Ethics in Medicine

Drugs for Acid Reflux (GERD): Serious Hazards Abound for Long Term Use

Kristen Sparrow • June 26, 2012


Woman holding abdomen in distress
Should have tried Acupuncture and Herbs!

I was happy to come across this comprehensive article about Acid Reflux (GERD) and the drugs prescribed to treat it, known as Proton Pump Inhibitors (PPI’s.) Yet another Blockbuster Drug Category found to have many nasty side effects.  The brand names for these drugs are Nexium, Prevacid, and Prilosec.  These are extremely widely used, the only drugs more commonly prescribed are Statins, or ? antipsychotics ( I wonder if they meant anti-depressants.)I urge you to read the whole article if you are taking any of these medications.  Bottom line is that long term use is hazardous, and they are difficult to get off of.  The main problems are that they make food difficult to digest and absorb leading to nutrient deficiencies. They can lead to increased bone fractures and Clostridium Dificil, a life threatening infection of the gastrointestinal tract.  They can lead to pneumonia since bacteria can grow in the stomach, and even to weight gain.  Experts recommend short term use only, and also think that the increase in GERD is from the obesity epidemic.
The scariest part is that though PPI’s curb the symptoms, they don’t stop the reflux so this was an astonishing fact

 “Squamous cell carcinoma, which is associated with smoking, has declined, but esophageal adenocarcinomas, which are associated with GERD, have increased 350 percent since 1970.”

Of course, Chinese Medicine has many different solutions for acid reflux and gastric distress.  Acupuncture is useful, and herbal supplements also.  I have had a few patients in my clinic who have been taking HCL tablets (Betain tablets,) and they have worked very well.  I thought I had done a previous post about the problems of PPI’s, but can’t find it.  Here is a link to an Acupuncture Today article on the topic.

Combating Acid Reflux May Bring Host of Ills
…Blood tests showed Ms. Rudell’s red blood cell count and iron level were dangerously low. But she is a hearty eater (and a carnivore), and her physician pointed to another possible culprit: a popular drug used by millions of Americans like Ms. Rudell to prevent gastroesophageal acid reflux, or severe heartburn.
Long-term use of the drugs, called proton pump inhibitors, or P.P.I.’s, can make it difficult to absorb some nutrients. .
As many as four in 10 Americans have symptoms of gastroesophageal reflux disease, or GERD, and many depend on P.P.I.’s like Prilosec, Prevacid and Nexium to reduce stomach acid. These are the third highest-selling class of drugs in the United States, after antipsychotics and statins, with more than 100 million prescriptions and $13.9 billion in sales in 2010, in addition to over-the-counter sales.
Studies have shown long-term P.P.I. use may reduce the absorption of important nutrients, vitamins and minerals, including magnesium, calcium and vitamin B12, and might reduce the effectiveness of other medications, with the F.D.A. warning that taking Prilosec together with the anticlotting agent clopidogrel (Plavix) can weaken the protective effect (of clopidogrel) for heart patients.
Other research has found that people taking P.P.I.’s are at increased risk of developing pneumonia; one study even linked use of the drug to weight gain...
But while using the drugs for short periods may not be problematic, they tend to breed dependency, experts say, leading patients to take them for far longer than the recommended 8 to 12 weeks; some stay on them for life...
“Studies have shown that once you’re on them, it’s hard to stop taking them,” said Dr. Shoshana J. Herzig of Beth Israel Deaconess Medical Center in Boston. “It’s almost like an addiction.”
P.P.I.’s work by blocking the production of acid in the stomach, but the body reacts by overcompensating and, she said, “revving up production” of acid-making cells. “You get excess growth of those cells in the stomach, so when you unblock production, you have more of the acid-making machinery,” she said.
Stomach acid is needed to break down food and absorb nutrients, he said, as well as for proper functioning of the gallbladder and pancreas. Long-term of use of P.P.I.’s may interfere with these processes, he noted. And suppression of stomach acid, which kills bacteria and other microbes, may make people more susceptible to infections, like C. difficile…
Stomach acid also stimulates coughing, which helps clear the lungs. Some experts think this is why some patients, especially those who are frail and elderly, face an increased risk of pneumonia if they take P.P.I.’s.