Use PPIs only when medically necessary

What to Do

If you take proton pump inhibitors (omeprazole, pantoprazole, etc.), discuss with your doctor whether you still need them. Long-term PPI use significantly alters the gut microbiome and should be limited to clear medical indications.

Why It Works

PPIs reduce stomach acid by up to 99%, which changes the pH environment bacteria encounter. Studies show long-term PPI use reduces microbiome diversity by 20% and increases oral bacteria colonizing the gut (which doesn't belong there). This is associated with higher rates of C. difficile infection and small intestinal bacterial overgrowth (SIBO).

Tips

• Many people remain on PPIs long after the original condition resolves
• Step-down approaches exist: switch to H2 blockers (famotidine) first
• Short-term use (2-8 weeks) for acute reflux is generally fine
• If you need long-term acid suppression, your doctor should monitor for B12 and magnesium deficiency