Tips

PPI starters instructions (people on the drug for the first time)

• Take your medication 30–45 minutes before breakfast
• If taking in the evening, take it 30–45 minutes before your evening meal
• Take your medication every day at the same time
• Don't skip days until you consume all the prescribed pills
• Don't take higher dosage without consulting your doctor
• Avoid alcohol, sodas, and smoking — anything that extends the healing process
• Consume less acidic foods and eliminate trigger foods
• Do moderate exercise and drink enough water
• If one PPI brand causes side effects, try another until you find one with minimal effects
• Use the minimal effective dosage — if 20 mg keeps your symptoms at bay, stay on it unless your situation worsens

Managing side effects

• Fatigue / brain fog: ensure adequate B12 and magnesium — PPIs can impair absorption of both
• Bloating / gas: digestive enzymes or probiotics may help; try different PPI brand or lower dose
• Rebound acid: taper slowly when stopping — do not stop abruptly after long-term use
• Bone concerns: ensure adequate calcium and Vitamin D; discuss bone density monitoring with your doctor if on PPIs long-term

Natural alternatives reported by patients

• Probiotics (reported helpful by many patients with IBS/GERD overlap)
• DGL licorice — deglycyrrhizinated form, taken before meals
• Apple cider vinegar — diluted, taken before meals (paradoxically helps some)
• Aloe vera juice
• Digestive enzymes
• Slippery elm
• Melatonin (some studies show benefit for GERD)
• Low-carb / Mediterranean diet
• Elevation of head of bed for night-time reflux
• Weight loss if overweight

See the full supplement statistics on the Statistics page.