Posted on 12/26/2006 8:10:16 PM PST by freespirited
People taking powerful antacid drugs called proton pump inhibitors face an increased risk of hip fracture, University of Pennsylvania researchers report.
Common proton pump inhibitors include Aciphex, Nexium, Prevacid, Prilosec and Protonix; they are often prescribed for stomach conditions such as gastroesophageal reflux disease (GERD). The report is published in the Dec. 27 issue of the Journal of the American Medical Association.
"If you take acid-suppression medications on a chronic basis and you are 50 or older, your hip fracture risk is even higher than usual," said study author Dr.Yu-Xiao Yang, an assistant professor of medicine and epidemiology.
"In addition, if you are one of the few patients who requires high doses, then your risk is even higher," Yang added.
In the study, Yang's team collected data on 13,556 people with hip fractures and 135,386 healthy people, all aged 50 or older. These people were listed in the General Practice Research Database from 1987 to 2003. This database contains information on patients in the United Kingdom.
The researchers found that taking a proton pump inhibitor for more than one year increased the risk of hip fracture by 44 percent, compared with people not taking these medications.
In addition, the risk was 2.6 times higher among people who took high doses over a long period. The risk of hip fracture increased with both the dosage and the duration of proton pump inhibitor therapy, Yang's group found.
Yang speculated that these drugs hinder calcium absorption in some people. Stomach acid is needed to help the body absorb calcium, and proton pump inhibitors work by slowing the production of stomach acid.
Among the elderly, hip fractures have a death rate of 20 percent during the first year after the fracture. For those who survive this period, one in five requires nursing home care, an emergency department visit, hospitalization, surgery and rehabilitation, all with huge health-care costs.
Yang said he thinks these drugs are prescribed too often. "Not everybody is on this medicine for good reasons," he said. "Proton pump inhibitors have been on the market for 15 years, and the general feeling is that they are safe to be taken on a chronic basis. So, they are given often without having a clear indication or without making sure the patient is benefiting from the medication."
Moreover, Yang thinks that both men and women taking prescription proton pump inhibitors should also take a calcium supplement to insure that they maintain their bone mass and lower their risk of hip fracture.
One expert thinks that people should not be overly concerned with this finding unless it is confirmed by other studies.
"This is a new observation," said Dr. Lawrence Brandt, chief of the Division of Gastroenterology at Montefiore Medical Center, in New York City. "It's exciting on the one hand, and alarming on the other hand. People should be aware that there are some data that show that there may be a higher risk of fracture."
Although Brandt agreed that these drugs are prescribed too often and used by some people for too long a time, he noted the findings shouldn't change clinical practice yet.
"If someone doesn't need proton pump inhibitors, they shouldn't be on the drug," he said. "Proton pump inhibitors are probably one of the most abused classes of drugs in the world. So, there are a lot of people on this medication who shouldn't be on this medication."
In addition, people should only take these medications for as long as necessary to treat the condition it's been prescribed for, Brandt said. "If you have to take it for a long time, then you should also have your bone density followed once a year," he added.
Brandt is not concerned with the safety of the over-the-counter versions of these drugs. "Most people who take drugs over-the-counter don't take them in a rigorous fashion," he said. "They take them when they need them, and their dose regimen is not going to be sufficiently compulsive and regimented that this is going to be a problem."
There are lots of alternatives to those drugs if people would do the research.....DGL, clean FISH OIL high in Omega 3's.....and on and on....
ping
(actually I prefer prescription Aciphex, but I hate going to the doctor, so when it runs out I go back to what I can get OTC)
Isn't most serious acid reflux a reaction to other prescription drugs?
Organic apple cider vinegar worked for me.
I cannot imagine licorce helping my stomach problems but perhaps I'll try some. The ranitidine I take is not a proton pump inhibitor but has me curious as I was diagnosed with osteoporosis at age 42 and had been on Zantac for a couple of years. Fosamax increased my bone density to above fracture level.
Your probably need Vitamin D....for the osteo.....and you can get that along with your Omega 3's in fish oil, if you take Carlson's Lemon flavored Fish oil (NOPE - don't sell for them....and I'm NOT a doc.....just done lots of research - and at age 55 have the bone density of a 25 year old.)
I would NOT doubt it.
When do you take the vinegar. With meals or after the onset of symptoms? How much do you drink?
I would sure like to get off of daily Prilosec.
I don't know about most, but I had nasty acid reflux and wasn't on any Rx meds. Omeprezole does such a good job of keeping it down I don't even bother with the daily dose--if I take it whenever I feel I might have about, and at least twice a week it keeps it in check.
I guess I've got to start taking calcium pills, esp. during Orthodox fasts when I don't get milk or cheese.
Vinegar would make me take more Gaviscon.
P.S....forgot to say....and I've ALWAYS hated milk.
"Plop, plop
Fizz, fizz
Oh what an unlucky break it is!"
My wife had severe acid reflux. Slept on an incline which helped a little.
Finally had a laparoscopy operation.
The surgeon wraps a muscle (I think)around the esophagus to reduce the size.
Cured, period.
Have you tried every other day? That works perfect for me.
It is recommended to take an ounce (or scant tablespoon) before meals or at onset of symptoms. Be sure that it is organic and non-pasteurized.
You will be surprised with the results. It works fairly immediately.
I do not know why it works. I have heard that lots of prescription drugs (and common processed foods) devastate the digestive enzymes that occur naturally in your digestive tract. Somehow the acid in the vinegar tricks your reflexes and at the same time builds up the enzymes. Over time the enzymes build up and you can cut back on the vinegar.
Hope it helps.
I don't know what a "scant tablespoon" is, since I don't cook, but I assume that it is less than a tablespoonful. Anyway, an ounce is 30 milliliters (roughly) and a tablespoonful is 15 milliliters. I think your equivalence may be wrong.
Thanks for posting... I've been on daily doses of Nexium for about 5 years and Prevacid prior to that following successful esophagastrectomy surgery over 13 years ago. I'll bring this issue up with my gastro-enterologist at my next appointment. Nexium has worked great but you always suspect there has to be some repercussions -- but it's tough to imagine daily life without it with my rebuilt digestive and plumbing system. Thanks again for sharing. Another fine service by the FREEP!
I saw this, too, and was curious since I take Protonix. I see they did this study in England, where people don't get enough sunlight to help their bodies process calcium. I've been looking around, and cannot find a link to this study. I'd like to read it myself, rather than just rely on the MSM for a McNews version of it.
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