Proton pump inhibitors (PPIs) such as Prilosec (omeprazole) and Nexium (esomeprazole) have been linked to numerous serious side effects, ranging from pneumonia, osteoporosis and kidney stones to cardiovascular disease and cancer. These medications have also been implicated in accelerated aging and dementia, although researchers have found conflicting evidence on this score.
For all their dangers, PPIs have been considered to be the most potent medication available for the suppression of acid production. However, some scientists are questioning whether or not proton pump inhibitors are even an effective treatment.
This question was raised in a recent study published in the journal Gastroenterology. A research team at the Cedars-Sinai Center for Outcomes Research and Education used a population-based survey to determine how well PPIs were working to treat patients with gastroesophageal reflux disease (GERD, more commonly known as “acid reflux”). They discovered that 40 percent of patients undergoing treatment with a PPI continued to experience symptoms. Over 30 percent reported having experienced symptoms within the previous seven days. Of those who were taking a PPI every day, more than 54 percent continued to have “persistent symptoms.”
The researchers noted some trends. Patients who were most likely to have persistent symptoms of GERD were young, female and/or Hispanic, or had comorbidities such as irritable bowel syndrome or Crohn's disease.
In April 2018, similar research involving approximately 800,000 patient records in Sweden found that long-term use of PPIs may cause esophageal cancer, a disease that ironically, these medications are supposed to prevent.
GERD affects one out of every five Americans – and 40 percent of them treat their conditions with PPIs. Nonetheless, most of them continue to suffer from symptoms of the disease. In light of research linking PPIs to serious and even deadly side effects, some health care systems have either stopped recommending and supplying PPIs altogether or are taking steps to reduce their use.
The frequency and length of time these medications are taken appears to be key in whether or not a patient will experience serious side effects. PPIs work by permanently shutting down the mechanism in parietal cells lining the stomach (the proton pump) that carries out the final step in the production of stomach acid. Patients who take PPIs occasionally for a short period of time (generally no more than eight weeks) appear to have little problem. However, these medications are over-prescribed and overused; some patients take them daily for years.
Now that new research has called the overall efficacy of PPIs into question, it remains to be seen whether or not more health care systems will start re-evaluating these medications.