July 2, 2012 — New research has prompted the U.S. Food and Drug Administration (FDA) to warn about the risks of using Proton Pump Inhibitor (PPI) acid reflux drugs for extended periods of time.
Although the drugs are only indicated for 8-12 weeks, some people take them for years or indefinitely. In 2010, more than 100 million prescriptions were written for PPIs such as Nexium, Prevacid, and Prilosec, Aciphex, Vimovo, and more. In 2010, sales of these drugs were nearly $14 billion.
Unfortunately, in recent years, there has been a growing amount of scientific research linking long-term use of PPIs to serious side effects. The FDA recently warned that PPIs could increase the risk of bone fractures of the hip, wrist, and spine, especially in older Americans. They also warned of a life-threatening bacterial infection from Clostridium difficile. Other studies have linked PPIs to an increased risk of nutritional deficiencies, anemia, pneumonia, and weight gain.
Experts had hoped that widespread use of PPIs might reduce the risk of a type of esophageal cancer that is linked to acid reflux, known as esophageal adenocarcinomas. Instead, these cancers are more common today.
Severe nutritional deficiencies are a risk of long-term use of PPIs. With less stomach acid, the body is unable to adequately extract nutrients and absorb them. PPIs are associated with deficiencies in magnesium, calcium, and vitamin B12.
Another issue is that the stomach compensates for a lack of stomach acid by creating more acid-producing cells. If the person stops taking the PPI, they may have even more acid-producing cells than when they started taking the drug. Severe acid reflux may make it very difficult to stop taking a PPI.
Stomach acid also plays a role in other body systems other than the stomach. The pancreas and gallbladder require normal levels of stomach acid. It also kills harmful bacteria that enter the gut, which may play a role in the body’s immune system. Coughing is also stimulated by stomach acid, which can help clear the lungs.
Some researchers are concerned that PPIs may be over-prescribed. Dr. Joel J. Heidelbaugh conducted a study in which he reviewed the medical records of 1,000 Veterans Affairs patients who were on a PPI. He found that only one-third of the people actually had a diagnosis that needed treatment with a PPI.
Many people who have acid reflux can treat their disorder by making changes to their lifestyle and diet. Over-production of stomach acid is often caused by eating foods that cause heartburn.
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