A study from the May 27 issue of the Journal of the American Medical Association (JAMA):
Acid-Suppressive Medication Use and the Risk for Hospital-Acquired Pneumonia
Found a 30% increased risk for pneumonia among hospital patients taking acid-suppressing medications, specifically proton-pump inhibitors (PPIs).
This was a big study. It analyzed data from 63,878 hospital admissions. The number of variables for which it controlled (which could confound the association) - was staggering. They included:
- Season of the year of admission
- Day of the week of admission
- Admitting service
- Admission type
- Length of hospitalization
- A slew of co-prescribed medications (e.g. Sedatives, NSAIDS, steroids, anticoagulants)
- A slew of comorbidities (e.g. Heart diseases, chronic lung diseases, kidney diseases, diabetes, alcohol/drug use)
1. Stomach acid kills bacteria and other microorganisms that cause infection. Changes in the mix of bacteria in the stomach and GI tract impose changes in the mix of bacteria in the respiratory tract, leading to respiratory infection.
2. PPIs such as Prilosec have been shown to inhibit the ability of white blood cells to disable infectious cells, both in the test tube (in vitro) and in the human (in vivo). Here's just one study:
Omeprazole Inhibits Natural Killer Cell Functions, Digestive Diseases and Sciences, 2007
"Omeprazole [Prilosec] significantly reduces natural killer cell functions. This finding suggests that omeprazole may also have some effects on the other systems in addition to parietal cell acid secretion."Long-term Adverse Effects
PPIs are only indicated for short-term use, 3 or 4 weeks. For those with erosion in the lower esophagus, the time is extended to a few months to encourage healing. They're not indicated for long-term use. Nonetheless, people use them on a long-term basis - for several years.
Long-term adverse effects are accumulating in studies:
- Hip fracture and osteoporosis. Stomach acid is needed to absorb calcium and other nutrients. Lack of acid may also interfere with bone formation.
- Reduced levels of vitamin B12. Stomach acid is needed to free B12 that is bound to protein in food. B12 is required for nerve function. A depletion leads to nerve-related disorders. Deficiency also causes reduced red and white blood cell counts, leading to anemia and inability to fight infection.
I ask myself (your input is welcome):
- Why do so many people have heartburn? (Acid-suppressors are one of the top-selling drugs in the world.)
- Why are over half of hospital admissions (in this study 52% of 63,878 admissions) receiving acid-reducing meds, especially when conditions don't warrant ("inappropriate prescribing practices in the inpatient setting")?
- Why are so many people taking these meds for longer than 3 or 4 weeks, the period indicated by the manufacturer?
- Are most people aware of the risks?
- And ... if not an acid-suppressor, what? What do people use, or do, as an alternative?
"It therefore seems unlikely that the benefit of these medications for gastrointestinal bleed prophylaxis would offset the risk."The tactics used by pharmaceutical companies to promote drugs that have not been adequately tested, and to market drugs for conditions for which the drug is not indicated - tactics that I outlined in my post, Corrupted Research - seem to be at play here.