Case Study: Proton Pump Inhibitors (PPIs) and Reflux
“Sam” is a 37-year old male banker who came to see Dr. Bhandari due to having chronic acid reflux (heartburn) for over a decade. It has been compounded by chronic anxiety and panics attacks, allergies, and debilitating neck, shoulder, and back pain. Sam has been so busy building a successful career that he hasn’t had the time to deal with chronic health issue. Recently married and wanting to start a family, Sam is ready to get the root of his issues.
Sam first asked Dr. Bhandari to put together a plan customized to his needs which would effectively treat his chronic pain. Sam’s goal was to regain better quality of life and reduce the amount of medications he was regularly taking.
What Dr. Bhandari M.D. Discovered
Sam’s limited production of digestive enzymes and stomach acid prevents his ability to properly digest food and adequately absorb essential nutrients, minerals, and vitamins. As a result, his cells had become malnourished and dehydrated. Poorly digested food often regurgitated back into the esophagus and respiratory tract leading to “classic heartburn”, panic in chest, tight jaw, and anxiety. Long-term use of PPIs (or Proton Pump Inhibitors) had further worsened the acid level inside the stomach and further inhibited the digestive process. Although PPI’s are often overprescribed and overused in the treatment of chronic acid reflux or GERD), they dramatically worsen digestive function, compromise the immune system and increasing the risk of infections, mood disorders, chronic pain, and osteoporosis.
Sam’s overuse of PPIs led to his entire digestive system not working properly. It eventually resulted in leaky gut syndrome with a high concentration of heavy metals and toxins leaking out into the bloodstream and eventually causing Hashimoto’s thyroiditis.
Sam had severe intracellular deficiencies of B vitamins (i.e., Vitamin B6, B12, folic acid), iron, magnesium, and vitamin D, which further compromised his immune system, and caused high levels of musculoskeletal and nerve pain.
Due to Sam’s diet often causing the blood to be very acidic, his body would compensate by leaching calcium from his bones in order to neutralize the blood’s pH level and to allow for normal cell function. As his kidneys were unable to effectively clear this excess calcium, the high levels caused calcium deposits on his blood vessels, joints, etc. eventually causing more chronic illnesses.
The chronic intracellular nutrient deficiencies worsening the repair process and hence, trigger increased production of stress hormones and often feeling overwhelmed. The inflammation throughout the body continues to rise leading to symptoms such as upper extremity pain, numbness, and anxiety attacks as in Sam’s case. .
Dr. Bhandari’s Solution
Persistent dyspepsia (aka., heartburn, esophageal acid reflux) is aggravated by items which are extremely dehydrating inside of the body. These items often require a great deal of water for production and often tainted with tons of industrial toxicants. The #1 items are any amount of animal protein (i.e., dairy products, eggs, red meat, poultry, fish), followed by GMO crops soy, corn, wheat, and rice often found in processed food. It is also worsened by alcohol, caffeine, nuts, and sugar.
Sam’s diet was high in heavy metals such as arsenic due to his frequent consumption of poultry, dairy products, eggs, and red meat which were all fed arsenic in their fed. Arsenic could not be effectively cleared by the liver and kidneys especially since they were further damaged by regular alcohol consumption.
Dr. Bhandari advised Sam to focus on hydrating digestive tract appropriately and consume plant-based, alkaline foods which require limited water in production. It excluded nuts, fruit, sugar, alcohol, and caffeine whenever possible. By having a 0.5 to 1 liter of warm water 30+ minutes before meals and in the early evening Sam would begin eating less and feel more satiated.
Sam was prescribed Innate’s Inflama-GI drink in between meals in order to assist in the digestive process of food. By evening Sam was advised to eat significantly less with intermittent 12 to 16 hours of night-time fasting since Sam was not able digest his dinner leading to night-time reflux, sinus congestion, poor sleep, fatigue, and increased irritability. To prevent acute and treat heartburn symptoms, Sam was to use DGLicorice chews before and after meals.
Sam was also prescribed Integrative Therapeutics’ Glutamine Forte drink throughout the day. The combination of turmeric and the potent antioxidant glutathione helps strengthen the gut’s tight junctions and lessen leaky gut.
Most importantly, Sam was asked to taper off his use of antacids and use them only as needed. Antacid make it very difficult for the stomach to function properly because they decrease the body’s own ability to produce the proper acidity levels.
The Results
With following the recommendations advised, Sam began to feel better every week. He is experiencing significantly less shoulder and neck pain allowing him to exercise most days, and go skiing twice this season. Acute reflux has dramatically lessened allowing Sam to no longer take PPI’s. He still requires antacids a few times per week with the hope he will be able to stop in the next few months.
Emotionally, Sam is very happy with his work and marriage. He is sticking to a plant-based diet most of the time and indulging in eggs and fish only during social gatherings when no vegan options are available. He is becoming better prepared by cooking most days. The struggle to voice out his preference to be plant-based in social settings is becoming easier especially since Sam feels the direct benefit every day. His health continues to greatly improve with easy lifestyle shifts.
Next Steps
Dr. Bhandari recommended Sam continue to avoiding alcohol and animal protein due to its slow transit time, dehydrating properties, and high heavy metal/industrial toxicant load. It quickly aggravates many of Sam’s symptoms with his body becoming less tolerant to the insult as the immune system has become stronger.
Check-ins are regularly done every month with his bloodwork rechecked every three months.
AUTHOR
Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of SF Advanced Health. She combines the best in Eastern and Western Medicine to understand the root causes of diseases and provide patients with personalized treatment plans that quickly deliver effective results. Dr. Bhandari specializes in cell function to understand how the whole body works. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.