Long-term side-effects of popular medications routinely used for acid reflux

Q: I have been taking omeprazole for years, whenever I stop my heartburn returns. Is it harmful to take medications like omeprazole over a long period of time? Can I do anything to come off omeprazole?

Gastro-(O)Esophageal Reflux Disease (GERD)

GERD occurs when the mechanism (i.e. sphincter) at the lower end of the oesophagus (i.e. swallow tube) fails to prevent the back-flow of the stomach’s contents into the oesophagus . “Heartburn” is experienced because, unlike the stomach, the oesophagus does not have a protective mucosal barrier.

What is omeprazole?

Omeprazole belongs to a class of drugs called the proton pump inhibitors (PPIs). PPIs reduce the amount of hydrochloric acid secreted by glands (parietal cells) lining the stomach. Over the last 25 years PPIs are the most commonly prescribed medications used for the treatment of GERD and acid-related stomach conditions.

These medicines are generally safe and effective. The most commonly reported side effects are nausea, bloating, abdominal pain, diarrhea, headaches, oro-pharyngeal and esophageal candida. Less than 3% of patients taking PPIs report short-term-use-related side effects.

Most commonly used PPIs

• Omeprazole (Prilosec)
• Pantoprazole (Protonix)
• Lansoprazole (Prevacid)
• Esomeprazole (Nexium)
• Rabeprazole (AcipHex)
• Dexlansoprazole (Dexilant)

Cautionary notes regarding of the long-term use of PPIs

• Persons taking PPIs for 4 weeks or more may experience rebound acid hypersecretion approximately 14 days after stopping the PPI. This hypersecretion can last from days to weeks.
• Researchers at the University of London have shown that PPIs, when used in persons with untreated Helicobacter pylori, may increase their risk by more than 200% of developing stomach cancer.
• A Stanford University study has shown that PPIs can significantly increase one’s chances of a heart attack.
• The use of PPIs is a risk factor for the development of osteoporosis (thinning of the bones) and related fractures.
• The incidence of non-Alzheimer’s dementia is slightly increased.

o Other documented consequences of PPIs:
o Intestinal infections (C. difficile)
o Reduced magnesium, iron & vitamin B12 blood levels

o Pneumonia

Once endorsed by your healthcare provider/ doctor here is what you can do to stop the long-term use of a PPI:

Step 1- Eliminate foods that would make your GERD worse; as well as make the necessary lifestyle adjustments. A good start can be found here: GERD Diet: Foods to Eat and Avoid for Acid Reflux (healthline.com)

Step 2. Reduce your PPI dose over 4 weeks. If taking one PPI pill a day, reduce to one pill every other day. If taking two PPI pills a day, reduce to one pill a day for 2 weeks, then take one pill every other day for the next 2 weeks.

Step 3. One may use antacids (e.g. Dica) or H2 blockers (e.g. Pepcid) if your GERD symptoms return while reducing or after stopping your PPIs.

In parting, it should be noted, while PPIs have an important role in treating Helicobacter pylori infections, a range of stomach conditions and GERD, however, unnecessary long-term use should be avoided.

Author of the article’s contact Information: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.