Are There Long-Term Side Effects of PPIs?
Proton pump inhibitors, or PPIs, are a class of drugs used for persistent reduction of gastric acid. PPI’s are used to treat a variety of stomach conditions, such as gastroesophageal reflux disease (GERD), ulcers, indigestion, acid reflux and heartburn. Some 100 million prescriptions of PPIs are filled in the United States each year. Examples of PPI’s include Prilosec, Aciphex, Nexium, Protonix and Prevacid. People are now able to treat themselves, with similar medications available over-the-counter. However, recent studies suggest concerns over long-term side effects of PPIs.
Increased Risk of Pneumonia
According to a 2007 article in the Archives of Internal Medicine, an increased risk of pneumonia was linked to proton pump inhibitors. Although the exact causal relationship is not known, researchers believe that the decrease in stomach acid allows bacteria that cause pneumonia to grow and spread.
Fracture
Increased risk of fractures is another concern with the use of PPIs. In fact, the FDA is now requiring all package inserts for PPI to disclose this risk. More than a handful of studies reported that wrist, hip and spine fractures were more prevalent in people taking PPIs for gastroesophageal reflux disease or other stomach condition, than those not taking these medications. By reducing stomach acid levels, proton pump inhibitors may have an impact on your body’s absorption of calcium. A decrease in calcium level may lead to increased fractures or osteoporosis.
C. difficile Infection
The risk of C. difficile infection in hospitalized patients taking PPIs was increased, according to a 2010 study. C. difficile infection can lead to severe dysentery, long standing colon problems and possibly death.
Vitamin B12 Levels
Similar to the body’s reduced ability to absorb calcium with reduced stomach acid, PPIs may also impact the body’s ability to absorb vitamin B12s. A deficiency of B12 may lead to anemia, gastrointestinal issues or neurological symptoms. For this reason, doctors routinely measure vitamin B12 levels while a patient is taking proton pump inhibitors for gastroesophageal reflux disease or other conditions.
What You Can Do
While the studies are just beginning to suggest some long-term side effects of PPI use, more studies will need to be conducted. If you only have occasional acid-reflux issues, it may be time to learn about your triggers. If chocolate, coffee or onions cause you to have heartburn, you may want to limit your consumption of them instead of popping PPIs. If nighttime heartburn is your only problem, consider raising the head of your bed. Sometimes the saliva produced from chewing gum, may be enough to wash the stomach acid back down into the stomach where it belongs. Of course, people with severe gastroesophageal reflux disease, may still need to take PPIs. It’s best to speak with your physician before starting or stopping a PPI therapy.