Proton Pump Inhibitors
Are you taking a Proton Pump Inhibitor (PPI) to lower the acidity in your stomach? If you are taking them short term, then possibly all well and good. If you take them all the time, then you really should take note of yet more writing on the wall. Here is why, together with advice on how to keep your stomach happier.
PPIs’ already known flip sides
- PPIs risk a 16% increased risk of myocardial infarction (heart attack) and a twofold greater risk of dying from this [Nigam H. Shah, MBBS, PhD, from Stanford University in California, and colleagues published this in Vasc Med. 2015 Aug; 20(4): 309–316].
- PPIs are associated with a 20–50% increase in the risk of developing chronic kidney disease [JAMA Internal Medicine 2015].
- PPI use is associated with an increased risk of fractures of the hip, wrist, and spine.
- PPIs increase the risk of Clostridium difficile infection [Consistent findings from prospective and retrospective studies].
- PPIs increase the risk of community-acquired pneumonia [Consistent findings from case-control studies].
- Discontinuation of PPI therapy is associated with symptoms of gastroesophageal reflux disease (GERD) from gastric acid rebound [Randomized double-blind studies demonstrate symptomatic gastric acid rebound lasting several weeks after discontinuation of PPI therapy]. Back to square one because the stomach’s protective lining didn’t repair whilst on PPIs, so you still have no natural tolerance to stomach acid.
- PPI therapy is known to cause hypergastrinaemia which in turn may promote the development and progression of pancreatic cancer. [Proton pump inhibitors on pancreatic cancer risk and survival, Malcolm D.Kearns, BenBoursi, Yu-XiaoYang; Cancer Epidemiology, Volume 46, February 2017, Pages 80-84]
And now there’s further disclosure that may prompt you to manage stomach burning differently…
Association of Proton Pump Inhibitors With Risk of Dementia
Researchers evaluated nearly 74,000 adults aged 75 and older without dementia in 2004, using claims from a large German health insurer’s pharmaceutical database. However, by 2011, close to 40% of the initial cohort were diagnosed with dementia. According to the researchers, 4% of all participants used PPIs regularly during at least one 12-to-18-month interval during the study period. When the investigators adjusted for confounders such as age, stroke, history of depression and polypharmacy (taking more medication than only PPIs), use of PPIs was associated with a 44% increased risk for incident dementia [JAMA Neurol. Published online February 15, 2016].
Interesting then to look at the findings of Alzheimer’s Disease International. “There are an estimated 46.8 million people worldwide living with dementia in 2015. This number will almost double every 20 years, reaching 74.7 million in 2030 and 131.5 million in 2050. Much of the increase will be in developing countries. Already 58% of people with dementia live in developing countries, but by 2050 this will rise to 68%. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours.” Those regions are adopting the Western way of life with its price tag attached, so you may not be surprised that there’s an appreciable increase in the use of PPIs in China [BMC Health Serv Res. 2015; 15: 11].
Stress and modern foods
The run up to gastric ulceration and GERD is that you have low stomach acidity (hypochlorhydria) to start with, without that natural defence helicobacter pylori can flourish in your stomach and damage your protective lining, without protective lining you become intolerant to natural levels of acidity necessary for digestion and for protection of your gut, you now have symptoms of gastric ulcer and reflux. So what can you do yourself to ease your tummy? The answer is food choices and life perspective choices.
| TRY THIS | WHY IT CAN HELP |
|---|---|
| Baking Soda NaHCO3 | If discomfort gets out of hand take ½ – 1 teaspoon dissolved in a medium glass of water as its alkalinity buffers the stomach acid. Like PPIs this is not your ongoing solution. |
| Raw Oats | An overnight soak in water removes the oats’ phytic acid and together with the alkalinity of milk this is a time honoured remedy. |
| Glutamine | Research published in 2009 found that gastrointestinal damage caused by Helicobacter pylori can be helped with the amino acid Glutamine found in foods such as beef chicken fish eggs dairy products and some fruits & vegetables. L-glutamine is the biologically active isomer of glutamine and is widely available as a supplement. |
| Aloe vera | Research aplenty about its gastroprotective properties. Beware of the type of supplement you take and make sure that laxative molecules are removed i.e. non-latex and that dosage is meaningful. Consider Aloeride Extra Strong at 1 capsule once or twice a day. |
| Pomegranate | Punicalagin in pomegranate juice produces significant gastroprotective effects via suppression of mucosal oxidative stress and inflammation through NFκB pathway as well as replenishing of nitric oxide and mucin content lacking the effects on acid secretions and prostaglandins. |
| Ginger root | Research aplenty about its gastro-protective properties. Add two slices of fresh ginger root to a cup of hot water and allow to brew; drink when tepid. |
| Slippery Elm | Stimulates nerve endings in your gastrointestinal tract which helps increase mucus secretion that in turn protects your gastrointestinal tract against ulceration. Make tea from powdered bark. |
| Lower your revs | Take a break go on holiday retire happily or learn to deal with life’s stress – nobody with gastric ulceration or GERD has a relaxed attitude towards the challenges of life. Consider this. |
| Clever Smoothies | the mixture of alkaline raw vegetables fruit berries herbs and probiotic milk kefir. |
Can you back up these negative statements with some written proof of what you have written in this scary article? We the people of the world would like to be informed.
Dear ~C, these are matters that all too often are not told to patients. If you think the article is scary then google “proton pump inhibitors cancer link” which will come up with many research articles (a few steps up from ‘some written proof’) of which https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303431/ and meta analysis https://www.frontiersin.org/articles/10.3389/fphar.2023.1129948/full#:~:text=This%20meta%2Danalysis%20included%2012,CI%3A%201.38%E2%80%932.31) are but two examples. As to your ‘We the people of the world would like to be informed’, I had hoped that, by alerting people to a flipside of PPIs longterm, I would have done just that. But there you are ~C calling it negative statements… Kind regards, Han.
My sincere apologies for my rudeness. I checked out your first link and discovered at least one of the causes of my stomach ulcers. You were right and I was wrong. It’s so difficult to trust in our world the way it has become. But that’s no excuse. I hope that we can all make our world a place where everyone can speak out and be believed. And I’m going to have a wee bit of a chat with my physician. Thank you for setting me straight.
~C.
No worries ~C and I do understand about the problem of false and incomplete information going on. In my clinic the “if not this then what” was a big thing. I have no problem with short term use of PPIs but I do think that long term use comes at a potentially high price. Too few people are told about that and, as a consequence, make an uninformed decision. If and when you talk to your physician the discussion will invarably come to “if not PPIs then what” and the study of Medicine doesn’t cater for that at all. So be kind on your GP. On my never shrinking to-do list is an article about peptic ulcers, reflux and sliding hiatus hernia, I am personally acquainted with the latter and can confirm that I am now pretty much completely symptom free. A very successful “then what”. Kind regards, Han.