PPI's and osteoporosis risk for women

February 14, 2012 3:08:28 PM PST
They're some of the most commonly use drugs around the world to treat heartburn and acid reflux.

Though they're considered safe, some of us may be at risk.

The drugs are called PPI's or proton pump inhibitors.

They're advertised in papers, the web and on TV.

Though short term use may not be an issue, long term use, especially in postmenopausal women may create a problem.

The problem is bone fractures, and it can make the risk of fractures in these women even worse.

Helaine Castaldi has reflux, which is stomach acid squirting up into her esophagus.

She was given Nexium; one of the most commonly used drugs to stop acid production in the stomach.

So Helaine Googled Nexium because she has osteoporosis and is on several other drugs.

She got a surprise.

"The side effects, bone fractures, wrist fractures, hip fractures," Castaldi said.

It's not news to medical people.

A study of chronic use of this drug family called PPI's done in 1982 found that hip fracture risk increased by 35% after taking PPI's for two years, 42% after four years, and 55% after six to eight years.

It's not news, but not commonly known to many users.

"Especially older women who have a risk for osteoporosis, these medications increase their risks," said Lis Ganjhu, D.O., St. Luke's Roosevelt Hospital.

Helaine was a heavy smoker until just a few years ago, and a recent article found that women who smoke and take PPI's have a higher risk of osteoporosis than non smokers.

PPI's include Aciphex, Prevacid, Nexium, Prilosec and Protonix.

Acid blocking drugs can cause bone problems by blocking calcium absorption, by changing stomach hormones, and by changing how bones are formed and broken down.

Some PPI's are sold over the counter.

Dr. Ganjhu says there may be other ways to control acid, such as stopping smoking, weight loss, avoiding fatty foods, and using liquid antacids as needed.

She adds that not using the PPI's for reflux has risks too like esophageal cancer and scarring of the esophagus.

But Helaine remains concerned about the drugs.

"The osteoporosis is enough to worry about, but if the medication is going to rush that, than that's a worry for me," Castaldi said.

Bone strengthening measures such as walking or running, getting enough daily calcium and vitamin D are all things to do if you have to take PPI's regularly.

If you're taking the over the counter PPI's for persistent heartburn and haven't seen your doctor yet, now's the time.

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