Proton Pump Inhibitor Acid Reflux Treatment, Worth The Risk?

Could your Proton Pump Inhibitors Be Helping Your Reflux But Making Your Bones Weak?

You can't sleep.

Your voice is hoarse.

You have a burning sensation in your chest.

You feel like you are throwing up in your mouth.

You can't stop burping.

You may have acid reflux disease or GERD (gastroesophagela reflux disease).

For years, physicians have handed out prescriptions for proton pump inhibitors - PPI's - 113 million scripts alone in one year. These drugs are powerful and prolific selling - they represent the third highest selling class of drugs in the US. Nexium, aka The Purple Pill, represents about $5 billion in annual sales.

The problem is that whatever is in these drugs, both prescription and over the counter, that prevents your body from making acid, also prevents your body from absorbing calcium.

According to a series of articles in the May 10, 2010, Archives of Internal Medicine, the potential harm caused by taking these meds, especially for simple heartburn, is greater than what most people should risk.

Mitchell H Katz, MD, of the San Francisco Department of Public Health says, "PPIs have been over-prescribed. Between 53% and 69% of PPI prescriptions are for inappropriate indications." Katz recommends that doctors use shorter courses and lower does when possible.

A study under Shelly L Gray , Doctor of Pharmacy, of the University of Washington, Seattle, studied more than 130,000 women enrolled in the Women's Health Initiative. Women who reported current PPI use were 47% more likely to have had a spine fracture, 26% more likely to have a forearm or wrist fracture, and 25% more likely to have any kind of fracture.

On June 1, 2010, there was more bad news for Astra Zeneca, maker of Nexium. The FDA is delaying the decision on Astra Zeneca's request to extend approval of Nexium whose patent protection expires soon.

Some patients need the drugs but if you can make lifestyle changes that help, why take a chance on potentially harmful meds?

Most physicians agree that there are three things we can do to help reduce GERD and its consequences:

Achieve and maintain a healthy weight.
Identify and eliminate trigger foods.
Sleep elevated 6"-8" while supported on an even plane through the torso.

Lauren Gerson, MD, Stanford University School of Medicine, and her colleagues reviewed more than 2000 heartburn studies published between 1975 and 2004. Their conclusion: there are two factors that reduce the incidence of heartburn: weight loss and upper body elevation.

Paul S. Jellinger, MD, MACE, and endocrinologist says: "GERD is among the many adverse health outcomes related to obesity. Weight loss is frequently associated with improvement in reflux and GERD. Dietary guidance and a sensible weight loss program should be part of the treatment program directed at treating obesity related illness including GERD"

And Myles Kreigor, MD, says sleeping elevated helps, "Let gravity work for you, not against you."

References: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213321.htm

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