There are more than 100 drugs available to treat acid reflux across 4 main classes of medication: Antacids, H2 Receptor Blockers, Proton Pump Inhibitors (PPIs) and Pro-kinetic agents.
As a whole, these drugs represent one of the most commonly used and prescribed pharmaceuticals on the planet and their use is growing.
Antacids or alkalizers neutralize stomach acid, H2 blockers and PPIs shut off the actual production of acid, and pro-kinetic agents stimulate faster emptying of the gut.
By far the most frequently prescribed and also most potent drugs for acid reflux are PPIs, which block the final step of acid production. “A staggering 113.4 million prescriptions for proton pump inhibitors (PPIs) are filled each year, making this class of drugs, at $13.9 billion in sales, the third highest seller in the United States.”
They work remarkably well at preventing reflux and so have become the standard of care in treating GERD and related digestive issues. Unfortunately, all of these drugs merely mask the symptoms and do nothing to address the cause.
But are they safe?
Despite the alleged safety of PPIs, the very fact that they drastically reduce the acid levels in the stomach necessary for good health means there are going to be downstream adverse consequences. The same can be said for antacids, H2 blockers and Pro-kinetic agents because they all change the composition of the gut bacteria that represent a significant part of our immune system.
As an acidic environment provides protection from ingested pathogens, helps us digest food by stimulating the release of digestive enzymes, and allows the absorption of protein, carbs, fats, boron, calcium, chromium, cobalt, copper, iron, magnesium, manganese, molybdenum, selenium, vanadium and zinc, unsurprisingly, PPIs and their ilk have been linked to a slew of deficiencies, infections and diseases.
Side effects include constipation, back pain, diarrhea, dry mouth, indigestion, nausea, dizziness, headaches, muscle cramps, insomnia, rapid heart rate and vertigo but these pale in comparison to:
• Asthma
• Chronic liver disease
• Clostridium difficile diarrhea
• Dementia
• Heart attacks
• Increased risk of death
• Inflammatory bowel conditions (Crohn’s, ulcerative colitis and IBS)
• Iron deficiency
• Kidney disease
• Leaky gut
• Low magnesium
• Osteoporosis
• Pancreatitis
• Pneumonia
• Stomach cancer
• Stroke
• Ulcers
• Vitamin B12 deficiency
In a German study reported on by Scientific America: “On average, participants who filled a prescription for a PPI at least once every three months were more than 40 percent more likely to develop dementia than their PPI-free counterparts,”
In another study: “The authors concluded that PPIs are associated with a 29% increased risk of fracture, including 31% increased risk of hip fracture and a 54% increased risk of vertebral fracture. These findings were robust and were consistent across all types of studies, for both low- and high-quality studies, for both long-term use (defined as greater than 1 year) and any use, and for both usual doses and high doses.”
Over- and inappropriately-prescribed
The other problem is that PPIs have a narrow therapeutic range and were originally approved by the FDA only for the duration of 4-8 weeks, but many people take them indefinitely.
Additionally, over-prescription is rife. “In this study, we found an astonishing extent of misuse of PPI therapy as nearly half of the prescriptions were based on unapproved indications or no indications at all.”
Last, but not least, PPIs can be addictive and therefore extraordinarily difficult to discontinue because they cause rebound acid hypersecretion when someone tries to stop using them, causing the very symptoms the drugs were supposed to treat.
I) https://www.drugs.com/condition/gastroesophageal-reflux-disease.html
II) https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/415861
III) https://www.newswise.com/articles/view/682405/?sc=dwhn
IV) https://www.theguardian.com/science/2017/oct/31/acid-reflux-drug-linked-to-more-than-doubled-risk-of-stomach-cancer-study
V) http://jpet.aspetjournals.org/content/248/2/799
VI) https://www.theguardian.com/science/2017/oct/31/acid-reflux-drug-linked-to-more-than-doubled-risk-of-stomach-cancer-study
VII) https://www.scientificamerican.com/article/do-popular-heartburn-meds-really-cause-dementia/
VIII) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090427/
IX) https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/415861
X) https://insights.ovid.com/crossref?an=00004836-200907000-00018
XI) https://www.nature.com/articles/nrgastro.2009.146
XII) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206261/
XIII) https://insights.ovid.com/crossref/00005625-201802000-00014?isFromRelatedArticle=Y