Q: Protein Pump Inhibitors, (PPIs) , have been in the news recently as studies have shown them to have risks if taken in quantity over a period of time. I have been taking 40 mg twice a day for 8 years and wonder about the wisdom of that and whether I should ask my doctor to change my dose.
A:
GERD (Gastroesophageal Reflux Disease) is common in Sjögrens patients. PPIs are often prescribed to provide relief for everyday use. Studies showing increased risk of fractures with long continuous use, (from 5-7 years), are mounting.
A recent study in the Archives of Internal Medicine (170:765-71,2010) showed 25-50% risk of fractures over 3 years and a modest decrease in bone density. Similar reports have been appearing since 2006.
Particularly interesting is the recent report of increased risk of recurrent c.difficile (clostridium difficile) infections in continuous PPI users, which was further increased for those over 80 and those with recent antibiotic use that was not effective for c. difficile.
Additionally, there is concern that using continuous acid blockers may interfere with optimum nutrition, as some acid is needed for proper digestion.
Other acid blockers such as over-the-counter products like Zantac may have similar risks. It seems prudent to speak with your health care provider about your situation and work with him/her to minimize risk while maintaining a good quality of life. Since each of us has a different response, it is important to stay aware of the results of medication change and report them to you doctor in order to adjust the medication and the dose..
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