First we get good news on PPI safety and bone density then today in the Daily Mail there is an article warning that PPIs could raise the risk of a Heart Attack .While reading this article I felt the research seemed a bit flawed and the UK Medicines Watchdog said the study did not prove that PPIs were to blame.
I had my Oesophagectomy 9 years ago and a few days ago I discussed my PPI medication with my surgeon before I read about this article
He assured me that this medication is very safe and very well tolerated and as been prescribed for nearly 30 years. Some of his own patients have been on it for over 20 years without any problems. I personally will continue to take this drug as I feel its does me more good than harm.
Phil
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phil
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i wonder if you could advise me, I have taken Diclofenac for about 20 years without any problems, my gp told me he couldnt prescribe it anymore as it had been withdrawn due to heart risks and put me on Naproxen which has damaged my stomach lining despite taking omeprazole along side it, I live in North Wales but people on the Pain forum still seem to get it prescribed, is it a cost thing? any comments would be useful
Whereas PPIs have been associated with increased risk of cardiac problems in patients with a prior cardiac event and treated with an antiplatelet agent (including aspirin) the research extends an increased risk to to the general population of patients treated with PPIs. The authors list the limitations of this study and state that the reslts should not change clinical practice and that further more definitive studies should be conducted Having looked at the paper I'm not going to stop taking my medication but I'll bear this in mind. I'm sure it will stimulate further research and we'll get a clearer picture at some time in the future. For those with a scientific interest, the paper is available as open access here
In the past I have expressed a concern about continuous use off ppi's specifically for those of us with significantly reduced stomachs. Ppi's are mostly taken by people with normal stomachs who suffer from heartburn or have been diagnosed with Barrets, we are in the minority. I am five years plus since my op and do not claim any specialist knowledge but found it difficult to get a straight answers from specialists as to what dosage I should take. So six months ago I stopped taking my omeprazole, I adjusted my eating habits with a bit of trial and error and now I rarely experience reflux. Usually when I break my own rules. I am not suggesting that everybody stops taking ppi's but it may be wise to review the situation now and again to see if they are really necessary.
I know a number of people who have experimented with leaving off PPIs and have managed this OK; but equally there are some who find that they really need them. If you have very little stomach, then probably it will generate little acid.
Omeprazole was quite expensive but is not cheap as it has recently come off patent, I believe. It is prescribed to reduce acidity / irritation to the stomach lining but there may be other ways of achieving this. I do not know anything about Diclofenac but probably any medication that you take for 20 years might lose effectiveness or have to be changed. It is a non-medical guess, but I imagine that the priority is to sort out the pain relief and then adjust the other medication to deal with the effects on the stomach as a side issue that probably needs adjustment with trail and error.
I was never told to take a PPI until I went to see the surgeon whom my chemotherapy recommended me to which was 4 hours away from his office as he is a Thoracic surgeon and I was placed on the Thoracic story of this hospital as our small town does not have a Thoracic surgeon incredible general surgeons but not many that could perform a minimally invasive surgery to remove the tumor. When I met the surgeon and had already consulted with one in our small area the Thoracic surgeon told me to start taking a PPI! I take what we call here in the states the purple pill which is called Nexium my first prescription I paid for was $200.00 us dollars then the patent was up the 3rd time I refilled it so can buy it now for around 35.00 us. anywhere without a prescription. I wish someone would have told me earlier in my life to take an antacid! Just suffered through heart burn and started almost 22 years ago when I was pregnant with my daughter! Had to eat before 5 p.m. everyday to go to bed by 9:00 or else I would have not eaten a thing. It continued silently for years??? Whom would have known? Quality of life is what it is all about. I get to turn 51 this week, have neuropathy, a lot of pain on the right hand side of my neck, trapezoid but I am 6 feet above ground! Going to Disneyland with all of our adult children and our one grandson just turned 6 a month ago and has never been! Life is good!
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Hiatal Hernia & Gerd now worse due to SIBO (small intestine bacterial overgrowth)
Gastrits no ulcer no erosion 
Omeprazole rebound
Managing bile - again 
