If you’ve ever experienced heartburn or reflux, you know how painful these conditions can be. Fortunately, there are medications—readily available over the counter—that can effectively treat those unpleasant symptoms.
Proton pump inhibitors (PPIs) are the medications most people take to treat acid reflux. “They were introduced into the market more than 30 years ago and they were a game changer for people dealing with acid reflux, inflammation and stomach ulcers,” says Anas Kutait, M.D., a gastroenterologist at Henry Ford Health.
But a study published in 2023—linking long-term use of PPIs with dementia—has made some people rethink their reliance on the medication.
What The Study Says About PPIs And Dementia
The study that made headlines did find an increased risk of dementia in people who used proton pump inhibitors regularly for more than four years. In fact, their results showed a 33% increase in dementia risk for those using these acid reflux medications long term.
“Patients see the alarming headlines and panic,” says Dr. Kutait. “But few read the actual study or fully understand its findings and—more importantly—its limitations.”
This was an observational study, which means it followed a group of people for a period of time and then analyzed data they collect about those people. Observational studies can reveal certain trends or findings, but they cannot prove a direct connection. “This was a good study, but it definitely does not prove that PPIs cause dementia,” says Dr. Kutait.
One thing Dr. Kutait notes is that this study didn’t account for many of the other factors that also increase dementia risk. “Obesity, smoking, high blood pressure and diabetes are risk factors for dementia,” he says. “People who have some of those conditions are also more likely to have acid reflux and take PPIs. So it’s hard to know if the medications lead to dementia or did their other risk factors cause it?”
How To Reduce Reliance On PPIs
Whether or not PPIs increase dementia risk, there are other reasons to try to cut down on your intake. “PPIs are a very good medication and overall they are very safe,” says Dr. Kutait. “But every medication carries the risk of some side effects, and the possibility of side effects increases with the more you take.”
Managing Acid Reflux
First, make sure you actually need to take them. Since PPIs are available over the counter, people use them because they think they have acid reflux. “But if you take a proton pump inhibitor for several weeks and you don’t feel better, it’s important to see your doctor. They can help figure out if something other than reflux is causing your heartburn,” Dr. Kutait advises.
Even if you do have acid reflux, you may not have to take medication for it every day—especially if you’re not having symptoms every day. “Try taking it every other day and continue to wean yourself down to the lowest effective dose,” says Dr. Kutait. “By cutting down on frequency and dose, you’re less likely to experience any potential long-term side effects.”
Other Ways To Safely Treat Acid Reflux
One way to effectively cut down your use of acid reflux medications is to reduce your risk factors for acid reflux. “There is strong link between being overweight or obese and acid reflux,” says Dr. Kutait. “My first recommendation to patients is to lose weight, and when they do, it can reduce or eliminate the problem.”
Other lifestyle changes that can help reduce acid reflux include:
- Avoiding food triggers: Foods that trigger reflux aren’t the same for everyone. But some common triggers include: coffee, chocolate, carbonated beverages, acidic foods, fatty or fried foods and spicy foods.
- Eating more frequently: Smaller meals are less likely to cause acid reflux, so aim to eat smaller, more frequent meals throughout the day.
- Managing stress: Being under stress can make the esophagus more sensitive, which means even a small amount of acid reflux can cause pain.
- Timing your meals: Laying down too soon after eating allows acid to more easily come back up from the stomach into the throat. That’s why it’s helpful to avoid eating for two to three hours before bedtime.
By making smart choices, you can reduce acid reflux—and your reliance on daily doses of medication to treat it.
Reviewed by Anas Kutait, M.D., a gastroenterologist who sees patients at Henry Ford Hospital in Detroit and Henry Ford Medical Center - Fairlane.
