Canadians are using acid blocking drugs called proton pump inhibitors (PPIs) such as Nexium, Pariet, Pantloc and Prevacid at an all time high. Last year alone nearly 17 million prescriptions were filled at a cost of over 1 billion dollars. It begs the question, are we experiencing a heartburn epidemic?
The reality is, people often start PPIs because of a few episodes of recurrent heartburn or ulcer related stomach pain and then never come off of them. Reasons for this may include fear of a return of symptoms, dependence, or no one has ever suggested discontinuing the medicines. However, the more people are on these drugs the more we learn about adverse effects that can cause long-term health complications far more serious than risks associated with heartburn.
A study has been recently published detailing the risks associated with PPIs. After 5 years of use our risk of hip fracture due to osteoporosis increases by 1.6. After 7 years, that risk jumps to 4.5 times that of someone not on PPIs. The drugs block acid, which is required to properly absorb vitamin B12 and calcium and destroy opportunistic bacteria. With this knowledge, physicians are providing caveats to patients that long-term PPI therapy includes potential for hip fractures as well as anemia and infections of C. Difficile bacteria. Fractures are concerning because of their debilitating effects and a 20% chance of death within 6 months of suffering a hip fracture. This may sound alarmist, but it is more an account of the unnecessary risks people are taking because of a symptom like heartburn which can be effectively treated by a variety of other means.
Diet and lifestyle are two very effective routes to reduce the triggers for heartburn. Digestive enzymes and botanicals with soothing properties are also supportive and healing to an irritated digestive tract. Getting a thorough medical history by a qualified healthcare practitioner is important to understand why symptoms persist. It is also prudent to reduce and eliminate current medications like PPIs. A qualified practitioner can initiate step down therapy of the drug, while supporting the digestive system.
Please see your healthcare provider for more information.
Dr. Bobby Parmar