Thursday, November 16, 2017

Got heartburn? Long-term use of proton pump inhibitors appears to raise risk of stomach cancer – explore alternatives!

Heartburn and gastro-esophageal reflux disease (GERD) describe a common group of symptoms that lead to more serious problems.  One of the most common treatment approaches is to suppress the stomach acid with drugs, typically proton pump inhibitors (PPIs) such as omeprazole and many others.  While these drugs do not stop the abnormal sloshing of stomach fluids into the esophagus where they don’t belong, they can certainly reduce the discomfort and help prevent some of the complications of GERD. However, there is increasing evidence that PPIs can have serious side effects, as well.  A 2017 study published in the journal Gut followed 63,000 patients over an average of 7.6 years, and found that chronic use of PPIs significantly increased stomach cancer risk, and the risk increased the longer patients were on the medications. [1]
My recommendation:
For patients with heartburn, I try to prescribe acid reducing drugs for as brief a time as possible, and take time to discuss the many evidence-based alternatives for treating GERD without medication, including vigorous lifestyle changes.  80-90% of GERD sufferers who overweight are able to eliminate or reduce their reflux drugs just by losing 10% of their body weight. [2]  To create a personalized action plan see pages 59-92 in Good Food, Great Medicine (3rd edition).  For additional GERD-fighting suggestions see our January 2017 newsletter.
Miles Hassell MD