Posted on 02/25/2017 8:28:08 PM PST by nickcarraway
Potential risk could outweigh benefit of taking the medication, study's author says
Popular heartburn medications taken by millions of Canadians could lead to long-term kidney damage without any warning, a new study suggests.
The drugs, called proton pump inhibitors (PPIs), reduce the symptoms of heartburn by lowering the amount of acid in the stomach. They include the brand names Losec, Nexium, and Prevacid.
Doctors previously monitored patients for acute kidney problems, such as decreased urination, swelling in the legs, ankles, or feet, and nausea. Such symptoms were thought to be a warning of more permanent kidney damage, and would often result in doctors taking patients off the drugs.
But the latest research, published today in the journal Kidney International, shows this isn't always the case.
'It's a silent disease'
"It's a silent disease, in the sense that it erodes kidney function very minimally and very gradually over time," said Ziyad Al-Aly, the study's senior author and assistant professor of medicine at Washington University School of Medicine.
Al-Aly and his colleagues analyzed data from 125,000 U.S. patients using PPIs and found more than half who went on to develop chronic kidney damage had no prior acute kidney problems.
The study also found that people using PPIs had, on average, a 20 per cent increase in developing chronic kidney disease compared with those taking H2 blockers such as Zantac or Pepcid. Those medications also reduce the production of stomach acid and are available over the counter.
Kidney problems remain rare in those taking PPIs, and the study does not prove causation. But Al-Aly notes that even a small potential increase in risk can be a big deal with a drug taken by millions of people.
PPIs are among the most commonly prescribed medications in Canada, according to the Canadian Institute for Health Information, and many patients take them for years.
Other health concerns related to PPIs
It's not the first time that PPIs have led to health concerns. Their use has been linked to increased rates of fractures, pneumonia, the gut infection C. difficile, and low vitamin B12 and magnesium levels.
"These drugs, should be used at the lowest dose and for the shortest duration appropriate for the condition being treated," according to Health Canada.
Emily McDonald, an internal medicine specialist at McGill University Health Centre in Montreal, suggests trying other interventions such as altering diet before PPIs, and where they are necessary, following up regularly to re-evaluate whether a patient needs to continue using them.
"This is another article that makes us think again about how many people are on these medications, and how many are on them unnecessarily," she said.
Proton pump inhibitors for heartburn point to overmedication
Al-Aly emphasizes that PPIs do a lot of good for people who need them, such as those with gastrointestinal bleeding or ulcers. But he recommends doctors de-prescribe those who don't need to be taking them.
"For those people, likely the chance of an adverse outcome outweighs any benefit."
I don’t have to often but I use baking soda. Works immediately and better than the drugs.
I just drink jack daniels..
glad I don’t live in Canada
Spoonful of baking soda in water.....burrrrp! Ahhhh! Healed.
Baking soda works for only 45 seconds for me.
Apple cider vinegar worked for a few days but then quit working and I ended up in the hospital for 24 hours.
Baking soda.
Heartburn relief..wait fot the burp/
Someone taught me the baking soda cure over thirty years ago, and I've used it ever since. Works in seconds, and your body likes it.
I am going through this with my 95 year old Mother. It was caught early by her doctor, and her function is almost back to normal. Ibuprofen can do the same thing, too.
I’ve tried all those. None of them worked, so I just went to 40mg famotadine at bedtime. It’s cheap, safe, and it works. When proton pump inhibitors came out 25 or 30 years ago, they were prescribed with a “do not use longer than 6 weeks” warning. But most doctors ignored that, because they did work for a lot of people. I’m a nurse, and I always balk any time my doctor wants to prescribe a new medicine. Sometimes, I don’t have a lot of options, but I prefer to use older medications, because a lot of times, the incidence of adverse effects don’t show up in the research for several years, and by then, it’s too late for a lot of people.
Acetaminophen used to be a prescription, then went otc. It was considered safe. Rheumatologists were advising their patients to take huge amounts, because it didn’t cause stomach bleeding and ulcers like aspirin and other anti-inflammatory meds did. Then, their patients started developing liver failure, which is why now, you’re not supposed to take more than 3000 mg/day. It was 4,000, just a few years ago, but they had to decrease it again.
I call it “yucky water” when I drink it in front of my daughter. It does taste horrible ...
You’re right — it does work immediately.
I’m told that it’s not good to take baking soda water when you have high blood pressure, as I do. So I try not to drink it too often ...
Actually, baking soda can raise your blood pressure, so be care if you have high blood pressure. :-)
Yes, famotidine works almost as well for me as the PPIs, but are a tad inconsistent.
Sorry. Didn’t see your post first. :-)
That happens sometimes with me, but not very often.
40 mg is the prescription dose. Sometimes taken 20mg twice a day, but I think it works better if taken at night. (Insurance usually pays for 40 tablets, but not 20mg.)
Yeah, they’re cheap. I got a whole bunch from India for pennies a dose. They do work. I can certainly take two, twice a day.
FR is so slow for me and with incomplete screens I can barely post. Other sites fine.
People with burning, and belching, and possible ulcer like symptoms should demand their doctor test them for H. Pylori (helicobacter pylori) bacteria, which causes many of these symptoms and 95% of ulcers. Too many neglect the tests and instead put their patient on a lifelong prescription of antacids. Antibiotics can cure, and a dietary supplement of mastic gum has been touted as successful in killing H.pylori.
The article here mentions antacids link to c-diff because lowering the acidicy of the stomach disallows the natural stomach acidicy to kill c-diff and enter the stomach and pass to the intestines. Then when the patient is also on antibiotics, the normal intestinal flora can be depreciated, thus allowing c-diff to flourish.
I know someone who used the mastic gum after being H. Pylori positive, and then no longer showed symptoms. Then had to wean self off antacids. That was 14 years ago and now can drink a vat of coffee, tomato sauce, OJ, wine, and beer. No more purple pills.
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