Proton-pump inhibitors (PPI) are a common treatment option for gastroesophageal reflux disease (GERD), stomach or intestinal ulcers, prevention of ulcers for long-term NSAID use, dyspepsia, Barrett’s esophagus, Zollinger-Ellison syndrome, and other disorders that are caused by the production of stomach acid. PPIs are fairly effective at treating and preventing ulcers and reflux because it blocks the enzyme that produces the acid. Commonly prescribed proton-pump inhibitor medications include omeprazole, lansoprazole, dexlansoprazole, rabeprazole, pantoprazole, esomeprazole. However, there are many side effects that are often rattled off in the small print of television commercials, and a great deal of them should actually be given more recognition due to their severity and how common they are. It is important to note that PPIs are not approved by the Food and Drug Administration (FDA) for long-term use, but many prescribing providers fail to mention this to their patients or warning them about the dengers of long-term use.
Common side effects of PPIs include headache, diarrhea, constipation, abdominal pain, flatulence, fever, vomiting, nausea, or rash. More serious and life-threatening side effects include anaphylaxis, Steven-Johnson syndrome, kidney failure, pancreatitis, and reduced liver function. Long-term or consistent high-dose use puts patients at high risk of Clostridium difficile, osteoporosis, vitamin B12 deficiency, hypomagnesemia, and heart attacks. Let’s discuss some of this more closely.
The common side-effects are fairly minor and are common of most medications. For most of these side effects, you should weigh the risks versus benefits of taking the medication and how you can better manage the side effects.
Long-Term Use or High Dose Side Effects
The side effects that should be of greatest concern to you are those that may occur related to long-term use or regular high dose use. Long-term or consistent high-dose use puts you at high risk of Clostridium difficile, osteoporosis, vitamin B12 deficiency, hypomagnesemia, and heart attacks.
Clostridium difficile, c. diff, is an infection of the gut that is caused by opportunistic bacteria that take advantage of the reduced levels of acidic stomach acid and good flora. C. diff can damage the lining of the colon and can lead to severe dehydration.
Nutrition-related problems are common with long-term use of proton-pump inhibitors. PPIs interfere with the absorption of iron, calcium, magnesium, and vitamin B12. Osteoporosis is the reduction of calcium and vitamin D in the bones that causes weak, fragile, brittle bones. Low levels of magnesium can cause heart arrhythmias. Low levels of vitamin B12 can cause fatigue, pain, ulcers, vision changes, anemia, depressed mood, and even dementia.
Severe side effects include increased risk of heart attack, stroke, and kidney failure. Long-term PPI use has also been linked to dementia. A major population study revealed a direct correlation between long-term PPI use and the development of Berrett’s syndrome and adenocarcinoma of the esophagus. In fact, one Swedish study showed a 600 percent increase in cancer risk for patients who used PPIs to control their GERD as opposed to those who used an antacid, Pepcid, or Zantac instead.
Some medications can increase the risk of these side effects when taken together. Some medications include digoxin, ketoconazole, diazepam, warfarin, phenytoin, and Plavix.
There Are Alternatives to PPI Use!
While using PPI medications is a great solution for infrequent or minor symptoms in low doses, long-term and high dose use is not the safest or most comfortable option. But, there is hope for better treatment options. Laparoscopic magnetic sphincter augmentation (MSA), such as LINX reflux management system can help treat the underlying cause of your acid reflux or chronic GERD, rather than simply masking the symptoms. MSA keeps stomach acid where it belongs — in the stomach. LINX reflux management system can help you find relief from heartburn, regurgitation, and bloating, and freedom from medication!
If you have chronic reflux symptoms or have been diagnosed with GERD and are on long-term PPI medications, schedule a consultation at Southern Reflux Center. Our physician GERD specialists want to help you improve your quality of life with treatments that provide alternatives to long-term PPI use. Contact us to schedule your appointment today.