Not a week goes by without hearing the latest bad news about Proton Pump Inhibitors (PPI).
When they were introduced in the 80s to treat stomach ulcers, people felt they were god send, relief was finally here: ulcers were healing fast, and we could eat everything without any sense of guilt, and no heartburn!
But the majority of doctors and patients forgot to look at the indications and prescribing information, which clearly stated the drugs were approved only to be taken for up to 8 weeks!!!
And now we are finding out more and more problems caused by prolonged use of these medications.
Shown below are the warnings that are included by pharmaceutical companies in the drug information packet, but rarely, if ever, explained to patients:
Gastric cancer and polyps
Acute and chronic kidney damage
Intestinal infection, including deadly C.difficile colitis
Bone fractures and osteoporosis
Cutaneous and Systemic Lupus Erythematosus
Vitamin B12 deficiency
Magnesium deficiency (vital to every cell of body function)
Interaction with multiple medications and supplements, like Plavix, St.John's wort, Rifampin, Methotrexate and others
Other data that has been accumulated in various literature and includes:
High risk of dementia
Malabsorption of vitamins, minerals (Magnesium, Iron, Zinc, etc.) and other nutrients, like proteins, that need gastric acid for digestion and absorption
Increased incident of heart disease, like heart attacks, atrial fibrillation (irregular heartbeat), and congestive heart failure
Decreased resistance to infection, including pneumonia (#1 killer of the elderly), travelers diarrhea, bacterial overgrowth
PPIs affect our microbiome, which can contribute to multiple disorders: anxiety and depression, IBS, Crohn's disease, asthma and multiple autoimmune diseases
Damage to blood vessels
And the list goes on. Almost weekly there is a new study being published regarding the unexpected adverse consequences of using these "wonder drugs".
According to IMS Health, Proton Pump Inhibitors were the 9th most commonly prescribed types of drugs in 2015.
An estimated 15 million Americans use PPIs, which are sold by prescription and over the counter under a variety of brand names, including Nexium, Prilosec, Protonix and Prevacid. There were 114 million prescriptions written for these in 2009, before most of them became available OTC. Americans spent $5.1 billion on Nexium in 1 year, the most popular PPI, alone.
It is time to step back and ask whether we've been reaching for that PPI bottle too often and too quickly. Occasional heartburn can be treated effectively with the old-fashioned antacids, like Tums or DGL. Some people find that only certain foods (chocolate, coffee, fatty food) trigger acid reflux, so they need to learn to avoid them. Switching to a low-carbohydrate diet and losing weight also helps. And of course: quit smoking!
A chewing gum habit increases the production of saliva that can soothe an irritated esophagus and wash stomach acid back down into the stomach. And if the problem is nighttime heartburn, not eating a heavy meal too late at night and elevating the head of the bed can help.
And if you do have an ulcer, take as recommended PPI for up to 8 weeks and then stop!
There are many natural, holistic supplements to prevent, treat and maintain a healthy gut.
To receive more information on how to wean yourself off PPIs and other health related advice, please schedule an appointment with Dr. Koganski at 215-750-7000 or www.NewtownInternalMedicine.com
JAMA Neurol 2016 Feb 15;[EPub Ahead of Print], W Gomm, K von Holt, F Thomé, K Broich, W Maier, A Fink, G Doblhammer, B Haenisch