Stomach acid-reducing drugs may raise risk of future allergies

[helvella]

I really don't feel the need to say much as an introduction after all the PPI posts here.

However, I shall take one sentence from the paper: We report an epidemiologic relationship between gastric acid-suppression and development of allergic symptoms.

And then suggest, while PPIs might have their own set of effects, if we take that at face value, it shouldn't matter WHY there is gastric acid-suppression. The same effects could well be expected due to hypochlorhydria however caused. Including hypothyroidism.

Stomach acid-reducing drugs may raise risk of future allergies – study

Lead scientist hopes findings raise awareness about proton-pump inhibitors’ side-effects

Prescription medicines to reduce stomach acid are associated with an increased risk of developing allergies, according to a study.

The research suggests people prescribed proton-pump inhibitors (PPIs) are twice as likely to be prescribed anti-allergy drugs in future years.

Scientists examined data from the health records of more than 8 million people in Austria – 97% of the population – over a four-year period.

“Previously there have been mouse studies, cellular studies and clinical observations, but this is the last brick in the whole picture,” said the study lead, Prof Erika Jensen-Jarolim, from the Medical University of Vienna.

The research, published in the journal Nature Communications, found the risks were especially heightened in women and people over 60.

Most healthy immune systems can tolerate the substances found in foods and the environment, but they can sometimes become hypersensitive, which causes allergies. Part of the initial digestion process involves stomach acid breaking down the protein molecules present in food into smaller pieces.

Patients with conditions such as gastric ulcers may be prescribed medicine to reduce the acidity in the stomach to relieve unpleasant symptoms. In this case, the normal chemical reactions involved in digestion do not work as well, meaning larger protein molecules and other potentially harmful substances are able to pass through to the intestine. This can trigger an allergic response from the immune system.

The use of acid-reducing drugs is widespread. In some cases, patients are prescribed a course covering a number of months or even years, although Jensen-Jarolim’s study shows that a potential allergic response could be brought about in patients prescribed as little as six days’ worth of acid-reducing drugs a year.

Rest of article available here:

theguardian.com/science/201...

Country-wide medical records infer increased allergy risk of gastric acid inhibition

• Galateja Jordakieva,

• Michael Kundi,

• Eva Untersmayr,

• Isabella Pali-Schöll,

• Berthold Reichardt &

• Erika Jensen-Jarolim

Nature Communications volume 10, Article number: 3298 (2019)

Abstract

Gastric acid suppression promotes allergy in mechanistic animal experiments and observational human studies, but whether gastric acid inhibitors increase allergy incidence at a population level remains uncharacterized. Here we aim to assess the use of anti-allergic medication following prescription of gastric acid inhibitors. We analyze data from health insurance records covering 97% of Austrian population between 2009 and 2013 on prescriptions of gastric acid inhibitors, anti-allergic drugs, or other commonly prescribed (lipid-modifying and antihypertensive) drugs as controls. Here we show that rate ratios for anti-allergic following gastric acid-inhibiting drug prescriptions are 1.96 (95%CI:1.95–1.97) and 3.07 (95%-CI:2.89–3.27) in an overall and regional Austrian dataset. These findings are more prominent in women and occur for all assessed gastric acid-inhibiting substances. Rate ratios increase from 1.47 (95%CI:1.45–1.49) in subjects<20 years, to 5.20 (95%-CI:5.15–5.25) in>60 year olds. We report an epidemiologic relationship between gastric acid-suppression and development of allergic symptoms.

Full paper freely available here:

nature.com/articles/s41467-...

[m7-cola]

Thank you for posting this. It highlights a separate reason I wouldn’t want to take PPi’s. I already knew it was contraindicated for hypos.

[Fruitandnutcase]

Worrying when you consider they are handed out willy-nilly at a lot of surgeries. Dare I say it - it’s almost a toss up which is most widely prescribed - statins or PPIs.

[TSH110]

Good point

[Zephyrbear]

I was prescribed these damned things (Omeprazole) when I was first diagnosed in 2004, before I knew any better... so I took them for a couple of months. A couple of years later I started getting episodes of becoming really itchy, accompanied by raised red areas (usually bilaterally) which would only be alleviated by taking Citerizine. I’ve been tested for all the usual allergies but all those came back clear. The really weird thing is that the itchiness has settled into a 3-day pattern where I only need the Citerizine every 3 days... Perhaps, you may have finally provided me with an answer. Thank you for posting this helvella.

[Nora-B]

Oh my goodness. That explains a lot.