NEW ORLEANS -- It's a common condition that can be made worse by nicotine, caffeine, alcohol, obesity, eating large meals and even stress. But some doctors say it might not be best to pop a pill every time you have heartburn or acid reflux, and you should know the latest warning on a popular medication.
Heartburn can be a very painful problem after you eat. For some, it's chronic acid reflux, known as GERD. And people turn to pills called Proton-Pump Inhibitors, the most powerful drug available to inhibit acid secretion. But some doctors say they are overused.
"So the dark side of Proton-Pump Inhibitors, because we've used so much of them for such a long period of time is beginning to emerge," said Dr. Henri Roca of LSU Health Sciences Center's Family and Integrative Medicine.
Proton-Pump Inhibitors used to be only by prescription, as "the purple pill" Nexium still is. Then the FDA allowed them to be sold over the counter, without a prescription, as Prevacid, Omeprazole and Prilosec are. So now their use has gone up tremendously. They are designed for use for seven to eight weeks, and being on them for more than 12 weeks can cause health problems. One is that minerals such as calcium might not be properly absorbed.
"So now we know that people who are on Proton-Pump Inhibitors for a long time, have a high risk of osteoporosis, absolutely documented. That's very significant since we have more and more people with osteoporosis, more and more older people are on Proton-Pump Inhibitors," Roca said.
Another problem is too little acid interferes with one of the body's defense mechanisms.
"The other thing that we now know is that pneumonia increases with people who use Proton-Pump Inhibitors," Roca said. "And gastrointestinal infections increase -- why? Because our food, no matter how clean we try to make it, will have bacteria on it."
And stomach acid kills those bacteria before they get in the intestines.
Also, with lower stomach acid, other medications might not be metabolized properly.
"So now recently we have a warning from the government saying that medications, like Plavix, which is very important for people who have had strokes to keep them form stroking again, doesn't work very effectively within the framework of these Proton-Pump Inhibitors," Dr. Roca explained.
The same is true for antibiotics and other heart medications.
And if you are going off of Proton-Pump Inhibitors, it is recommend that you wean yourself off slowly. If not, you could feel worse for six to eight weeks.
"One of the unintended effects of Proton-Pump Inhibitors is that when you go off them, the body over compensates acid production. So if you go off of the Proton-Pump Inhibitor your body will produce more acid than it did before," Dr. Roca added.
So make sure you tell your doctor you are on these medications and find out what is causing the acid reflux. There are many different causes with different solutions.
One is taking Calcium Tums, which can also help your bones, and you can take the H2 Blockers such as Zantac, which is also very effective.
Some of the causes of GERD can be:
- A bacterium
- Your body is making too much acid all of the time
- Your body is making too little acid, so when you eat you get a big spike to compensate for the below average amount
- The lining of the stomach can be impaired
- The sphincter between the esophagus and stomach is too loose.
Roca said knowing the cause and getting to the underlying reason for the reflux will help you target a treatment or cure, so you are not in pain and needing to take PPIs too often.
He also said people who have the kind of GERD caused by low acid that spikes during a meal can be helped by an easy solution. Take a teaspoon of lemon juice or apple cider vinegar to increase the acidity in the stomach so it will be level and not spike.
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