WASHINGTON, Aug. 11, 2008

Acid Reflux Pills Linked To Hip Fractures

Prilosec, Prevacid, Nexium And Other Heartburn Drugs Work Wonders, But Long Term Use Has Risks, Study Shows

  • Play CBS Video Video Meds Linked To Bone Fractures

    Millions of Americans take prescription drugs for heartburn and acid reflux. A new study finds prolonged use of many of these drugs could put you at risk for bone fracture. Nancy Cordes reports.

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    CBS News medical correspondent Dr. Jon LaPook examines various health issues and treatments.

(CBS)  Millions of Americans suffering from heartburn and acid reflux take a class of prescription drugs that includes Nexium, Prevacid and others. With 180 million prescriptions a year and sales topping $14 billion, these drugs are a success story. But, as CBS News correspondent Nancy Cordes reports, a new study shows using them long-term may significantly raise your chances of fracturing bones.
Dr. Martin Bashir of Washington Hospital Center prescribes acid blocking pills for his patients with chronic heartburn.

"It's like more burning in my chest," said Cindy, one of Bashir's patients.

"It's like a burning pressure?" he asked.

"Yes, pressure," Cindy answered.

For patients with chronic acid reflux, acid blocking pills with well known names like Prilosec, Nexium and Prevacid work wonders. They're part of a class of drugs called proton pump inhibitors, or "PPIs".

"They solve their symptoms they make them feel good and they essentially want to stay on them forever because once they go off them acid reflux returns!" Dr. Bashir said.

But new research indicates what's good for your stomach might, over time, be bad for your bones, Cordes reports.

Doctors studied more than 60,000 Canadians ages 50 and older.

They found people who took PPIs for 5 years were more than one-and-a-half times more likely to have hip fractures. Those who took the drugs for 7 years were four-and-a-half times more likely, which is of particular concern, because 30 percent of seniors who break a hip die within a year.

"There may be patients who have very mild symptoms of heartburn who while they get relief from these medications may find they get equally good relief with less aggressive medications," said Dr. Laura Targownik.

PPIs work by blocking the stomach from producing hydrochloric acid. But that acid helps the body absorb calcium - a key ingredient in bone health. Researchers theorize that over time, the drugs' acid-blocking effect could speed up bone loss.

"I get the pains in my bones, I can feel the bone pain," patient Barbara Paul tells Dr. Bashir. "I think the first thing we need to do is stop the medicine altogether.

Bashir puts his patients on a "holiday" from PPIs once a year, especially if, like 57-year-old Paul, they have osteoporosis.

"It's amazing that you're trying to take care of one situation and you're causing a problem in another area," Paul said.


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Add a Comment See all 28 Comments
by wl7bzh August 11, 2008 7:18 PM PDT
Old news.

While were at it, what about vitamin B12 absorption in the elderly related to PPIs?
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by tomanyt August 11, 2008 7:48 PM PDT
So what? Everything you eat, drink or breath will kill you anyway.
Reply to this comment
by Syndicate August 11, 2008 8:15 PM PDT
Weak Bones or Cancer of the Esophagus. Your Choice.
Reply to this comment
by jlsosamd August 11, 2008 8:35 PM PDT
It is important to report side-effects of medication, but just as importantly should be to report alternatives to medications. Heartburn is often a symptom of GERD. Proton pump inhibitors or blocker do not treat the underlying problem of GERD but merely mask the symptom. There is very effective laparoscopic anti-reflux surgery which can cure GERD. It is low risk and minimally invasive. Patients with severe enough GERD to require years of PPI therapy should strongly consider surgical treatment. Many physicians do not know enough about this very effective surgery to recommend it to patients.
Reply to this comment
by August 11, 2008 8:36 PM PDT
And the Hits just keep on coming from Big Pharma. When will the people learn that their synthetic drugs are foreign to the human body and laced with side effects. Their cure is worst than the disease.
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by Haug_Dude August 11, 2008 8:42 PM PDT
My son had GERD for many years which went away when he learned how to avoid certain acidic and fatty foods, not to eat too fast, or too late in the day. We are by and large (so to speak) fat, over medicated suckers for the quick fix.
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by jean243 August 11, 2008 8:43 PM PDT
I took Prilosec and Nexium for about 4 months at the age of 58. You naturally have less stomach acid at age 58 than when you are younger. As a result of taking Prilosec, I could not digest vitamin B-12 because the Prilosec blocked off too much of my stomach acid. So I got severe, really severe, neuropathy as a result, from vitamin B-12 deficiency. It was not diagnosed correctly for a year, until my primary doctor finally referred me to a neurologist. After taking B-12 pills daily, after 3 years I have very little neuropathy left. My acid reflux was cured by my losing weight, eating smaller meals, and not drinking coffee any more.
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by toolmangler-2009 August 11, 2008 9:09 PM PDT
they typically report on subjects far beyond their depth.
Posted by babykilller at 08:14 PM : Aug 11, 2008



