Are millions of us born with a genetic defect that makes us produce too much stomach acid? Do we need powerful, acid-blocking drugs to prevent heartburn and reflux?

Or, could something simply be out of balance? Consider this: At least 10 percent of Americans have episodes of heartburn every day, and 44 percent have symptoms at least once a month. Overall, reflux or gastroesophageal reflux disease (GERD, also known as heartburn) affects 25 to 35 percent of the U.S. population.

Fast on the heels of Lipitor and Plavix (drugs for cholesterol and heart disease), acid-blocking drugs are the fourth top-selling pharmaceutical in America’s $286 billion drug market. In fact, three of the drugs to treat reflux — Nexium, Protonix and Prevacid — are in the top 20 best-selling drugs, accounting for some $13 billion in sales annually.

Now, these drugs are given like candy to anyone who has had too many hot dogs at a ballgame. And one drug, Prilosec, whose patent expired, is now available without a prescription. I’ve even seen a commercial showing a family rushing to stop their father from eating a big sausage with fried onions and peppers — and he tells them not to worry because he took his acid-blocking pill!

So, why are these drugs so bad? Well, their supposedly “good” effect — shutting down stomach acid — is actually a bad effect. Stomach acid is necessary to digest food, to activate digestive enzymes in your small intestine, to prevent bacterial overgrowth in your small intestine, and to help you absorb important minerals like calcium and magnesium and vitamins like B12.

Research indicates that taking these drugs can prevent you from properly digesting your food, cause mineral and vitamin deficiencies, and lead to irritable bowel, depression, hip fractures, and more.

For example, studies show that people who take long-term acid-blocking medications can become deficient in vitamin B12, which can lead to depression, anemia, fatigue, nerve damage and even dementia, especially in the elderly.

Studies also show that taking these drugs can cause dangerous overgrowth of bad bacteria in the intestine, which can lead to life-threatening infections.

For many more people, low-grade overgrowth of bacteria in the small intestine leads to bloating, gas, abdominal pain and diarrhea — which, by the way, are many of the common “side effects” noted in the label warnings for these drugs.

The funny thing is, back in my medical school days, GERD was not even on the radar as a significant illness. Some people had heartburn, and then there were people with ulcers. For the most part, that was it.

The upshot? It’s my view that drug companies invent diseases to create markets for their products. It is absurd to think that humans can’t feel good and live with normally functioning digestive tracts without help from powerful drugs with dangerous side effects.

These drugs may occasionally be necessary for short-term use, but if we deal with the root causes of digestive imbalances (as the practice of functional medicine suggests), reflux and other acid-related conditions usually can be managed without medication.

Your Gut: A Day at the Office

Wondering what the heck your gut does all day long? For starters, it ...

1. Breaks Down Your Food: Mechanically and chemically separates and digests food with the help of adequate stomach acid, digestive enzymes and bile.
2. Ushers in the Good Stuff: Absorbs (through a delicate one-cell-thick layer) just the right molecules — amino acids, fats, sugars, vitamins and minerals — to keep us properly nourished.
3. Bounces the Bad Stuff: While letting in the nutrients essential for life, it must prevent, block or neutralize nasty toxins, bugs and chemicals that flow through our “inner tube of life.”
4. Makes Raw Materials: Your gut bacteria produce vitamins and other health-giving molecules that nourish you and make up your gut ecosystem.
5. Protects You: Balances your gut immune system (called the GALT, or gut-associated lymphoid tissue), which comprises 60 percent of your immune system, thereby protecting you from illness and supporting your vitality.