Posts Tagged ‘gerd’

Heartburn drugs are pricey. An advertising blitz for the purple pill made it become the number 2 best selling prescription in the U.S. with sales of 6.3 billion last year. The pill is Nexium and its close cousin Prilosec has billions in sales also.

The Real Price

The real price is in the harm that these drugs cause. This is a category of heartburn drugs, called proton pump inhibitors. A series of new studies published in the Archives of Internal Medicine found that daily use of these suppress the production of stomach acid, increases the risk of infection with an intestinal bacterium. The hard to treat bacterium causes severe diarrhea and other medical problems, and can be life threatening if not properly treated.

The second problem with the drugs is that it increases the risk of fractures in postmenopausal women. Previous studies also showed an increase in the likelihood of contracting pneumonia.

The Unnecessary Use 

The unnecessary use of heartburn drugs is where the real price comes apparent. “About 60 to 70 percent of people taking these drugs have mild heartburn and shouldn’t be on them,” says Mitchell Katz, director of the San Francisco Department of Public Health who wrote an editorial that accompanied the new studies. “It’s not just a question of unnecessary costs, but unnecessary side effects.”

Where proton pump inhibitors do help, Mitchell Katz said is for the treatment of bleeding ulcers, infection with the ulcer-causing bacteria Helicobacter pylori, or management of a rare condition called Zollinger-Ellison syndrome, which causes the stomach to produce excess acid. It also may be warranted in cases of severe reflux, where an endoscopy reveals damage to the esophagus.

“Harm will result if these commonly used medications are prescribed for conditions for which there is no benefit, such as non-ulcer dyspepsia [heartburn],” Dr. Deborah Grady and Dr. Rita F. Redberg of UC San Francisco said in another editorial.  

 Managing Heartburn

Managing heartburn is easy; it just takes a willingness to make some changes. “There’s no question that these drugs will relieve indigestion and reflux,” says Katz, “but, beyond symptom relief, there’s no long-term benefit to taking them, while there are some long-term risks.” There is a 74 percent increase in risk of infection with harmful intestinal bacteria and a 25 percent increase in the risk of fractures in postmenopausal women.

The ads are costly to the audience, because they become convinced that relief is in a pill. There are many ways to manage heartburn. Understanding the problem is the first step to managing it.

Drugs Wrong Treatment

“A staggering 113.4 million prescriptions for proton pump inhibitors are filled each year, making this class of drugs, at $13.9 billion in sales, the third highest seller in the United States,” writes Mitchell H. Katz, M.D. of the San Francisco Department of Health. These medications treat inflammation of the esophagus, gastroesophageal reflux disease (GERD), ulcers, and some other conditions. Evidence suggests that between 53 percent and 69 percent of proton pump inhibitor prescriptions are for inappropriate indications, he notes.

There is a misconception that too much stomach acid is the cause of heartburn. The acid is what breaks down and digests our food. Stomach acid declines with age. Younger people have lots of stomach acid. Yet, they hardly ever complain of heartburn. The reason is they usually do not have heartburn.

Older people that have heartburn often have low levels of acid. The medication to eliminate the little acid left makes no sense.

Here are ways to optimize digestion, because that is part of the problem.

Drinking a glass or two of water before each meal can provide enough liquid to help absorption of nutrients from the meal.

Eating vegetables marinated in vinegar as an appetizer can help increase the acidity of the stomach.

Chewing food well makes for smaller pieces and mixes the food with your saliva that is filled with digestive enzymes.

Get tested before downing antacids, they may be the wrong solution.

An aspirin a day is cause for concern for a few reasons.

People who take aspirin regularly for a year or more may be at an increased risk of developing Crohn’s disease, according to a new study by the University of East Anglia (UEA).The study led by Dr. Andrew Hart of UEA’s School of Medicine.

An Aspirin Is A Drug

Aspirins are so common that they are thought of a benign addition to a health plan. I am surprised that they are not included as a food group.

Aspirin is in a group of drugs called salicylates. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body.

As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis, and other musculoskeletal conditions. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition.

Aspirin Crohn’s Disease Connection

There seems to be an aspirin Crohn’s disease connection. Crohn’s disease is characterized by inflammation and swelling by parts of the digestive system. It can put patients at risk for bowel cancer. There is some research that has shown that aspirin can have a harmful effect on the bowel. To investigate this potential link further, the UEA team followed 200,000 volunteers aged 30-74 in the Uk, Sweden, Denmark, Germany and Italy. The volunteers had been recruited for the EPIC study (European Prospective Investigation into Cancer and Nutrition) between 1993 and 1997.

The volunteers were all initially well, but by 2004 a small number had developed Crohn’s disease. When looking for differences in aspirin use between those who developed the disease, the researches discovered that those who took aspirin on a regular basis for a year or more were about five times more likely to develop Crohn’s disease.

Aspirin Causes Numerous Problems

Regular daily aspirin use has been linked to an increase in macular degeneration, a condition that causes blindness in older people. The long term use of aspirin this means 10 years or longer in associated with a 44% increase in a disabling form of cataracts, known as posterior subcapsular cataracts.

The North American Society for Pediatric Gastroenterology found that GERD was a growing problem in children, especially teenagers. NSAIDS, which include aspirin, showed up as one of the primary factors leading to reflux problems. Half of those with GERD problems, also reported a higher incidence of Asthma symptoms. Acid reflux can trigger attacks that mimic Asthma.

Researchers at Tel Aviv Medical Center found that daily aspirin, in doses of 75 – 325 mg could have a significant adverse effect on renal (kidney) function in elderly adults. After only two weeks in a study of 100 elderly patients were placed on daily aspirin, researchers began to document decreased kidney function. In 72% of the patients, the urinary excretion of creatinine decreased and in 65% of the patients, uric acid excretion decreased. Both decreases are known signs of kidney impairment. After the aspirin was discontinued in these patients, kidney function began to improve but 48% of the patients experienced some residual impairment as much as three weeks later.

Taking aspirin has been associated with increased loss of vitamin C in urine and has been linked to depletion of vitamin C.

Aspirin

Aspirins are at best a short term solution for an acute problem. When taken for a chronic condition they are not a long term solution. Aspirins are not something you pop in your mouth for a health condition. They aren’t a substitute for a sound lifestyle; just because they give immediate relief doesn’t mean they solved the problem. On the contrary they could be the long term problem.