When Acid Reflux Attacks: The 8 Dangers of Long Term PPI Use


acid refluxIf you have had acid reflux, you probably know the struggle of waking up in the middle of the night due to stomach pain. You most likely know what to do in such instances. You just pop an antacid pill and go back to sleep.

What are those pills called? They are Proton Pump Inhibitors (PPIs). These medicines work like magic and provide instantaneous relief. The problem with acid reflux is that it tends to cling. For that, you have to take PPIs for longer durations.

But, are these medicines safe? How do they work? Should you expect any side effects with the long term use of these medicines? This article will address these and a lot of other questions. It will tell you some natural ways you can decrease your dependence on these drugs. So let’s get to it.

1. Studies Link PPIs to the Increased Risk of Heart Attack

Researchers have long known the link between long term PPI use and heart attack, but newer research has unfolded some astounding facts.

heart attackResearchers did a study that got published in PLOS One. The main purpose of that study was to find a possible link between long term PPI use and heart disease. Researchers found that individuals using PPIs were 16 to 21 percent more likely to get a heart attack. That risk was in comparison to those who do not use PPIs.

Researchers know that such link exists in individuals who already have heart disease. That is due to the ability of PPIs to decrease the blood thinning effects of anti-platelet drugs.

Your blood has different kinds of cells. Platelets are one of these cells. Platelets function to form a clot when you bleed. This way they prevent excessive bleeding. But in heart patients, platelets function in a somewhat abnormal fashion.

In such patients, platelets start to stick together to form a blood clot inside the vessels. This is dangerous because this clot can travel up to the vessels of the heart and block them. The end result of this process is a heart attack.

That is why; doctors may put you on anti-platelet drugs to prevent this from happening. But, that becomes a problem when you use PPIs with anti-platelet drugs. PPIs hinder their function and increase the risk of heart wreck.

But, does that mean that PPIs increase the risk of heart attack in normal individuals, too? Probably yes. Researchers have observed that PPIs are dangerous for normal individuals, as well. Even if you do not have any heart disease, PPIs may still interfere with your heart function. Why that happens? Researchers are still unsure about that.

This situation is alarming. That is because one in 14 people is on long term PPI therapy. This makes PPIs the third most common prescribed and used drugs. It also means that the use of PPI puts you at an increased risk of heart disease.

doctorWhat can you do about it? Here is what you should do:

  • Be vigilant. If you have heart disease and have been recently diagnosed with stomach ulcers, too. It is important that you tell your doctor about your heart disease.
  • Talk to your doctor. It is also critical that you tell your doctor about your prescription medicines. Again, that is more important if you have a heart disease and using some medicines for that.
  • Learn more. You should get more information about the link between PPIs and heart disease.
  • Limit usage. It is important that you do not use PPIs for more than six to 12 months.
  • Find alternatives. There is another class of drug called the H2 receptor blockers. These medicines work in a fashion like PPIs, but do not increase the risk of heart attacks. Your doctor may put you on H2 receptor blockers if you require long term therapy.

2. PPIs Decrease the Absorption of Iron and Cause Iron Deficiency Anaemia

Iron is one the key nutrients that your body needs. Your body needs this mineral for the formation of blood cells and a lot other body processes.

The iron you eat is in Fe+3 form, but your body cannot absorb this form of iron. Your body first converts this Fe+3 iron into its Fe+2 form. This reaction is the reduction reaction that makes iron absorbable.

This reduction reaction is under the control of your stomach acids. PPIs function by blocking the production of stomach acids. If you do not have stomach acids, it means your body will fail to absorb iron. It can lead to the decrease of iron in your body, a condition known as iron deficiency anemia.

Researchers at the Michigan State University studied this effect of PPIs. They studied 98 participants who took PPIs for one year duration. After a year, researchers examined their blood for iron content. Compared to non-users, they were five times more likely to develop iron deficiency anaemia.

What can you do to avoid that? Be sure to tell your doctor if you:

  • Are already suffering from iron deficiency anemia.
  • Have undergone an operation involving the removal of a part of your stomach or gut.
  • If you develop symptoms of iron deficiency. These symptoms include:
    • Lethargy
    • Body aches
    • The palms of your hand and your skin turns pale
    • Difficulty in breathing, especially after exertion

Your doctor may prescribe you vitamin C or iron supplements to help you deal with your condition.

3. PPIs Hinder Calcium Absorption and Increase the Risk of Osteoporosis

CalciumCalcium is another important mineral. Your body needs this mineral for bone and teeth formation. Most of the calcium you eat is in the form of calcium salts. Your stomach acid helps separate calcium from these salts. This process assists in the absorption of calcium.

