How to heal heartburn WITHOUT drugs: Acid reflux pills taken by millions cause crippling side-effects and are even linked to cancer and dementia. Now doctors reveal what to do

It is the uncomfortable chest pain that nearly half of us will experience at some point – and for many, it can be completely debilitating. The most recognisable symptom of acid reflux is a burning sensation when stomach acid leaks up into the oesophagus and throat – which is why it’s often referred to as heartburn.

But the condition can also trigger nausea, a sore throat and cough, bloating and bad breath. For years, GPs have relied on a go-to treatment: a type of drug called a proton pump inhibitor, or PPI, which reduces the amount of acid produced in the stomach. The most widely used, omeprazole, costs as little as 15p a pill and is remarkably effective.

The tablets ease discomfort quickly and can help prevent further bouts of heartburn. They are considered safe, with few if any side-effects, when taken for a month or two. But, increasingly, patients in the UK are being kept on PPIs for years – in some cases, even decades.

As a gut health specialist, I find this troubling. I often see people who were put on a repeat prescription years ago and advised never to stop.

Some patients even say they don’t know why they were prescribed the tablets in the first place. PPIs are sometimes handed out as a precaution alongside other medicines known to cause heartburn, to stop symptoms before they start. However, mounting evidence suggests there can be serious health risks from taking PPIs for too long.

Some studies have linked long-term use to mental health problems, bone-thinning osteoporosis, cancer, Parkinson’s and dementia.

While the jury is still out on some of these associations, my main concern is that PPIs don’t address the root causes of heartburn – meaning patients may never truly be free of it.

What’s more, for some, excessive use can actually make their heartburn worse.

It’s why when we see new heartburn patients taking PPIs, we ask them if they feel it’s absolutely necessary to stay on them – particularly if they are still experiencing symptoms.

Instead, my colleagues and I believe that in most cases heartburn can not only be reduced, but often cured, through simple changes to diet. Best of all, these changes can start to improve symptoms within weeks.

And the need for better treatments is clear. Around one in five Britons currently suffer from heartburn, and 40 per cent will experience it at some point in their lives. Smokers, pregnant women and people who are overweight or obese are most at risk. It also becomes more common as we age, which is why the majority of patients are over 40.

Certain medicines – including anti-inflammatory painkillers such as ibuprofen – can also raise the risk, as can chronic stress.

Sometimes, though, heartburn is triggered by physical problems inside the body – ‘plumbing issues’, you could say. The valve at the top of the stomach, which normally keeps food down, can become too loose, allowing acid to leak upwards into the oesophagus.

In other cases the cause is a hiatus hernia – where the top of the stomach pushes through a weakness in the muscle above it and gets trapped. This can stop the valve from closing properly, leading to reflux.

When severe, heartburn can disrupt sleep, with symptoms waking sufferers during the night.

Studies show that prolonged sleep loss increases the risk of depression, obesity, diabetes and heart disease.

Over time, chronic heartburn can trigger a condition called Barrett’s oesophagus – pre-cancerous changes in the gullet which, if left untreated, can develop into life-threatening tumours.

For mild, temporary heartburn symptoms, over-the-counter remedies such as Rennies and Gaviscon usually do the trick. These drugs neutralise the acid that has leaked into the oesophagus.

But for more severe symptoms, most GPs will prescribe PPIs such as omeprazole or lansoprazole. These drugs bind to cells in the body – called proton pumps – that help produce stomach acid, preventing them from functioning properly. Studies show that around four in five heartburn patients who take PPIs experience a significant improvement in their symptoms within the first week.

When these drugs were launched in the 1980s, they completely revolutionised the treatment of acid reflux. However, they were never meant to be used long-term.

Prescribing guidelines set out by the National Institute For Health And Care Excellence (NICE) clearly state that GPs should not prescribe them for longer than two months. If patients are still experiencing symptoms after that, other treatments should be considered. In reality, that rarely happens. Around two-thirds of people prescribed PPIs take multiple courses or remain on them continuously, according to the National Institute for Health and Care Research.

This often happens because GPs are busy and don’t take the time to consider other options beyond PPIs, especially if the patient doesn’t complain. It helps that the tablets are cheap, too.

There are also question marks over the use of PPIs for preventing reflux from occurring in the first place. Thousands of patients are prescribed these tablets long-term by their GP in combination with other drugs, such as ibuprofen, which are known to irritate the stomach.

Patients who do get heartburn as a result of taking other medication will need to take a PPI as long as they continue on that drug. That’s because, left untreated, drug-induced stomach irritation can lead to painful ulcers and internal bleeding.

But studies have shown that patients taking preventative PPIs are just as likely to develop reflux as those who do not, meaning they provide no clear benefit.

Worse, these patients may be putting their health at risk.

There is strong evidence that extended use of PPIs damages the gut microbiome – the thriving community of trillions of bacteria and other ‘friendly’ microbes in the stomach.

When PPIs were first launched, our understanding of the gut microbiome was limited. Today, we now know it’s crucial for a healthy body. And a poorly functioning microbiome is linked to a host of health conditions, from mental health issues to cancer and even, potentially, dementia.

This might explain why overuse of PPIs is linked to so many worrying health conditions.

Moreover, we need our stomach acid. It’s crucial for fighting off gut infections, and studies do suggest that PPI patients are more prone to these bugs.

A growing number of experts also believe that, without a well functioning gut microbiome, heartburn can get worse. One study, which looked at people with such severe acid reflux that they needed invasive surgery to tighten the stomach valve, found two-thirds of these patients had extremely poor microbiomes.

This suggests a lack of the right bacteria could be causing some extreme cases of heartburn.

