Emblematic of symptom-suppression over root-cause resolution, acid blocking medication is sold like an over the counter vitamin, causing disruption of digestion, B12 absorption, and, now microbial death. Appropriate acid production triggers enzymatic release and breakdown of food into its most basic building blocks. The lower esophageal sphincter can allow for even low levels of stomach acid to reflux in the setting of food intolerance and small intestinal bacterial overgrowth, leading patients and doctors alike to believe that overproduction of stomach acid is the cause of GERD.
Our resident microbes are responsible for protecting us against pathogens. A new cohort study examined the diversity of microbes in stool samples of those taking two doses of proton pump inhibitors and found changes comparable to those with clostridium difficile infection, after even one week of treatment.
It would seem that diminished absorption of vitamins and minerals in addition to potentially dangerous changes to bacterial composition of the stomach and small intestine is an undesirable tradeoff for comfort that could be achieved through dietary change, or even natural remedies such as baking soda, glycyrrhyza, or a trial of betaine hydrochloride.