As use of certain medications continues over time, there is always the chance that evidence of side effects or complications will mount as more and more people take them. When you take a drug, you essentially become a participant in a long-term safety study of that medicine, since most safety studies are shorter compared to the length of time that some people may be taking them. That’s somewhat of a gamble if they’re not absolutely necessary!
The latest to come under scrutiny are the proton pump inhibitors (PPI’s), anti-reflux medications like Prilosec, Nexium and Prevacid. Two separate studies have recently shown associations between PPI use and risks for stomach cancer and kidney trouble. Use of these drugs are high as they have been one of the most commonly prescribed in recent years, as well as becoming accessible as over-the-counter options. That could equate to a lot of potential problems!
On the kidney side, researchers looked at 5 studies covering more than 500,000 people and found that those who took PPI’s were a third more likely to develop chronic kidney disease or failure than people who didn’t. This research was being presented at the annual meeting of the American Society of Nephrology.
Similarly, in a study published in Gut in October, there was another association noted with a multi-year study that followed PPI users being treated for H. pylori, a bacteria linked to stomach cancer. 63,400 patients were initially given a PPI and 2 antibiotics over a 7-day course of treatment. Their PPI use was tracked for several years thereafter until they either developed stomach cancer, died, or the study ended. Another comparative group was also observed, but they used H2 blockers (another reflux drug) instead of PPIs. Some unsettling results occurred:
- Continued use of PPI’s beyond the initial treatment was linked with more than twice the risk of developing stomach cancer. None was noted with H2 blockers.
- Daily PPI users had 4 times the risk compared to weekly users
- Length of use also increased risk for stomach cancer – 5x the risk at more than a year, 6x at two, and more than 8x the risk for 3 or more years of use!
Many doctors will acknowledge that in some cases PPI’s may be necessary, such as in trying to prevent esophageal cancer in patients with Barrett’s esophagus. But many also agree that they were not originally intended for long-term use. The crux is that if people are not educated about what may be driving the reflux in the first place (the most common being their diet!), they are left with no other options than to pop a little purple pill, consequences be what they may.
Fortunately, we have seen many people make great improvements in reducing and eliminating their reflux primarily through dietary means. Sometimes in as little as just a few weeks! We also assess to make sure H. pylori isn’t a contributing factor to the problem. If a poor diet proves to be the driving factor, and improvements allow a patient to wean off their medication successfully, they are usually able to stay off it as long as the body has been given enough time to heal properly and the aggravators are no longer added back.
Our programs focus on healing the digestive system first so that we have a clean slate with which to work, and then building the best diet to help you get healthy and then stay that way for the long term. Not only does this help with the reflux symptoms, but patients also note improved ability to fall and stay asleep once they are gone, and making meal times and social gatherings more enjoyable. The power to control your reflux may be easier than you thought!