Proton-pump inhibitors, or PPIs as they are commonly known, are among some of the world’s most commonly prescribed medications. In fact, according to a study, it is estimated that Americans spend $11 billion on PPIs yearly. These small pills are prescribed to treat and prevent acid-related conditions like acid reflux. Although these pills can ease acid reflux symptoms, they may do more harm than good in the long run.

By reversing the amount of acid in the stomach, this conventional treatment, in turn, begins to block the enzyme responsible for acid production. Common misconceptions include the idea of acid reflux symptoms being a result of excess gastric acid. Normally, it’s the complete opposite, as there isn’t enough stomach acid. The medication is not treating the problem and is ultimately putting you at risk for liver disease, according to a 2017 study published in Nature Communications.

Acid Reflux Medication and Liver Disease


Since our stomachs produce acid to kill ingested microbes, the consumption of medications that suppress the secretion of gastric acids can lead to changes in the composition of the gut microbe.

According to researchers at the University of California San Diego School of Medicine, evidence found in mice and humans suggested that stomach acid suppression may promote liver injury and the progression of three chronic liver diseases: alcoholic liver disease, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).

Specifically, researchers found that the lack of gastric acid promotes the growth of the bacteria Enterococcus in the intestines. When the bacteria translocates to the liver, it increases inflammation and chronic liver disease. In order to confirm the increased bacteria was behind the onset of chronic liver disease, the team colonized mice with Enterococcus faecalis to imitate the overgrowth they had observed with acid suppression. The results showed that an increase in Enterococcus alone was sufficient to induce mild steatosis and increased alcohol-induced liver disease in the mice.

Even though a large, randomized, controlled clinical trial is needed to definitively show the link between PPIs and the risk of chronic liver disease in humans, this introductory study sheds light on the potential concerns related to these acid reflux medications.

Other Acid Reflux Medication Side Effects

Acid Reflux

While the possible risk of liver disease can cause enough concern for anyone to toss aside conventional treatment such as PPIs, other common side effects include:

  • Headaches
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Flatulence
  • Fever
  • Vomiting
  • Nausea
  • Rash

Long-term, high-dosage use of acid reflux medications may result in:

  • The growth of Clostridium difficile (C. diff)
  • Osteoporosis and arthritis
  • Reduced absorption of vitamin B12 (cyanocobalamin)
  • Magnesium deficiency
  • Heart attack
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Reduced kidney function
  • Pancreatitis
  • Erythema multiforme
  • Ulcers
  • Inflammatory bowel conditions, including Crohn’s disease, ulcerative colitis, and IBS
  • Leaky gut
  • Asthma


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