Medslant Acid Reflux Newsletter

Acid Reflux Meds and Pneumonia Risks

New research suggests that giving acid suppressing meds, i.e. proton pump inhibitors, to hospital patients may actually increase the patient's risk of developing pneumonia while in the hospital. A study published in the May 27, 2009, Journal of the American Medical Association, found that acid suppressing meds may not be as benign as once believed. Shoshana Herzig, MD, study author, an internist and an instructor in medicine at Harvard Medical School, said 'What we found after controlling for other factors is that there was an association between acid-suppressive medications and hospital-acquired pneumonia.' Between 2004 and 2007, researchers reviewed the records of 65,000 patients hospitalized for at least 3 days and found the rate of hospital-acquired pneumonia was 30% higher among people on acid suppressing meds.

In critically ill hospital patients, the meds have been shown to prevent serious gastrointestinal problems caused by the physical stress of illness. The potential for benefit seemed clear and the risk of side effects, low. Thus, the use of the drugs also became common for patients who were not in critical care. Today an estimated 40-70% of hospital patients receive some form of acid suppressing meds. There are two different classes of meds that reduce stomach acid; proton pump inhibitors which block acid from being pumped into the stomach, and H2 blockers which decrease acid in the stomach but are not as effective at reducing acid as proton pump inhibitors. Both are sold as prescription drugs and OTC meds. Dr. Herzig said that several theories might explain how the meds increase pneumonia risk: by suppressing acid, more bacteria might flourish and travel to the lungs; acid might stimulate the cough response which is one of the body's ways of clearing infectious agents; and, acid suppressing meds might depress the immune function.

Mitchell Cappell, MD, chief of gastroenterology at William Beaumont Hospital in Royal Oak, MI, says that he thinks the use of acid suppressors for every patient should be reconsidered. He added that it is important to realize that even though the risk of hospital-acquired pneumonia is increased with acid suppressors, the overall risk remains low and cautioned that the study findings need to be confirmed with additional research. Both doctors agree that people taking the drugs for GERD need not be concerned and emphasized that the study findings apply to hospitalized patients on these types of drugs with no clear indication for them. Dr. Herzig's advice: 'Don't stop taking your medications. Discuss any concerns with your physician.'

Food Allergies as Alternative Diagnosis to GERD

For some patients experiencing GERD but not responding to the usual treatments, a diagnosis of eosinophilic esopagitis, or EE is possible. EE is believed to be an allergic reaction to foods ' milk, soy, eggs, wheat, nuts and fish are the likely triggers ' and perhaps pollen. The allergens cause inflammation in the wall of the esophagus that results in difficulty in swallowing. Although the condition is not nearly as common as GERD estimates are that there are one to four cases in every 10,000 children and adults. If you are not responding to GERD treatment and meds, an allergist or gastroenterologist can confirm the diagnosis.

Immune System Most Active During Sleep

Researchers at Stanford University used fruit flies to test their theory that that the benefits of a good night's sleep just increased. Teams infected fruit flies with two strains of bacteria, some flies getting the injections during the day and others at night. Those getting infected at night were much more likely to survive the infection than those infected during the day. Strong evidence exists that this effect carries over to humans. Just like fruit flies, our bodies are regulated by circadian rhythms ' the internal clock that makes us want to eat, sleep, and work at the same time every day and makes us feel uncomfortable when our natural sleep cycle is interrupted.

And here's a thought to consider from American psychologist and philosopher: 'Human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives.'

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