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Advisory - eating uncooked foods while on PPI/H2 therapy

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Posted 3/14/2013 7:54 PM (GMT 0)
Hi folks,

I have been reading a few posts in this forum about patients who are on acid reducing meds, i.e. PPI's, H2's and then go and eat Sushi, among other raw and/or undercooked things. IMO, this is a questionable practice, since you are probably compromised in terms of your stomach acid already, which may not be able to destroy some nasty pathogens that wouldn't normally bother you if your acid level was strong.

Stomach Acid is among first line of immune defense and lowering it, which these drugs obviously do, increase your chances for gastrointestinal illness. As a matter of fact, I am a prime example of this. When I dine out, I have to make sure that my food is properly handled and cooked well. This also includes vegetables. Utensils should be wrapped up in a napkin, or you are taking a chance by leaving them exposed to the air. Only in this way do I reduce my chances of getting sick. When I eat at home, these issues are not a problem since my environment is tightly controlled.

The only practical solution is getting off these classes of meds if possible - not easy, I know, from experience.

I hope that this short rant helps inform others!

Feel well!

Gastricman :-)

Post Edited (Gastricman) : 3/17/2013 3:50:02 PM (GMT-6)

Posted 3/14/2013 11:09 PM (GMT 0)
Hi, I agree it seems risky. I do eat soft spreadable cheese but that's the biggest risk I'll take!

MMM
Posted 3/16/2013 6:39 PM (GMT 0)
Great point Gastricman! I'd never thought of that, but it makes sense.
I've been drinking a lot of Nutribullet smoothies. All raw vegetables, greens, fruits, nuts, seeds, almond milk or yogurt...
My husband is the pro at making these for us. When we first started with them, I noticed he wasn't washing the fruits and veges well. I had more stomach upset than usual, and that now make's sense. We've decided to use as much frozen as possible now.
They're ready to use, and frozen soon after picking, preserving the vitamins.
Have you tried going off PPI's? I tried once almost a year ago and it was awful. I actually had a Nissen scheduled but got bumped by the surgeon as he felt my issues were well controlled by the PPI's.
Having the surgery was hopefully going to get me off of them, and now I have to wait until next week to find out why the surgeon changed his mind. Very frustrating.
BTW...It was the surgeon who told me on my first visit with him, that long term use of PPI's can cause stomach carcinoma. That was when he also told me I was an excellent candidate for the surgery. Sigh.....

This just adds more ammo for me to get off of them. My biggest issue with the PPI's are not being able to absorb B vitamins, calcium, magnesium and who know's what else, but factor this in and really it probably isn't the best thing to put in our bodies.

PS-I don't get the last post about the soft spreadable cheese :)
Posted 3/16/2013 10:18 PM (GMT 0)
Hi GM,

I'm not a sushi eater, but I have to say this...I have been on PPIs for a long time (prior to surgery 40mg Protonix before breakfast and dinner, and Ranitidine 300mg at bedtime--after surgery 40mg Protonix before dinner--I have asthma and sensitive lungs and my asthma doc has requested I continue to protect any errant reflux).  In that time I've eaten any and all foods, and haven't had a problem at all.

I just don't want to overly concern people and make them think they're doomed to having infections due to lack of stomach acid.  If this were a serious possibility, I'm confident that my PCP and GI docs would warn of these risks.  Is it possible to have a problem?  Probably.  But in my experience, knowing many who are on PPIs for many years without a problem, I have to assume the risk is quite small.

I don't think that people need to be overly worried or concerned, unless they have another immune suppression/compromise issue or other illness that would make them at risk.  Your normal, fairly healthy GERD sufferer is very unlikely to have a problem like this caused by taking PPIs.

That's the way I see it.  I understand that there is room for a variety of opinions, but thought I'd stop by and offer mine.  There is always a risk of a stomach illness, but if this were a high risk issue, I think I would have succumbed during the past 17+ years I've been on PPIs.

You're right that it's better not to take these meds long term or at all, but for some, there aren't a lot of options.  I hope you'll find your way to a perfect situation, and find an answer that is just right and go with it. I have never been so lucky.  I've had to go with the next best thing! turn

Take care,

Denise

Posted 3/17/2013 8:50 PM (GMT 0)
Hi Denise,

It is well documented that PPI therapy does leave you predisposed to gastric infections, as per my post above.

My point was to enlighten people on the potential dangers of eating raw or undercooked foods. Now, everyone is different and I was on PPI's for over 10 years before I started getting sick after dining out. At first, I thought it all was a coincidence, but in reality, it was not.

I have been to a couple of respected GI MD's who understand this and have been told that I am not the only one.

BTW, my gastric infections do not happen often, but eating raw and/or undercooked foods is not the best, IMO for any people with serious GI problems, especially in this day and age of contamination. Food safety is paramount.

Don't forget that when your stomach acid is lowered, it does, by nature, make you a bit immunocompromised. I'm just pointing out that there are risks with eating these types of foods from personal experience with PPI's and suggest nothing more. Just be careful where and what you eat.

Respectfully,

Gastricman :-)

Posted 3/25/2013 4:29 PM (GMT 0)
Hi GM,

I have absolutely no doubt that your facts are correct.  My post was simply to put some real life experience into the medical reality.  Many things are risks, but that does not mean that everyone who fits into that risk category will succumb to those negative effects.

It is important to share your information.  I just wanted to provide a little balance by sharing my own life experience.  I don't want to scare people into being afraid to eat out and enjoy life because they are on PPIs.  If you find you are prone to this side effect, by all means, take precautions.  However, that doesn't mean that everyone is.

If someone is getting repeated GI infections, then there is evidence that requires action.  Not everyone will fall into that category.

Thanks again for sharing your experience and knowledge.

Take care,

Denise

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