How safe are heartburn medications and who should use them?

How safe are heartburn medications and who should use them?

Many people suffer regularly from heartburn - a burning feeling in the chest caused by stomach acid travelling up the food pipe (oesophagus) after eating. This causes inflammation and irritation of the lower oesophagus, and also ulcers. The most commonly prescribed medications to treat what is known as gastro-oesphageal reflux disease, are “proton pump inhibitors”.

Proton pump inhibitors (known in Australia by names such as Nexium, Pariet, Losec, Somac and Zoton) work by preventing key pumps in the cells of the stomach that produce stomach acid from working. In stopping the production of stomach acid they help to reduce the inflammation and heal ulcers caused by the stomach acid.

Often people on these medications will take them for years. But recent reports of dangerous side effects and even early death have led some to question whether this is the right medication for them.

Vincent Ho, Lecturer and clinical academic gastroenterologist, Western Sydney University, examines how effective and safe these medications are and how they should be used: theconversation.com/how-saf...

For those of us with anaemia, particularly if we have trouble maintaining adequate vitamin B12 serum levels, note particularly that 'Proton pump inhibitor use can also lead to vitamin B12 deficiency. This is unlikely to affect your health provided the detected low vitamin B12 levels are corrected.' Some of us lacking Intrinsic Factor en.wikipedia.org/wiki/Intri... may need vitamin B12 injections, as a B12 supplement will not be absorbed.

Neil

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Greetings Neil... I have hiatus hernia and was on pariet for many years, until I heard adverse reports re PPIs. I now only take one very rarely, usually if woken in the night with an attacK of heartburn. I suck on a mylanta othertimes!! vitamin b 12 levels are good.

Sheila

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Thanks -- I also had a hiatal hernia, but I gave up on the PPI's after hearing some of the suspected side effects, and find that calcium carbonate + magnesium hydroxide chewables (Rolaids, here in the US) work pretty well for me. I typically chew a couple just before bedtime.

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Thanks for posting this article stating that up to 70% may be prescribed inappropriately and long term use is not routinely monitored and re-evaluated.

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As I have posted a number of times, I find that eating one to two forkfuls of kimchee or sauerkraut immediately alleviates heartburn. Delicious cure with no meds and no troublesome side effects.

Friends who get heartburn from drinking their morning coffee love being able to get their caffeine fix once they know a little kimchee chaser keeps them comfortable.

I don't know if it works for a hiatal hernia, but it sure helps regular heartburn. Kimchee got me through the months that imbruvica was causing discomfort.

Worth a try?

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CLL patients should be tested for H.pylori... its often overlooked.

Previously on HU

healthunlocked.com/cllsuppo...

NIH

cancer.gov/about-cancer/cau...

~chris

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Many years ago I was prescribed Lansoprazole (a proton pump inhibitor) for severe oesophagitis. It worked very well, but whenever I tried to stop taking it, the oesophagitis came back. So my GP said I should continue longterm with the Lansoprazole..

However, after a few years I developed a sun sensitivity, which is a rare side effect of Lansoprazole. I didn’t know that at first, and for a long time I had to avoid any sunshine, even dappled sunshine, which was extremely limiting on my lifestyle. (I love hill-walking).

It was a great relief when a dermatologist (whom I saw about a wart) said that Lansoprazole could cause sun sensitivity and suggested I stop it. At last, an answer! A week or so after I’d stopped it, I was able to go walking in the sun again.. . What bliss! However, I had to take LOTS of Gaviscon to treat the heartburn that came back with a vengence.

I also had a probable Vitamin B12 deficiency at that time, though I was never tested for this so I cannot be sure. However, I was getting depressed every evening for no apparent reason (very unlike me), and when I took Vit B12 tablets, that daily depression soon lifted. It was a dramatic change!

Because of my continuing problem with stomach acid, my GP then suggested I try Ranitidine, which is NOT a proton pump inhibitor but also inhibits acid production.). I’ve been taking Ranitidine for several years now, and it has worked very well (with no side effects that I’m aware of).

Juliette02 and SeymourB posted about this a few weeks ago.

healthunlocked.com/cllsuppo...

As Seymour pointed out, Ranitidine needs more careful timing, to be taken before meals rather than just once daily (like Lansoprazole). This can be inconvenient, but for me, the change has been well worth it.

So, for those of us who have longterm problems with stomach acid, I think it’s worth considering Ranitidine instead of proton pump inhibitors like Lansoprazole or Omeprazole. (Lansoprazole and Omeprazole seem to be the most commonly prescribed PPIs in the UK).

Paula

P.S. I love the photo, Neil. So atmospheric...

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Due to the valve between my stomach and oesophagus not working, I have endured gastric reflux for many years. I did not even know I had it and thought the sensations and pain I experienced, mostly but not entirely, at night were due to panic attacks and anxiety. Visits to the doctor initially led to misdiagnosis and led to me being put on anti-depressants! It was not until a very severe attack when my mother was dying that I had a gastro-endoscopy that identified the problem. Then I was prescribed Omeprazole and Ranitidine. That was 2012. Research showed me even then it was not good to be on these things long term.

It was not until a couple of years ago that a chance conversation with a friend informed me that it was possible to have surgery to repair the valve, an option never told to me by the GP. With long NHS waiting lists and following repeated coercion of my GP, I was referred in April 2016, had some further tests done to measure the actual acid reflux and saw the consultant about it.

Against their advice, I have flatly refused to take PPI's and am insisting on referral for surgery. However all this has been complicated by my having to have FCR from February! While this is now thankfully finished, I am not yet sure how long it will be before I can be considered for surgery.

Holly

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