In other words, your stomach acid is critical for the absorption of calcium you eat. Since PPIs decrease stomach acids, it may lead to decreased absorption of calcium, too. Even research proves this fact. Research shows that long term use of PPIs may have a link with decreased body calcium.

One of the biggest complications of decreased body calcium is a condition called osteoporosis. Your bones are the storehouse of your body calcium. Calcium gives them their typical strength. Calcium is the concrete for your bones.

When your body fails to absorb the calcium you eat, the level of calcium in your bones starts to decline, too. This decline in your bone calcium can lead to poor bone strength. It also leads to increased chances of fractures. Research shows that using PPIs for more than one year increases the chances of bone fracture. In one study, individuals using PPIs were two times more likely to suffer hip bone fracture.

What can you do to avoid that from happening?  Be sure to talk to your doctor if you:

  • Already have or suspect you have a bone disease.
  • Have hit menopause. Menopause is when your menses stop. It is a risk factor for osteoporosis.
  • Experience bone pain or fractures. The use of calcium supplements is not usually recommended with PPI use, but you may need them in special circumstances. It may be a sign of poor calcium absorption after PPI therapy.

4. PPIs Are Bad for Your Vitamin B12 Levels

Vitamin B12Vitamin B12 is an important body vitamin. It takes part in several important body processes. It finds its way in the production of blood cells and maturation of body cells. It also plays its role in the proper functioning of your brain and nerves.

PPIs may affect the absorption of this important vitamin from your gut. Vitamin B12 requires an acidic environment in your gut to get absorbed. But PPIs take that away from you. With the lack of acidic environment, the absorption of vitamin B12 also gets impaired.

The deficiency of vitamin B12 can lead to a multitude of malfunctions in your body including:

  • Your body cells fail to mature when you have a vitamin B12 deficiency. This leads to immature red blood cells and weaker immunity.
  • Vitamin B12 has a central role in the proper functioning of your body nerves. You suffer a lot of complications if your body is low on vitamin B12 reserves. Here is what you may experience:
    • Vitamin B12 deficiency can lead to a condition named as peripheral neuropathy. In this condition, your nerves stop functioning. This way, you lose your ability to feel things. It typically affects your hands and feet.
    • It can also lead to spinal cord compression. Spinal cord is a structure running down your spine. Its compression can lead to muscle paralysis and loss of sensations.

All this may sound grave to you, but chances of you developing these complications are not too high. But you are at an increased risk, if you:

  • Are older than 50, and suffer from nerve and spine diseases.
  • Have undergone an operation involving resection of your stomach or gut.
  • Are taking PPIs for more than one year.

Talk to your doctorTo avoid these side effects, you should observe following cautions:

  • Talk to your doctor about any other medical condition you have. You should especially mention the ones involving your spine and nerves.
  • Tell your doctor immediately if you develop any of the above mentioned conditions.
  • Your doctor will closely track your blood vitamin B12 levels and may also prescribe a multi-vitamin supplement. This will prevent your B12 levels from falling below a critical level.

5. Prolonged PPI Therapy May Drop Your Magnesium Levels

Magnesium is a mineral, and your body uses this mineral in at least 300 different reactions. It keeps your heart steady and boosts your metabolism. It also functions to control the level of blood sugar. It assists in giving you stronger bones, too.

MagnesiumThere have been several cases of hypomagnesemia. It is a condition in which your blood magnesium fall downs to a dangerous level. In all those cases, the condition of patients improved when they discontinued the use of PPIs. But what is the link between PPI use and hypomagnesemia? Researchers still do not know this link.

Hypomagnesemia may cause the follow symptoms, such as:

  • Abnormal movements of the eyes
  • Seizures
  • Fatigue
  • Numbness
  • Muscle weakness

alcoholYou are more likely to suffer this side effect of PPIs if you have:

  • Long standing diarrhea
  • Addiction to alcohol
  • Kidney failure
  • A condition in which you sweat excessively
  • High blood calcium levels
  • Some disease of the gut where your gut fails to absorb magnesium

Is there any way to avoid these side effects? Here are some words of caution:

  • Tell your doctor if you have any of the above mentioned conditions.
  • You should also talk to your doctor if you are in the habit of drinking more alcohol than usual.
  • Your doctor may track your blood magnesium levels. He may prescribe you a supplement if your blood magnesium levels are low.

6. Long Term PPI Use May Increase Your Risks for Pneumonia

There is seemingly no link between stomach and your respiratory system, but these two systems do share a common beginning in your mouth. So, what happens in your stomach may affect your respiratory health, too.

Pneumonia is the infection of your lungs. It is the result of bacteria entering your lungs due to your weakened immunity. You may not believe that but your stomach helps improve your body immunity.

How does that happen?

It is due to the acid present in your stomach. The environment in your stomach is strongly acidic. This environment kills most of the bacteria that somehow manage to enter into your body.

