It’s days like this where the practice of gratitude comes quite naturally. Today, I can compare where I was several years ago to where I am now, and be awestruck by the unlimited potential for healing we have as human beings. I was operating under the assumption that our health is, for the most part, out of our control, and so I just assumed that ailments like IBS, TMJ, allergies, and acid reflux were something that would be with me for the rest of my life. Acid reflux is “genetic,” but I stopped blaming genetics for my dis-ease a long time ago. Ever since my grandfather past away from esophageal cancer in 1991, there has been a deep-seated fear in the family that not taking a proton pump inhibitor for the rest of your life will lead to the same fate that he suffered.
This bit of family history ignited a conversation with my gastroenterologist; Dr. Bill Salt, MD, who retired from Ohio Gastroenterology, a practice he helped form in the 1970s, in order to devote himself to his clinic, IBS Gut and Microbiome Solutions. Dr. Salt has become a mentor of mine, and he explained the trajectory of GERD treatment in his field over the last 40 years. Until that point, I was under the impression there was little else you could do that to avoid spicy foods, take an antacid here and there, and be on your merry way! While it used to be true that there was little they could do for patients with functional problems like Barrett’s esophagus, until the advent of omeprazole in the 1980s, also known as a Proton pump inhibitor (PPI). Salt says, “Patients who fit that diagnoses definitely need to be on such a medication, but for the majority of the population on PPIs, they are on a medication they don’t need to be on, and one that could very well harm their health in other areas due to the drug’s numerous side effects.”
Now before I began working with Dr. Salt, I had been far and wide trying to find some resolution with my myriad of health problems in my early 20s. I initially went to my primary care physician in the spring of 2015 for acid reflux that was so bad it was interrupting my sleep at night. So we started on omeprazole at 20 mg, with minimal improvement, until a month later when we bumped it up to 40 mg. I did experience significant relief once I started the 40 mg, but knowing what I now know about GI health from an integrative perspective, PPIs are not the only option for sufferers of GERD.
Since reflux was far from my only symptom as far as gastrointestinal discomfort, my primary care doctor soon referred me to the major medical group in central Ohio, Ohio Gastroenterology. There I met Dr. Gupta, a genial gentleman who was relatively fresh out of residency. I told him that I’d been kind of on and off with taking the Nexium because I swore it made my IBS worse. My concerns were confirmed, he said that it was not uncommon for the drug to increase the frequency of IBS-D, but that it would only help in treating GERD if you took it every day. It was puzzling that when I brought up how these side effects were making my health worse, his sentiment seemed to be, “It is what it is.”
Dr. Gupta was not a terrible doctor by any stretch, but the passivity and carelessness of he and his colleagues were profoundly shocking. The Western view of medicine has all but abandoned the fundamental principle of “Do No Harm.” After my first endoscopy, Dr. Gupta said that I had erosion and that I would probably never be able to get off of Nexium for the rest of my life. This statement right here was a radicalizing moment in my life, where I vowed that I would never again allow myself to be under the care of physicians who refuse to employ critical thinking skills. It may sound harsh, but the hamster wheel of conventional medicine doesn’t require the use of critical thinking, and just like any other muscle, it begins to atrophy if not exercised.
I explored alternatives through functional medicine during this time, flirting with acupuncture, Ayurveda, holistic medicine, craniosacral therapy, the list could go on forever. While I initially thought they were just looking down at other methods of treatment, I did come to understand and agree partially with conventional doctors when they explained their askance to me regarding functional or holistic medicine, in terms of treating such ailments as acid reflux. Using herbs and natural remedies such as ginger, papaya, licorice, aloe Vera juice, peppermint oil, special teas, baking soda, all of which I have employed at various points over the years in my attempts to alleviate symptoms; those are just masking the problem, in the same way as the prescription drugs. Now, the side effects are considerably less with holistic remedies, but we still aren’t getting to the bottom of why the body is in disarray.
For me, what finally brought about my long term and lasting relief, and healing was working with Dr. Salt to heal my intestinal permeability, also known as “leaky gut.” I have been fortunate enough to experience firsthand why Dr. Salt shines as an integrative physician; he’s a healthy balance between conventional and functional medicine. He says, “The functional medicine crowd does tend to overkill the notion that most Americans are too acidic. In reality, most Americans have low stomach acid, especially as they get older. While it may seem counter-intuitive, the name acid reflux is part of what leads people to believe they’re overly acidic.”
After taking omeprazole for two solid years, I finally decided to get off of it. Little did I know that the withdrawal would be shockingly painful! I titrated off of it, I was cautious with not just stopping cold turkey, yet it still felt like I had been punched in the chest by Hulk Hogan. I felt like I was going to vomit 24/7 for two weeks straight. The idea of eating sounded like torture, but the hunger did eventually win out. Nevertheless, it was one of the best decisions I’ve ever made, and my body has been able to achieve a level of healing and rejuvenation I would have never thought possible this time three years ago. I am happy to say that my chronic GERD is little more than a distant memory at this point.
Dr. Salt used to give Barrett’s patients up to a gram of Tagamet before Nexium hit the market, and he feels strongly that Tagamet is manifestly safer than Nexium. His rationale is, “The PPI drugs shut off your stomach acid, and in pursuit of optimizing the integrity of the gut microbiome, that handicaps our ability to help patients achieve substantial relief from chronic symptoms. Not only that, but we are seeing a rise in C. Dif in hospitals because of chronic PPI usage, we need stomach acid to fight off such infections.”
Intestinal permeability, the clinical name for leaky gut, makes the body vulnerable to a host of autoimmune comorbidities, for our gut lining contains roughly 70 percent of the cells that make up our immune system. Thus, we become more sensitive to foods, allergens, and chemicals, leading to a body-wide hyper-reaction known as Mast cell activation syndrome (MCAS). You can cut out spicy foods, but as was my experience, it was as if the list of triggers just kept growing longer and longer. We’ll cover MCAS another day; it deserves a column all to itself!
We immediately started a product called Entergam, which helps bind the lining of the gut. Also, he had me start taking an H1 blocker and an H2 blocker every day, which for me meant an Allegra (non-drowsy) and two Zantac every day to control the mast cells. Seven months after my first endoscopy, I went back in for another because Dr. Salt was concerned that my dysphagia might be eosinophilic esophagitis. Thankfully, that was not the case, the slow motility in my GI tract was from getting off Nexium, and so my body had to adjust to making stomach acid for the first time in two years. They said my esophagus looked beautiful, and that it had never looked better!
Here’s the catch, I had a different doctor than Dr. Gupta to perform the scope, Dr. Dietz, who said he recommended that I get back on the PPI to keep the problem at bay. To instruct patients to get back on a medication that they admittedly don’t need to be on, for no real discernible reason other than, “Just in case” is truly unethical. When I went for my follow-up with Dr. Gupta, I told him point blank I didn’t follow his colleague’s logic, and while he tried to remain diplomatic, he apologized and admitted that he found such a suggestion to be “nebulous” as well. The scary part is that Dietz is far from the only one in the medical field who would do such a thing.
The lassitude of the medical field has been a source of great aggravation in my life the last several years, which I am now grateful for because it forced me to take my health into my own hands. The fault is not on the patients alone, for conventional medicine often makes people feel like they have no choice but to take the pills that are prescribed without question. They sadly throw around phrases like “non-compliant patient” in order to bully anyone who dares question their logic. Is it any surprise that American medicine is in such turmoil?
*Several Names Have Been Changed To Protect Individual Privacy