Memorial Health - August 10, 2018
by Dr. William E. Kyle

Q: I've taken Prilosec daily for acid reflux for many years. Are there health risks associated with long-term use of reflux medicine?

A: There has been a lot of discussion about the safety of proton pump inhibitors (PPIs), such as omeprazole (Prilosec), esomeprazole (Nexium) and pantoprazole (Protonix). Recent studies have found possible connections between long-term PPI use and vitamin deficiencies, bone fractures and kidney disease. However, these have been inconclusive.

PPIs work in the stomach by shutting down or decreasing the amount of acid being produced by the stomach. Acid in the stomach is necessary to help break down food to be digested, but too much acid is harmful.

The most common disorder is acid reflux, which causes the acid and/or partially digested food to come back up the esophagus. If too much acid is exposed to the esophagus for long periods of time, Barrett's esophagus or cancer can occur. Also, if too much acid sits in the stomach, ulcers may develop.

Current research has noted potential side effects of long-term PPI use that include fractures, pneumonia, vitamin B12 deficiency, chronic kidney disease and dementia. Researchers at the Mayo Clinic analyzed the research and concluded that there is not enough evidence to support a definite association with PPIs.

Even though these studies sound significant, they only show a possible association, not a documented cause and effect. To prove that a drug causes a long-term problem, you need prospective, randomized, controlled trials.

Always ask your doctor about the significance of these studies before starting or stopping medication.

If you are taking PPIs for acid reflux, avoid these foods to reduce or eliminate your need for medication: alcohol, chocolate, coffee, fried foods, onions, citrus fruits and juices, peppermint, carbonated sodas, spicy foods and tomatoes or tomato sauces.

Of course, do not stop taking any medication without talking to your doctor first.

Quitting smoking, losing weight and reducing stress can also help you manage the symptoms of acid reflux.

Millions of people take PPIs for relief of painful or chronic conditions. Talk to your healthcare provider about whether you need to take this medication daily or if intermittent or short-term use will work for you.

Dr. William E. Kyle is an internal medicine physician at Memorial Health University Physicians | Adult Primary Care Bluffton.