But using PPIs for long disturbs these dynamics of your body. With no stomach acid, bacteria get an opportunity to sneak into your body and cause infection. Research shows that you are two times more likely to get pneumonia if you are using PPIs.

Are you at a risk too? Well, it depends on a lot of factors. For instance, you:

  • Are more likely to get pneumonia if you have been using PPIs for more than one year.
  • Need to be using a high dose of PPIs to develop such infections.
  • Are more prone to get such infections if you already have some respiratory illness.

So, be sure to should talk to your doctor and discuss all these concerns with them. 

7. It May Predispose You to a C Difficile Infection

Clostridium DifficileClostridium Difficile or C difficile is a bacterial infection of your gut. Your gut has an ecosystem of its own. The good bacteria in your gut help maintain your gut health. These bacteria also prevent the overgrowth of bad bacteria, like C difficile.

Your stomach also plays an important role in keeping your gut healthy. As mentioned before, the stomach acid aids to kill the bacteria that gain entry into your body. But, PPIs take away this feature of your stomach. As a result, disease cause bacteria, like C difficile, gain entry into your gut.

When C difficile enters into your gut, it starts to grow rapidly. A point comes when it outgrows the good bacteria in your gut. This is when you get life-threatening C difficile infection.

C difficile infection may manifestation as:

  • Diarrhea not responding to over the counter medicines.
  • High grade fever.
  • Blood in the stool.
  • Severe abdominal pain.

You are more likely to suffer this infection, if:

  • You are using PPIs for more than one year.
  • You are using antibiotics for more than two months.
  • You have experienced such infection before.

Unfortunately, there is little you can do on your own once you develop this condition. This condition requires immediate hospitalization and intensive care. But, the only cure is caution. You should observe caution and should avoid the non-judicious use of PPIs and antibiotics.

8. PPIs May Even Lead to Kidney Failure

Your kidney functions like a natural filter in your body. Without your kidneys, your body will be a storehouse, full of wastes and toxins. In fact, your kidney is the only thing between your health and death due to toxins.

Your kidneys are sensitive. A lot of drugs can destroy their structure and compromise their function. PPI is one such drug. There have been some reports where the users have faced life-threatening kidney failure after using PPIs.

But what causes renal failure after PPI use? According to researchers, that is because of PPIs triggering an abnormal immune response. Your immune system functions to fight off infections and diseases. But, there are instances when it backfires and starts targeting the tissues of your body.

Users of PPIs develop such condition as well. In some individuals, the use of PPIs triggers an abnormal immune response. This abnormality in immune system then targets body organs, like kidneys.

painYou should immediately contact your doctor if you experience following symptoms:

  • Difficulty or pain when you urinate.
  • Seeing traces of blood in your urine.
  • Experiencing pain in your sides.
  • Seizures or unconsciousness.

You should consult your doctor if you experience any allergy with PPIs. It may be a sign of an imbalance in your immune system.

How to Decrease the Risk of Side Effects

PPIs work like magic, but at a price. But what is the alternative? Can you something to avoid these side effects and still beat stomach ulcers and acid reflux? Fortunately, yes, you can do a lot of things to avoid the negative outcomes associated with PPI use.

But what is the alternative?Here are some words of caution and natural alternatives you can use. These methods may not be absolute alternatives, but these can help decrease your reliance on PPIs. So here goes:

  • Do not use PPIs for more than one year. Talk to your doctor and ask for an alternative prescription drug.
  • H2 receptor blockers are a group of drugs that work like PPIs. But these drugs have an excellent safety profile. They are excellent for long term use and do not cause side effects as are with long term PPI use.
  • You can eat digestive enzyme supplements. These supplements help reduce the need for stomach acid. This way you produce less stomach acid. You can get these supplements from any pharmacy or an online health supplement vendor.
  • Mix in a teaspoon of apple cider vinegar in a glass of water. Also add honey to your taste. Drinking one glass before or during meals can help reduce stomach acid production.
  • Eat less protein. Protein rich diet stimulates stomach acid.
  • Do not eat fatty foods. Fatty foods make your stomach movements sluggish. The longer food stays in your stomach, the more acid your stomach releases to digest it.
  • Do not drink a lot of water with your meals. This stimulates your stomach to secrete more acid.
  • Eat more fruits and vegetables. These give you a feeling of fullness without increasing stomach acid.
  • Avoid overeating as it stimulates acid production. Instead of eating two or three heavy meals, eat five or six smaller meals every day.

PPIs are like magic pills, but they have a downside, too. Despite their wide usage, their safety profile is questionable. Sooner or later, you will develop complications related to PPIs. You need to decrease your reliance on these drugs. Adopt a healthy lifestyle and try cutting down on these drugs. That is the only way you can avoid long term complications of these drugs.


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