new negative ppi study

[mike1955]

New study published in all major UK papers this week,suggests increased risk of early death for ppi users ,study published in BMA OPEN JOURNAL.

[Hidden]

Thanks, Mike. There is another post about 'PPIs - getting the risk into perspective' that Gutlesswonder posted a couple of days ago, that has a discussion about what I presume would be the same study.

I think anyone from the OPA who has had an oesophagectomy and lost their lower oesophageal sphincter valve to keep any stomach acid in place is in a far different position than the people who took part in this study. There has been a lot of repeat prescribing of PPIs, which are very popular drugs, rather than properly diagnosing what the underlying problems are. All these medications have benefits and drawbacks, benefit from reviewing from time to time, and might have consequences for long term use that were not realised when they were first introduced.

[revdj in reply to Hidden]

Alan, would I be able to access that report on ppi's? Also, after having had the Heller Myotomy, Fundoplication & Balloon Dilation, acid started coming up from the stomach. Gaviscon didn't work, so I was put back on Rabeprazole to see if this would help. It has. Acid problem went away. Is the report you are referring to, saying that it is dangerous to be on something like Rabeprazole permanently? What would be the alternatives to Rabeprazole? I respect your opinion, as you have helped me in the past.

[haward]

There are dangers associated with PPIs. But for those of us who have had an oesophagectomy the danger of not using them may be far greater. I asked a surgeon about the issue at an OPA meeting and that was his opinion.

[kierank in reply to haward]

I had an oesophagectomy 2 years ago but I have seldom used PPIs . What are the risks ?

[Hidden]

I think this is the one that mike1955 was referring to, and indeed Gutless Wonder in his post about PPIs in Perspective.:

bmjopen.bmj.com/content/7/6...

The study was on US Veterans who comprise a very large database that is the basis of quite a lot of studies, but the number of them who have had oesophagectomies, or achalasia for that matter, must be very small within that study population. These are special factors that sometimes make taking PPIs absolutely necessary.

I do not know about Rabeprazole in particular, but these things are to do with benefits weighted against side effects. I do think that long term exposure to reflux is a fairly definite health risk even if it does not cause pain and discomfort, whereas this study may be a bit vague on the details of why people might die earlier after taking PPIs.

If you are worried, it may be worth consulting your doctor to see whether there may be alternatives to Rabeprazole. Sometimes H2 receptor antagonists like Zantac are also used to control acid reflux but I really do not know enough to be able to judge whether one might be better than the other. It may be that any medication that alters the bacteria within the gut will have long term effects, and it is normally prudent not to be too influenced by just one study. In any event, any individual patient has to have their own risks judged by a doctor familiar with their situation rather than being too influenced by these studies. It is one of the jobs of the doctors to try and put research like this into context for their individual patient.