar to those caused by PPIs, such as issues with vitamin B12 and magnesium absorption, and an increased risk of SIBO and new food allergies due to chronic low stomach acid. They may also exacerbate stomach dysbiosis by further reducing acid production.

Laxatives (e.g., Miralax): These medications soften stools and increase intestinal contractions. While generally safe for short-term use, habitual or long-term use can lead to severe side effects, including intestinal muscular atrophy, electrolyte imbalances, inflammation of the intestinal lining, dysbiosis (which increases the risk of C. difficile infection), dehydration, and increased gut permeability (leaky gut).

Reglan (Metoclopramide): This antiemetic and gastroprokinetic agent increases the tone of the lower esophageal sphincter and encourages the stomach to empty its contents. However, Reglan can cross the blood-brain barrier and cause severe side effects, including restlessness, drowsiness, fatigue, and focal dystonia. A significant concern is tardive dyskinesia, which can cause permanent involuntary body movements. The FDA has issued a black box warning for Reglan due to the risk of this condition.

Amitriptyline (Elavil): This tricyclic antidepressant, prescribed for reflux disorders, has various adverse effects. It can weaken the upper and lower esophageal sphincters, potentially worsening reflux. Furthermore, it slows gastric emptying and motility, contributing to constipation and increased abdominal pressure. It also reduces stomach acid production, leading to or exacerbating stomach dysbiosis and maldigestion. While it may alleviate symptoms, it does not address the root cause of reflux.

Metformin (Glucophage): Commonly used for type 2 diabetes, metformin can cause frequent gastrointestinal side effects, including diarrhea, abdominal cramps, nausea, vomiting, bloating, burping, and flatulence. It may disrupt bile acid reabsorption in the ileum, leading to diarrhea and potentially increasing the growth of opportunistic bacteria such as Escherichia and Shigella. Long-term use is also associated with malabsorption and deficiency of vitamin B12.

While medications can offer relief for various conditions, they can also significantly impact digestive health. Always discuss the potential risks and benefits with your healthcare professional and consider comprehensive approaches to gut health. Contact me for coaching and let us fix your gut!