July 2, 2012 — Proton Pump Inhibitors (PPIs) are the third most popular class of drug in the United States, but researchers and the FDA are warning that long-term use of PPIs (drugs including Prilosec, Prevacid, Nexium, Aciphex, Vimovo, and more) could increase the risk of severe side effects.
These drugs block the production of stomach acid, which is a treatment for severe heartburn, acid reflux, and gastroesophageal reflux disease (GERD). However, the FDA has warned that long-term use of a PPI increases the risk of bone fractures and a life-threatening bacterial infection with Clostridium difficile.
Other research has linked these drugs to increased risk of pneumonia, anemia, and weight gain. Although researchers hoped widespread use of PPIs could reduce the risk of esophageal cancers, the type of esophageal cancer that is associated with acid reflux (esophageal adenocarcinomas) have increased substantially.
One of the biggest problems with acid reflux drugs is that without stomach acid, the stomach is less capable of breaking down foods and extracting nutrients. If the drugs are taken for long periods of time, they can inhibit the absorption of magnesium, calcium, and vitamin B12.
Another problem is that once people start taking a PPI, they often become dependent upon the drugs to reduce stomach acid. The stomach may over-compensate by creating more cells that produce stomach acid. If a person stops taking the PPI, there are even more acid-producing cells than when they started taking the drugs — producing even worse symptoms of acid reflux.
Stomach acid is also necessary for other body systems, which you might not expect. It is necessary for healthy functioning of the pancreas and gallbladder. Stomach acid kills harmful bacteria in the gut. Stomach acid also prompts coughing, which helps clear the lungs.
Some doctors are concerned that patients are over-prescribed PPIs. Dr. Joel J. Heidelbaugh reviewed medical records for 1000 people at a Veteran’s Affairs clinic who were taking a PPI. Dr. Heidelbaugh found that only one-third of the patients had a diagnosis that justified the prescription. Furthermore, acid reflux is often a side effect of obesity or eating foods that cause heartburn. Some people start taking the drugs to avoid lifestyle changes that would reduce the symptoms of acid reflux.
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