By now, news of the connection between the use of proton pump inhibitors (PPIs) on patients and serious kidney damage has spread widely. Investigation into PPI drugs that include Prilosec and Nexium has just begun, although other safety concerns about PPIs (involving the elevated risk of heart attacks and osteoporosis) were first raised over a decade ago.
One aspect of PPIs has largely been flying under the radar, however. Several years ago, Danish researchers discovered that once patients begin taking PPI medications it is nearly impossible for them to stop. The reason has to do with a phenomenon known as “rebound acid hypersecretion.” Essentially, PPIs wind up causing the same symptoms they are intended to treat.
This was demonstrated in a 2009 study carried out at the University of Copenhagen. Subjects who had no previous history of acid reflux (heartburn, indigestion and acid regurgitation) were given prescription-strength PPI medication for two months. After the medication was discontinued, these otherwise healthy adult patients started developing acid reflux symptoms – and wound up producing stomach acids at even higher rates than before. The study, which appeared in the July 2009 issue of Gastroenterology, showed “...evidence that proton pump inhibitor therapy induces symptoms that it is used to treat.” At the time, Dr. Christina Reimer, who led the study, said, “We have known for years that long-term treatment with PPIs induces a temporary increase in the secretion of acid, but the thinking has been that this probably wasn’t clinically relevant.” Researchers found that the “rebound” effect can continue for as long as three months.
According to Reimer and her colleagues, the rebound effect is caused by excessive production of gastrin, a hormone that stimulates the production of stomach acid. This overproduction of gastrin is a physiological response to the suppression of acid production in the stomach. In other words, once PPI medications start shutting down the production of stomach acid, the body responds by creating more gastrin. Once a patient stops taking a PPI medication, excess gastrin in the bloodstream sends signals to acid-producing cells in the stomach, causing them to produce even more acid.
While there are patients who do have a legitimate medical need for PPI medications, the sad fact is that they have been greatly over-prescribed for a number of upper gastrointestinal (GI) tract issues that would be better treated with changes in diet and lifestyle. In fact, another culprit behind the apparent rise in upper GI disorders may very well be genetically-modified organisms (GMOs). Another clinical study, appearing in the June 2013 issue of Journal of Organic Systems, found that pigs who were fed a GMO diet suffered higher rates of stomach inflammation than did those receiving non-GMO foods.
Of course, there is no profit to be made by recommending that patients simply change their diets. Furthermore, the fact that patients who cease taking PPIs suffer serious withdrawal symptoms for weeks afterward must be a real boost for Big Pharma's bottom line.
Here are a few figures: currently, around 15 million people in the U.S. are taking either prescription or over-the-counter PPI medications, placing them among the best-selling drugs of all time. In 2013, one PPI, esomeprazole (sold under the brand name Nexium) was the second-best selling drug in the industry, generating over $6.1 billion in sales worldwide.
If litigation, such as the type being pursued by the law firm of Levin Papantonio, reveals that there was an attempted cover-up on the part of drug companies involved in the manufacture and sale of PPIs, it would not be the first time.