Long Term Consequences of PPIs
When it comes to treating chronic heartburn and gastroesophageal reflux disease (GERD) there are only a few options that stand apart from the rest. Dr. John Bagnato, your GERD surgeon, typically recommends fundoplication or TIF in cases of severe esophageal damage from chronic and frequent acid reflux. However, if you are not seeing a reflux specialist for your heartburn, then you may find yourself prescribed the long term use of proton pump inhibitors or PPIs.
PPIs are a class of medication that prevents stomach acid from being released during digestion, thereby preventing the occurrence of acid reflux and heartburn. For PPIs to work effectively, they must be taken regularly as a form of preventative treatment. As they only prevent acid from being dispersed and do not correct the dysfunctional valve that is permitting the acid to wash into the esophagus, the reflux returns when they are discontinued.
Treatment for GERD
The production of stomach acid isn’t necessarily the problem that prompts GERD. Stomach acid is valuable during the digestion process, and while it’s damaging when it escapes from the stomach, preventing its production altogether is counterproductive in certain aspects. Though the acid should not leave the stomach, it’s doing that routinely in GERD patients.
To correct GERD and successfully prevent future bouts of chronic reflux and heartburn, the lower esophageal sphincter (LES) needs to be repaired. The LES separates the esophagus from the stomach, opening to allow food to travel further along the digestive system. When the LES is dysfunctional, digestive juices escape and travel upwards into the esophagus as food travels down.
There are non-invasive surgical techniques that can repair the LES without requiring a single incision, alleviating the cause of GERD and providing patients with heartburn relief without mandating long term medication. Unfortunately, since only an experienced GERD surgeon can perform these types of procedures, too many patients receive PPIs from their primary care physician and cope for years with the side effects of the medication without realizing there is an easier and more effective treatment option available.
The Problems with PPIs
PPIs are the third-highest class of prescription medications in the United States, which points to how many people are relying on their use for heartburn relief. However, a lot of people don’t realize that using PPIs for an extended period of time is linked to health conditions like anemia, increased risk of fracture and pneumonia.
PPIs can prevent the proper absorption of nutrients into the blood stream, including magnesium, calcium, iron and vitamin B12. When PPIs are combined with other popular medications like anticlotting agents, your heart health can potentially be compromised as well. The use of PPIs is also linked with weight gain, which is an added concern as excess pressure on the stomach can increase your likelihood of experiencing acid reflux in the first place.
The recommended duration for taking PPIs is eight to 12 weeks, but a lot of patients continue their use for years without so much as a warning from their primary care doctor about the potential hazards of the medication. Research indicates that once you are taking PPIs for an extended period of time, it is hard to stop using them.