If you’ve had heartburn, you know how uncomfortable that burning pain in your chest can be. You may even be taking over-the-counter medication to relieve it.
Proton pump inhibitors (PPIs), which work by blocking stomach acid production, are among the most popular and effective drugs for treating the symptoms of heartburn or acid reflux. But long-term use of PPIs has been connected with gut infections, bone fractures, chronic kidney disease and type 2 diabetes, among other disorders. For this reason, doctors often direct heartburn sufferers to use them sparingly and over short periods of time.
However, if you’re a PPI user, you may want to shelve the drug altogether for the time being due to an alarming connection made recently by some researchers…
PPIs and positive COVID-19 results
A survey of 53,130 U.S. patients has revealed that the use of PPIs once or twice daily may increase the odds of a positive COVID-19 test compared with patients that don’t take PPIs. The survey was conducted online from May 3 to June 24, 2020.
Of all survey participants, 3,386 patients, or 6.4%, reported a positive COVID-19 test. Analysis of the data indicates individuals using PPIs either once or twice a day had higher COVID-19 infection rates than those not taking PPIs, with those taking PPIs twice a day having the highest rate.
Patients taking histamine-2 receptor antagonists (H2RAs), another class of less-potent heartburn drugs, did not face an elevated risk.
All the participants were 18 years of age or older and were first shown a list of common GI symptoms. Those who indicated a history of abdominal pain or discomfort, acid reflux, heartburn or regurgitation were separately asked about any use of PPIs or H2RAs. For those currently using those drugs, frequency and duration of use were assessed.
Respondents were also asked whether they were tested for COVID-19, and those with a positive test were asked about any new symptoms they experienced, including gastrointestinal symptoms. Analysis of the results considered the duration of PPI or H2RA usage and relevant demographic, socioeconomic, lifestyle and comorbidity variables.
“We found a strong, independent effect of using PPIs on risk of COVID-19, including a dose-response relationship with nearly a fourfold increased risk for twice-daily dosing,” says Dr. Brennan M. R. Spiegel of Los Angeles-based Cedars-Sinai, one of the study’s authors. “But we found no relationship with the less powerful H2RAs, such as famotidine or cimetidine.”
The power of a good gastric environment
The researchers note that right now the impact of acid suppression on SARS-CoV-2, the coronavirus that causes COVID-19, is unknown. But previous data show that the normal pH of a healthy stomach reduces the infectivity of a similar coronavirus, while a less acidic pH environment such as that achieved with PPI therapy does not inactivate the virus.
This is a significant point because while SARS-CoV-2 is more likely to enter the body through the respiratory system, it can also gain entry through the GI system. The coronavirus uses a receptor that is widely expressed through the intestinal tract to rapidly invade and replicate within certain cells lining the intestines. Once it colonizes the GI tract, it can lead to gastritis, enteritis and colitis. And infectious SARS-CoV-2 has been found in the stool of patients with severe COVID-19.
Since analysis shows twice-daily PPIs do not offer a meaningful benefit over once-daily dosing for gastroesophageal reflux disease (GERD), the researchers further stress that PPIs should only be used when clinically indicated and at the lowest effective dose.
On the other hand, since COVID-19 will be with us for a while, it may be important to find safer ways to relieve heartburn and acid reflux. You can tame heartburn through lifestyle changes such as quitting smoking and drinking; eating smaller, more frequent meals; and thoroughly chewing your food. Or you can use natural remedies such as apple cider vinegar or chamomile or ginger tea to cut down on acid and soothe digestion.
One interesting point made by Dr. Michael Cutler is that heartburn and reflux, rather than being caused by acid overproduction, can actually be signs of incomplete digestion. With all the processed foods we consume these days, the stomach often doesn’t get the signals it needs to release enough digestive enzymes to properly consume your food during mealtimes. That results in an overproduction of digestive juices between meals, which can lead to heartburn and reflux.
There are some natural supplements you can take with meals to boost the number of digestive enzymes in your stomach and ease your heartburn symptoms. These will also help restore your stomach’s optimal pH, which could then help inactivate any coronaviruses lurking there…
Helping to balance your stomach pH
The nutritional supplement betaine hydrochloride (HCl) has been used for over a century to safely return gastric acidity levels to normal and to support healthy gut function. Betaine is often recommended by doctors as a supplemental acid source for people suffering from low stomach acid production.
Be careful not to confuse betaine HCl with anhydrous betaine, a nutrient used to control homocysteine levels.
The amino acid L-glutamate (glutamic acid) activates the stomach’s digestive enzyme pepsin, which helps your body break down and absorb protein. Taken along with betaine HCL, L-glutamate can also balance the pH of your digestive tract.
Gentian root is a powerful digestive aid used throughout Europe. This bitter herb acts on the taste buds, stimulating the production of saliva in the mouth and hydrochloric acid in the stomach.
Peppermint is another herb that promotes the secretion of gastric acid and aids digestive function by fighting gas and increasing bile flow. It also helps to relieve discomfort caused by spasms in the upper digestive tract.
Proton pump inhibitor use increases risk of positive COVID-19 test, survey says — Becker’s GI & Endoscopy
Increased Risk of COVID-19 Among Users of Proton Pump Inhibitors — The American Journal of Gastroenterology
Gastric Balance: Heartburn Not Always Caused by Excess Acid — Nutrition Review
Betaine Hydrochloride Uses—PeaceHealth Health Information Library
Say Goodbye to Heartburn, Gas and Bloating! — Easy Health Options