The Downsides of Acid Blocking Drugs

By Jacob Schor, ND

 

  Drugs that prevent and treat heartburn are among the most widely prescribed medicines in the United States, accounting for over $13 billion in annual sales. New research on their side effects says that the money spent on acid blocking drugs may be the least of the costs of using them.

 

BIG Business

  Before talking about the medical side of this, we need a little business background.

  In 2000, Prilosec was the world's largest selling prescription drug, with annual sales over $6 billion. Patent protection for Prilosec was set to expire in 2001. In anticipation of this, AstraZeneca, the drug's maker, began an advertising campaign and spent between a quarter and a half billion dollars to get patients to switch from Prilosec to Nexium. Nexium became the most heavily advertised drug in the United States. Remember the ads? "Today's purple pill is Nexium, from the makers of Prilosec." The promotion allowed AstraZeneca to maintain its income. In 2003, although revenues from Prilosec slid to under $1 billion, worldwide Nexium sales were up to $3.9 billion.

  The "good news" in those advertisements for those purple pills crowded out the questions regarding their safety. Yet questions keep turning up. Research has shown that acid blocking drugs increase risk for antibiotic resistant infections, gastritis, pneumonia, bone fractures, vitamin deficiency, and possibly cancer.

  Our bodies make stomach acid for good reason. Acid kills bacteria, viruses and molds before they enter the bloodstream. Acids also process the minerals and vitamins in food into forms we can absorb. It is no surprise that interfering with the body's natural production of acid creates problems.

  Acid blocker drugs are divided into two general drug groups. One group is the histamine-receptor antagonists like Zantac, Tagamet, and Pepcid AC. The other and more potent group is the proton-pump inhibitors (PPIs) and includes Prilosec, Protonix, Prevacid, and Nexium The important distinction when talking about these drugs is type, not brand.

 

Antibiotics and Acid Suppression: A Bad Combination

  Taking antibiotics frequently causes intestinal upset. Taking them in combination with acid blockers compounds the problem. Antibiotics kill off bacteria in the intestines. Stomach acid also has a protective effect. Removing both these protective barriers at the same time leaves the body defenseless.

  To test this, researchers gave mice two kinds of antibiotic resistant bacteria for three days. One group of these mice was then given an acid-suppressing drug, another group was given an antibiotic, and a third group was given both. The mice given both drugs were three times as likely to end up with intestinal infections as mice just given the antibiotic.

  Reducing acid in the animals' stomachs, gave "free passage through the stomach" for germs. Normally stomach acid would kill them. The antibiotic killed bacteria like Acidophilus and Bifidobacter allowing the drug resistant bacteria to thrive. Taking acid blocking drugs triples the risk of serious bowel infection.

 

Pneumonia

  In the October 2006, the Journal of the American Medical Association ( JAMA ) reported that acid-blocking drugs increase a person's chance of getting pneumonia. After reviewing medical records from more than 360,000 people, researchers found that people using acid blockers were 4.5 times as likely to develop pneumonia as were people who never used the drugs. Current users were twice as likely to get pneumonia as past users.

 

Increased Fractures

  Last December's issue of JAMA , reports that drugs like Nexium, almost triple the risk of hip fracture. The authors combed British medical records, finding 13,556 people over 50 who had suffered broken hips. They compared these people with approximately 135,000 people of similar ages who hadn't. People taking high doses of acid blockers for longer than a year were 2.6 times as likely to break a hip as were people not taking the acid blocker. Those taking even modest doses for one to four years were still more likely to break a hip. The longer the people took the drugs the greater their risk of fracture.

 

Cancer

  In a 2005 report, researchers studied 20 mice, half of which were genetically engineered to lack gastrin, the hormone that controls stomach-acid production. Six of the mice lacking gastrin developed stomach tumors at 12 months of age, but none of the normal mice did. In mouse years, 12 months is about a third of a lifetime. These purple pills have not been on the market long enough for people to have taken them a third of their lifetime. What can we expect when people are taking it for that length of time? Something to think about when you get tired of worrying about global warming.

  People and their doctors still love these drugs. Ask anyone who has found relief using them. But there are risks that come with their use. We are just starting to discover how serious those risks are.

  There are certainly naturopathic therapies that may be substituted for these drugs. The advantage they provide is their low risk of side effects. Given the low risk in employing these therapies over the long term,, one should consider trying them first before resorting to chemical acid blockers. If relief is found through these alternative treatments, then one can avoid having to make the decision whether the risks are worth the benefits in using these drugs.

 

Jacob Schor, N.D. majored in Food Science and Product Development as an undergraduate at Cornell University, and received his doctorate in Naturopathic Medicine at National College in Portland, Oregon in 1991. He served as President of the Colorado Association of Naturopathic Physicians from 1992-1999 and maintains a private practice at the Denver Naturopathic Clinic. This and many other essays by Dr. Schor can be found at www.denvernaturopathic.com.