Are Nexium and Prilosec Too Popular?

(CBS)  Five studies in the raise new concerns about the third most popular class of prescription drugs in America - proton pump inhibitors - very effective at lowering stomach acid and taken for acid reflux and stomach problems. About 113.4 million prescriptions for these drugs are filled each year, accounting for $13.5 billion in sales.

These drugs work well to lower stomach acid, but they may cause some serious side effects, reports CBS News medical correspondent Dr. Jon LaPook. Researchers, for example, found a 25 percent increased risk of bone fractures in women and in both sexes - almost 75 percent increased risk of a serious intestinal infection Clostridium Difficile - known as C Diff.

"They can change the bacteria that live in your body and therefore possibly predispose you to an infection," said Dr. Christine Fissora, a gastroenterologist at New York Presbyterian and Weill Cornell Medical Center.

Previous studies have found patients on these drugs have a higher chance of getting pneumonia.

An editorial in Monday's Journal said more than half of prescriptions for these drugs are unnecessary - they're often given for complaints that are not relieved by lowering stomach acid.

"We really need to get better at making the diagnosis and number two we should only give these medicines to patients who really need them," Frissora said.

This could be another example of Americans relying on a pill to solve a health problem when there may be safer alternatives. If you have acid reflux, try to avoid things that increase acid like alcohol, caffeine, spicy and fatty foods. Don't eat within three hours before bedtime and try elevating your head more while sleeping. Other options? If you smoke, quit and try to lose excess weight.

[JayArthur]

Heartburn & acid reflux are common symptoms of an autoimmune disease called Celiac Sprue. It is considered one of the most underdiagnosed diseases in the US because it is not well known by many doctors and because the symptoms vary drastically. However, two of the most common symptoms are heartburn and anemia. I know - I have this disease.

Celiac sprue is found mainly in people of N. European descent and is caused by a gluten intolerance from certain proteins in wheat, barley and rye. If the disease goes undiagnosed the lower intestine gradually becomes badly damaged, food is not absorbed and the person suffers from malnutrition. This leads to many bad things, including osteoporosis. Thus it is highly likely that in many cases the drugs noted in the report are masking Celiac Sprue, which is the real cause of the medical problems now attributed to the anti-acid reflux drugs.

Anyone who has continuously bad stomach acid problems should take the simple, inexpensive blood test for Celiac Sprue!

[BRHurt]

Great article and helpful comments! I work with a Naturopathic Doctor and Digestive Care Expert named Brenda Watson who has gives some great, natural solutions to reflux. She weighs in on this article and adds her suggestions on her blog: http://blog.brendawatson.com/

[Obey041160]

Doctors are knowingly prescribing another one of the "stomach" medicines knowing it helps with acid...but it actually keeps them in the business of giving EGD's and removing polyps because it Causes polyps. I know one poor lady that had a dozen polyp's removed during an EGD, then the doctor changed her medication because they have found that it caused polyps. It makes me wonder what else doctors are giving us to insure "repeat" business?

[Paul123z]

The approach of giving "medicine" to basically healthy people in a bid to either prevent future disease or treat a symptom of a disease is more often than not a losing proposition. There are probably few foods one could eat every single day for years on end and not expect some difficulty. To suspect that one can take, the latest synthetic laboratory chemical concoction, heretofore unseen by human physiology or even nature, and derive a net benefit over years of use is at best blithley optimisitc and more likely something akin to pharmaceutical Russian Roulette.

Unfortunately, if one considers corporations to be amoral, their concern is not with health it is with profits, which is why so many drugs are designed for chronic conditions which still allow the user to be a wage earner while taking the drug. From the company's point of view, if chronic exposure to the drug causes a second condition, which does not debilitate the customer but allows them to continue to earn a wage while needing a second chronically administered drug this would be a "win/win".

As a compromise, companies should begin by going back and characterizing all the off-target effects of currently approved drugs, thus allowing them to pursue additional indications while improving drug safety.

Paul D. Maher, MD MPH

http://healthjournalclub.blogspot.com/

[joymotte]

I take Protonix for acid reflux. I've been on it or Nexium for years. I don't smoke or drink. I don't drink caffene and refraim from eating much before I go to bed. I have done everything that was suggested. What that report did not address is that acid reflux can cause erosions of the stomach and esphagus as well as cancer.