very good point.
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by pcucharlie August 11, 2008 10:09 PM PDT
At age 52 I was diagnosed with stage IVa esophageal cancer, caused in the most part by GERD causing a condition called Barrett''s esophagus. I wish to God that I had been diagnosed with GERD and put on a PPI like Prevacid, Protonix, or Nexium before I was diagnosed with an incurable cancer like esophageal cancer. If you have GERD get an endoscopic examination called an EGD, it may save your life. I will more than willingly trade the potential of breaking a hip with the certainty of an incurable cancer.
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by rlenham-2009 August 11, 2008 10:13 PM PDT
Good post seaandgreen. This type of reporting is the worst because it is unbalanced and distorted and the journalists have not background in the area they are reporting on. Their intent is to scare us... My wife takes Prilosec, manages the way she eats, etc. She was unable to control her GERD with the simple measures some people find helpful. One size does not fit all.
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by blondejag August 11, 2008 10:21 PM PDT
Since I''ve had Achalasia and was tentatively diagnosed with Barrett''s Esophagus I''ve been Prilosec every single day for over a year. It''s the only thing between me and Barrett''s. I really don''t know what else I can do about this problem, and, the
Achalasia can always get worse, too. Proton pump meds I''ve used in the past have also created non-cancerous growths in my stomach, which I''ve had removed. Like the other posting person who''d rather have had the PPI, and possibly a broken hip, than the esophageal cancer, ditto.
Reply to this comment
by blondejag August 11, 2008 10:23 PM PDT
By the way, since this issue has come up, could Dr. Jon LaPook also research Achalasia and PPI''s ?
I''ve been trying to find info. on this for some time and I''d really welcome any info. at all.
Reply to this comment
by wardoglrs August 11, 2008 10:25 PM PDT
And Marijuana is illegal? UnFlipping believable
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by sdm9093 August 12, 2008 12:35 AM PDT
I understand people are afraid to get off these medications that they have been on for years, because they are semi-dependant on them and have come to think of them as their "friend" who helps out in times of need.

But the bottom line is these are serious, harsh chemicals that you are putting in your body. A friend is not something that breaks down your ability to absorb calcium, something you need later on in life.

My only problem with this article is the lack of a mention of more natural alternatives. There are many natural alternatives out there that claim to help with acid reflux. Some are dubious, some are legitimate.

Do your research, but instead of looking at it as if you have to choose between breaking your hip and having esophageal cancer, try to find something that may help with heartburn while at the same time allow you to have a healthy esophagus.

Here is one natural alternative (aloe) from an article in better nutrition:

http://www.betternutrition.com/document/629
Reply to this comment
by toldyouso12 August 12, 2008 7:42 AM PDT
The dirty little secret about acid reflux pills are that doctors are encouraged and paid to over prescribe them. In about 2002, I went to the doctor complaining of severe heartburn. I was asked if I had acid coming up in my stomach--answer NO

I then was asked how many times had I had heartburn in the past year besides the present incident--

How many times in 3 years? 0, How many times in 5? I told the Dr that this was the 3rd case I had in 20 years. She told me I should try prevacid and gave me a script for it. I handed it back and told her that was irresponsible. 3 episodes in 20 years does not indicate a chronic condition. I further told her that since these drugs artificially inhibit acid in the stomach, to stop taking them makes the problem worse as the body is constantly trying to produce prodigious amounts to compensate for the drug--in other words--if you take these drugs--if you did not already truly have acid reflux, you would if you stopped taking the drugs--they are a sure monthly money maker for the drug companies. You get addicted to them and they can help to perpetuate the problem. But I''m a scientist so I knew the drug was not necessary. Number of episodes since that refusal? 1.
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by toldyouso12 August 12, 2008 7:44 AM PDT
As usual, reporters have no idea what they''''re talking about. Heartburn and acid reflux are two different things. Occasional heartburn is normal, acid reflux is a result of GERD, which may lead eventually to esophageal deterioration, and in extreme cases, hemorrhage and death. Be wary of any news story regarding medical or scientific topics; these are reporters, not geniuses, and they typically report on subjects far beyond their depth.

Posted by babykilller at 08:14 PM : Aug 11, 2008


Drs have been prescribing drugs for GERD for heartburn, they get incentives like discounts on equipment, etc to do so.
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by estabwary August 12, 2008 7:47 AM PDT
The pills may help a very small group of people who need them because nothing else wroks. Those people should receive extensive education on the long-terlm risks. That means there should be long-term study before market. Before hitting the pills, all patients should be taught nutrition -- that is provided the doctor knows nutrition and how to treat with non-processed food first, not reach for a prescript pad & pen first. Passing these pills out like candy does not substitute for proper medicine for the masses. It does however, make tons of money for the drug co''s & makes the doc offices good buddies with lobbyists. Take heed.
Reply to this comment
by toldyouso12 August 12, 2008 7:54 AM PDT
Passing these pills out like candy does not substitute for proper medicine for the masses. It does however, make tons of money for the drug co''''s & makes the doc offices good buddies with lobbyists. Take heed.

