Proton pump inhibitors or PPIs are one of the largest selling category drugs in the United States. They work to reduce the effects of acid reflux and heartburn by reducing the amount of acid the stomach produces. Well-known PPIs include Prilosec, Nexium and Prevacid; physicians wrote over 114 million prescriptions for these PPIs last year, and Americans spent over 5.1 billion dollars on Nexium alone.
Unfortunately many people assume PPIs are harmless and will use them far beyond the time they are intended to be taken. When PPI’s were first introduced on to market, the FDA recommended they be taken for no longer than 6 to 8 weeks. It can become difficult to quit using PPIs though. As noted before, PPIs work by blocking the production of acid in the stomach. The body’s natural reaction to this is to produce more acid. When one discontinues use of the PPIs, the symptoms worsen because of the increased production of acid forcing the consumers to go back on the PPI. This results in a vicious cycle of use, and overproduction of stomach acid, making it very difficult to quit using PPIs.
Because PPIs inhibit the production of acid in the stomach they also inhibit the absorption of important nutrients, create bacterial overgrowth, and reduce resistance to some infections. Long-term use of PPIs can reduce absorption of vitamins and minerals including magnesium calcium and B12; resulting in an increased risk of bone fractures and infections. Additionally because stomach acid induces coughing that clears the chest, is also been associated with pneumonia in the elderly.
There are now indications that PPIs could cause other serious health problems. Recently, a study by SUNY Buffalo School of Medicine and Biomedical Science, of 24,000 people with chronic kidney disease, it was determined that one in every four patients had previously been treated with PPIs. The study also found that those people who took the PPIs were almost twice as likely to die prematurely as people who never took the medication. A study by the Royal Brisbane and Women’s Hospital in Australia also found a connection between PPIs and chronic kidney disease. Their studies found that those people who used PPIs had a 50% increased risk of developing chronic kidney disease as compared to non-users.
Other studies have linked prolonged PPI use to heart disease and heart attacks. Dr. John Cook of Houston Methodist Research Institute told CBS news that PPIs increase the risk of heart attack in the general population by about 15 to 20%. The reason for this potential heart damage is that PPI’s may damage the lining of blood vessels that reduce plaque buildup. With prolonged damage to the lining of blood vessels, the risk of heart attack and heart disease increases.
Not all doctors oppose the use of the PPIs, many doctors note that the drugs reduce ulcers and other gastrointestinal problems and believe the benefits of PPIs exceed the risk.
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