[elizabrett]

My 16 year old son just had two tests to determine the source of his chronic and unyielding reflux. Endiscopy and an upper GI to assess the shape of his stomach surrounding his esophagus and the valve that shouldn't open backwards after 3 minutes spewing HCl onto what was once a delicate single layer of tissue but has now become multiple protective layers of abnormal growth to sheild the vasculature underneath from the assault of acid. The acid BELONGS in his stomach. The ONLY reason the are pushing hard and heavy on the proton pump inhibitors is to prevent CANCER. ISN'T THAT WHAT WE'VE BEEN AIMING FOR THESE LAST 20 YEARS? Stop smoking or never start, eat lots of fiber, and now, don't burn out your esophagus and please... Gardasil: now for girls and BOYS.

[rf35]

Typical of modern American medicine...throw a pill at it. I get so tired of doctors who barely do an exam and then head straight for the prescription pad. There are plenty of times when a prescription drug is necessary, but they are being given to people who don't really need them, mostly because those people bug their doctor for the latest "in" drug they see on TV. I something think doctors should try placebos on these patients. I knew a woman who used to be convinced that Prilosec immediately relieved her heartburn the moment she took it. It doesn't work that way, but she was so sure it would provide instant relief that it did!

[isotron-2009]

Maybe you should take a look at yourself before you speak ill informed. As a Physician of over 30 yeras, I have had NUMEROUS patients that INSIST on a pill (and frequently one that is mentioned on TV), instead of good old fashioned common sense. They feel they are not being treated properly if the newest and greatest isn't prescribed immediately. Telling them to lose weight or stop smoking in POINTLESS since it involves difficulty on their part and they don't want difficulty- they want a pill, they want easy, they want antibiotics, a fast fix, a painless life, more and better MAGIC and they are not hesitant to insist or demand it.

[VoteThemOut2010]

Poisoning America for profit! This probably is no longer an issue though since we now have "Health Care Reform". Oops, I was wrong, the problem just go worse! Now no one has to figure out how they are going to pay for their poison pills.

Natural Cures like Marijuana are the answer, boycott the Criminal Medical Industry!

[elizabrett]

let's go back to the good ole days when Coke had cocaine in it and 7-Up had lithium in it and everything was au natural and unregulated and tasted delicious with that extra splash of anti-freeze! Yum! Nobody died of poisoning then.

[bar22mike]

I question the ethics and/or judgment of doctors prescribing these meds. Prescription strength PPI is usually double that of the OTC version and many insurers deny payment for the drugs because the same result can be obtained by taking 2 pills of the same med available right off the drugstore isle.

[elizabrett]

They prescribe them so that you can get insurance coverage if you have it. Being OTC does not equal cheap.

[anidea4u]

A tablespoon of apple cyder vinegar in the morning (with a glass of water or juice) is more effective than drugs. It lowers stomach acidity so that the stomach doesn't feel it has to produce any more acid. Somehow it is great for loosing weight too! and keeps helicobacter pylory in check. I have used this treatment for six months now and I only wish I would have known earlier.

[elizabrett]

That just shows the power of the mind to convince you that adding acid to a stomach that produces excess acid is a good idea. You might want to convince yourself that a glass of water with a tablespoon of baking soda in it in the morning is a better idea. Sodium bicarbonate is an acid neutralizer and the first line of stomach remedys.

[littlepye]

Please help to inform the public that there are additional options. A laparoscopic surgical procedure can be very effective in resolving esophageal reflux symptoms, if medical management fails. It certainly should be considered for patients facing years of proton pump inhibitor use. After the laparoscopic gastroesophageal fundoplication surgery, the medicines can be discontinued.

[elizabrett]

Thanks for the idea littlepye. We almost thought my 16 year old had a hiatal hernia which would have needed to be corrected this way. He has enough other health issues that I didn't want him to have to take a PPI for the rest of his life. Thankfully, my kids have health insurance so I don't let the cost determine my choice.
There are long term problems with constantly reducing your stomach acid. You need a certain ph in order for your body to convert pepsinogen to pepsin which is the first stage of protein digestion. All of our bodies tissues are made from protein. Also, the hip fracture rate is related to malabsorption of calcium due to the reduced acid levels and reduced utilization of vitamin D. Calcium and vitamin D are interdependent and you can't get enough from the sun. Even the amount you get in your diet is hindered by PPI's over long term use.
IT IS STILL BETTER THAN CANCER. BUT IF SURGERY CAN ELIMINATE THE NEED EARLY IN MY SON'S LIFE, IT IS SOMETHING TO CONSIDER BEFORE THE ACID CAUSES REAL DAMAGE.