Posted by estabwary at 07:47 AM : Aug 12, 2008


Many people do not know that Doctors are routinely courted to peddle pills to their patients. It is considered a win, win for Pharm and the dr. Many big pharm companies also sell Medical devices. By simply peddling and subtly "Pushing" legal medicine to a client, a doctor can get huge discounts on equipment like ultrasound machines, x-ray machines and even MRI equipment. Think about it, if a person can save up to 500K just by getting a few more people to use certain drugs (that they may or may not need) how many doctors will not prescribe them? The same goes for lab testing, a lot of doctors will state certain diseases exist or conditions and run tests and retest--they often do not actually do the testing, but they do charge for it. Either way, unnecessary drugs or testing==unwary patients are a dr''s dream.

There is a reason the AMA has reported that over 80% of all hysteretomies and over 40% of all prostate removals are unnecessary. What they are really reporting is fraud in their own ranks--but since they do not call it that, and many people think their dr is a god--this is not known.
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by hologram5 August 12, 2008 9:17 AM PDT
I do take this medication and have a hernia in my stomach as well as acid reflux. I do not, however, take them on a daily basis. I take one every other day or sometimes every two days as needed. This is not overtaking the medications. Sometimes I only take them when I get heartburn. I am the type that I get heartburn from milk. I quit drinking alcohol which helped and also watch my diet but still need the meds.
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by iuphockey12 August 12, 2008 9:33 AM PDT
I take Prilosec every day!
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by jbright9 August 12, 2008 10:21 AM PDT
I have a rare autoimmune disease. I could not function without these medications. Some of your attitudes are pitiful.
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by fid4cbs August 12, 2008 2:20 PM PDT
The ignorance of estabwary and toldyouso12 is only surpassed by their arrogance. Obviously, neither of them suffer from frequent reflux, but for some reason they consider themselves experts on the subject (and probably many other subjects). I also view drug companies with skepticism, and never thought I''d be on a chronic medication. Let me tell you, the awful pain of acid reflux turned my head around fast. This is not just heartburn. The Omeprazole (generic for Prilosec) has been a godsend, and has given me back my ability to sleep at night. I discussed the pros and minuses with my Dr., who is hardly a pill pusher. I urge anyone suffering from this several times a week, as I was, to ignore the comments of those who know nothing about the subject, and discuss these medications with your Dr.
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by piercetheval August 12, 2008 5:45 PM PDT
...I take Zantac and I see no mention of it here.
I''d rather take my chance with my bones in old age than have to endure acid reflux.
For those of you that don''t experience it....YOU"RE LUCKY...
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by piercetheval August 12, 2008 5:46 PM PDT
...and maybe the solution is to up your Calcium intake.
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by va6377a August 13, 2008 8:37 AM PDT
My heart goes out to those GERD and reflux sufferers. On that note, I''m curious if any of you have tried natural methods of curing the problem. I will not claim to know it through and through, but it seems that acid reflux on a whole is a more recent trend on the rise, which leads me to believe that there is something else going on behind the scenes. Also, as one other commentator here said, "since these drugs artificially inhibit acid in the stomach, to stop taking them makes the problem worse as the body is constantly trying to produce prodigious amounts to compensate for the drug--in other words--if you take these drugs--if you did not already truly have acid reflux, you would if you stopped taking the drugs." I can''t help but feel a little skeptical...
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by ejgoff August 13, 2008 8:45 AM PDT
the article was interesting, but it would be more to the point, if the good Dr. also included what he suggested in lieu of the "bad" drugs.
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by shameonbush August 14, 2008 4:20 AM PDT
Ayone who gets a prescription for acid reflux, as I do, can tell you that they cannot go without it. Life is too miserable when you feel like you have a fire going on in your chest. I can''t even sleep it gets so bad. The only thing that helps are these pills. I don''t want to break my hip but I don''t want to live with such discomfort either. Everything has a price.
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by mawgan4 August 14, 2008 5:21 PM PDT
FOR the past 7 years Nexium has been a god send. In my mid thirties I almost died of an ulcerated esphogus in my 9th month of a pregnancy. At that time I was given a concoxtion made by the attending physician at the hopspital. I dread coming off of Nexium To help me better absorb calcium my doctor prescribed Slow-Mag. Thank you CBS for putting the item on your news program.
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