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Jun 23

FDA Report Links Bone Fractures to Acid Reflux Drugs

Drugs and medications, Lee's Summit Chiropractor, Preventative Care Comments Off on FDA Report Links Bone Fractures to Acid Reflux Drugs
“Epidemiology studies suggest a possible increased risk of bone fractures
with the use of proton pump inhibitors for one year or longer, or at high doses…”

—Joyce Korvick, M.D., deputy director for safety in FDA’s Division of Gastroenterology Products

Proton-pump inhibiting drugs (PPIs) account for $13.6 billion in sales in the U.S. with 110 million prescriptions written yearly. These impressive numbers for drugs originally invented for use in extreme gastrointestinal conditions (e.g. bleeding ulcers, severe gastric reflux, ulcerative esophagitis, etc.) pose a particular risk taken by the public en masse, placing casual users of these drugs, such as those simply coping with heartburn, at particular risk over long-term use—with an estimated 53-69% of proton-pump inhibiting drug over-prescription. The mounting evidence has only recently caught the attention of the FDA, prompting them to issue a warning to the public about the risk of bone fracture with long-term use of PPIs. However, as you’ll see, the risks of these drugs don’t end with bone fractures.

Studies have shown the following:

  • An eight-year study by the University of Washington studied the effect of PPIs on a sample of over 140,000 postmenopausal women, finding a 25% increase in the risk of fractures among women using PPIs in the study (with a 47% increase in spinal fractures and 26% increase of forearm and wrist fractures)
  • A five-year study by the Beth Israel Deaconess Medical Center, measuring data from 100,000 patients discharged from the hospital, found that the risk for C. difficile, a type of bacteria that can cause severe diarrhea and possibly death if not treated properly, rose according to the levels of PPIs the patients were on. For instance, patients taking no PPIs had a 0.3% risk of C. difficile, while those taking heavy doses of PPIs had a 1.4% chance of infection—a 366% increase!
  • A study by Boston Medical Center supports the theory that C. difficile risk is raised in patients using PPIs—finding that among the 1,166 patients treated in the study for C. difficile, 25.2% of those taking PPIs suffered a recurrence of their infection, representing a 36% increase in risk among those not taking PPIs in the study.

Why proton-pump inhibitors cause side-effects such as fracture or increased risk of C. difficile infection is still debated among healthcare professionals, but the prevailing belief is that altering stomach pH decreases the body’s ability to kill food-born illnesses (increasing the risk for food-poisoning) while making minerals harder to separate from the food sources from which they came. Hydrochloric acid or HCL (the acid present in the stomach) aids in separating minerals for use in the body while helping to kill off bacteria that reaches the stomach. Limiting the production of HCL in the stomach is believed to affect the body’s ability to breakdown minerals for use in the body—specificially, calcium, zinc, and iron, thus increasing the risk for fractures in individuals taking PPIs as a long-term solution to acid reflux or heartburn.

Treating Heartburn Naturally

There are many cases where proton-pump inhibiting drugs can be of benefit to the patient, but these cases are relegated to more extreme health conditions—not for the prevention of heartburn or minor acid reflux. Taking PPIs prophylactically to ward off the symptoms of heartburn ignores the cause of heartburn and leads to drug-dependence of PPIs, which places the patient at greater risk for side-effects associated with PPIs. If you are taking PPIs, consider discussing alternative therapies with a qualified healthcare professional.

Some natural alternatives include:

  • Eating less food with each meal, making sure to chew your food completely while eating at a slower pace, giving the body a break from the task of digesting more food than it was intended to digest. Over the last 20 years, plate sizes have grown from 10 inches to 12 inches and so have our waistlines, as this increase in plate size has been accompanied by an increase in food portions. With this increase in plate size and portion size, we have seen a four-fold increase in patients seeking treatment for acid reflux. Coincidence?
  • Consider supplementing with: enzymes to help ease the body’s workload in digesting food; probiotics to keep H. pylori in check, while boosting the beneficial bacteria in your gut; betaine HCL—many in the alternative health community believe it is a lack of HCL (acid), not too much acid, which causes acid reflux; aloe vera, which is effective at healing damage to the stomach and gastrointestinal tract
  • Limit water or fluid consumption during meals as this dilutes stomach acid, but increase water consumption throughout the day, making sure to keep adequately hydrated with clean, pure water
  • A teaspoon of apple cider vinegar mixed with a little honey and water can be effective in curbing heartburn when taken before a meal
  • Ginger and fennel has been taken for 1000’s of years in Eastern cultures to aid in digestion
  • Avoid common food triggers of acid reflux and heartburn, such as spicy foods, fried foods, carbonated beverages, chocolate, NSAIDS (aspirin, ibuprofen, etc.), alcohol, nicotine and caffeine—and if there are any known food triggers you’ve experienced acid reflux with before, it’s best to avoid these foods as well

Remember, never embark on any regimen, natural or conventional, without first consulting with a qualified healthcare professional. As mentioned previously, there are instances where PPIs are effective and warranted and if you are presently taking PPIs for heartburn or acid reflux, never go off of them cold-turkey as this can actually increase your symptoms. You must wean your way off of these drugs with the assistance of your primary care physician who prescribed these drugs to you.

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