It’s for all these reasons that I think we need to move away from relying on PPIs to treat the nation’s heartburn problems.

Instead, the most effective – and safest – treatment is tackling the underlying cause of the heartburn, which, in my experience, is almost always food.

At our clinic, there is a group of triggers that we see most. These include simple carbohydrates (such as white bread and rice), onions, garlic, sugary drinks – both fizzy and fruit juices – alcohol, chocolate and sweets.

Spicy food – it’s almost always curries – and very acidic foods, such as lemons and oranges, are also common culprits.

Drinking caffeinated beverages such as coffee and tea is one of the worst thing someone with reflux can do, because caffeine loosens the stomach valve.

Another trigger many people are unaware of is fatty foods such as burgers, hot dogs and fish and chips. Fat takes a long time to digest, which means the stomach can get ‘backed up’, pushing acid up into the oesophagus. Every heartburn patient will have different triggers, so what we often recommend is removing these items from their diet one by one.

In many cases – such as with fatty food, alcohol and chocolate – consuming fewer of these items will also have the added benefit of helping patients lose weight.

This is important because excess weight puts pressure on the gut, which in turn leads to more heartburn.

These are all relatively simple changes to make, but the effects can be profound. I have seen patients with such severe heartburn that they were told they needed surgery.

However, just a few months after changing their diet and cutting out triggers, their symptoms reduced and they were able to avoid the procedure.

In fact, we are so convinced that diet changes are the way forward when it comes to treating heartburn that, later this year, our clinic is running a clinical trial where we will compare the symptoms of patients taking PPIs to those who are given diet advice and over-the-counter antacids.

We hope that our findings – which I believe will show that PPIs are the less effective treatment – will change how the NHS treats this common condition. Because, right now, many patients are not getting any advice from their GPs and, instead, are turning to social media for help.

In recent years, apps such as TikTok and Instagram have become filled with influencers offering so-called ‘heartburn hacks’ that supposedly cure the problem instantly.

These videos, which are often watched by millions of people, typically suggest eating ice cream, milk and bananas to combat the excess stomach acid in the oesophagus.

This strategy has a kernel of truth to it. These foods all contain alkaline – which means they can cancel out the effects of acid. However, the amount of alkaline in a banana is nothing compared to the high-strength acid that comes up from the stomach (which is strong enough to dissolve metal).

Eating alkaline-based food may provide a small amount of temporary relief, but the change is not going to be significant.

In fact, some of these foods, including ice cream and milk, can make symptoms worse because they contain a lot of fat.

The only hack that I ever recommend to my patients is to sleep on their left side. This is because the stomach is on the left side of the body while the tube connecting it to the oesophagus is on its right side.

By sleeping on the left, gravity keeps acid pooled on the other side of the stomach to the oesophagus, making it difficult for the acid to escape.

However, this isn’t a lasting solution to heartburn.

To be clear, there will always be patients who benefit from a short course of PPIs. They are highly effective drugs and anyone taking them should not stop without talking to their GP first.

It is important to note that patients who develop heartburn as a result of taking other medication, such as ibuprofen, will need to take a PPI as long as they continue on that drug to avoid stomach irritation. In this case, the benefits of taking a PPI outweigh the risks.

But I think the sheer effectiveness of these tablets has been a double-edged sword in the battle against everyday heartburn.

These days, they are treated as a lifestyle drug – something that patients can simply pop after a big weekend of drinking and bad eating – rather than tackling the poor choices that trigger their symptoms.

But the fact is, the only way the majority of people can escape the horrible symptoms of heartburn is through the diet changes I have outlined here.

It really is that simple.

Dr Anthony Hobson is a clinical director at The Functional Gut Clinic

Case study: I was on acid reflux tablets for a decade – until I made these changes

For as long as Suzanne Emery can remember she has suffered with uncomfortable heartburn.

The 48-year-old hairdresser from Peterborough says that she had all the tell-tale symptoms.

‘I would feel this burning sensation in my chest,’ she says. ‘But I also got a scratchy throat and felt nauseous whenever these episodes came on.

‘If it started at night, then I’d wake up. It was really annoying.’

Suzanne, who lives with her partner James, pictured right, says the heartburn would occur if she ate just before bed, or after heavy meals.

‘However, sometimes there’d be no clear reason for it starting.’

In 2010, after speaking to her doctor about her heartburn, she was put on omeprazole – a proton pump inhibitor (PPI) that blocks the production of stomach acid.

While omeprazole is designed to be taken for a maximum of two months at a time, Suzanne remained on the tablets for a decade.

‘My symptoms weren’t as bad while I was on the pills, but I felt like I was just masking the problem,’ she says.

‘Eventually, the tablets stopped working, meaning my symptoms got worse again, so my doctor switched me to lansoprazole [a different PPI].

‘At one point I asked whether it was safe to take these drugs for so long, but I was told not to worry about that.’

Eventually, Suzanne made a private appointment at The Functional Gut Clinic, where she was given suggestions on how she could change her diet to help manage the symptoms.

‘I stopped drinking any coffee, tea or alcohol,’ she says. ‘I cut out onions and garlic and stopped eating rich, spicy food at restaurants, like curries.

‘Within months I noticed that I was getting fewer and fewer symptoms. So I gradually stopped taking the lansoprazole and my symptoms still didn’t come back, which was a massive relief.’

Today, Suzanne is no longer taking PPIs and says she rarely gets heartburn. ‘If I do, I take a Rennie and that usually helps,’ she says.

‘It can be difficult not being able to eat like everyone else, but when you’ve had years of heartburn like I have, you realise that it’s worth the sacrifice.’