The Problem With Some Heartburn Treatments
Taking PPIs? It’s Time to Talk to Your Doctor About Your Risk of Kidney Failure.
Chronic heartburn is rampant in this country. More than 15 million Americans who suffer from heartburn, ulcers and acid reflux disease get prescriptions from their doctors to treat it. Millions more buy drugs over the counter.
Doctors breathed a sigh of relief when a class of drugs called Proton Pump Inhibitors (PPIs) proved extremely effective for controlling heartburn.
PPIs include drugs such as Nexium (Esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole) and Aciphex (rabeprazole). They were so effective that many people started using PPIs on a regular basis to avoid the gastric discomfort.
“We get busy and when patients feel better, we tend to overlook potential consequences with long-term use. We should not prescribe any medication without evaluating the risk-benefit profile,” according to Dr. David Kerman, a gastroenterology specialist at the University of Miami Health System.
Think about this …
A study published in the February 22, 2017 issue of Kidney International evaluated the use of PPIs in 125,000 patients. It showed that patients on long-term use (over 90 days) had an increased risk of chronic kidney disease and kidney failure. Even the over-the-counter versions caution patients not to take them for more than four weeks, but many do it anyway.
The problem with the drugs, the study demonstrated, is more than half the patients who develop chronic kidney damage or end-stage renal disease don’t experience typical symptoms such as low urine output, fatigue or swelling in the legs and ankles that could signal a problem.
And end-stage renal disease has two treatments: kidney dialysis or kidney transplant.
“Long-term use of PPIs should be monitored by a gastroenterologist for this potential problem as well as others,” Dr. Kerman adds. “PPIs have also been linked to increased risk of development of osteoporosis and osteopenia, increased risk of lower GI infections, and possible risk of dementia. Given these issues, gastroenterologists should prescribe long-term PPIs carefully.”
Both Dr. Kerman and the study authors suggested that before starting a medication, you should look at other long-term ways of controlling heartburn:
- Reducing risk factors
- Stop smoking,
- Reduce alcohol intake
- Lose weight
- Increase exercise
- Don’t eat close to bedtime
- Trying other medications first, such as H-2 receptor antagonists (zantac, ranitidine) etc.
“Losing weight and developing a healthier lifestyle can cure the heartburn much better than any drugs,” says Dr. Kerman.
Talk to your doctors about heartburn symptoms and medications to find other solutions to long-term use of PPIs.
Written by a staff writer.