Wed, Nov-01-17, 08:50
To Good Health!
Plan: IF Fung/LC Westman/Primal
More (really) Bad news for PPIs
I have received two special alerts about a new study linking PPIs and cancer.
Here is one.
Do Acid Surpressing Drugs Cause Cancer?
A new study suggests that long-term use of acid-suppressing drugs might pose a substantial risk for stomach cancer in patients treated for H. pylori.
Proton Pump Inhibitors (PPIs) are among the most popular drugs in the pharmacy. Physicians prescribe them to 15 million people every year for ulcers, acid reflux, heartburn and Barrett’s esophagus. They believe that powerful acid-suppressing drugs like esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) protect the digestive tract from cancer. But a new study suggests that people taking PPIs after being treated for a stomach infection called Helicobacter pylori are at higher, not lower, risk of stomach cancer (Gut, online, October 31, 2017).
Helicobacter Pylori, the Bug from Hell:
The gastroenterology community was slow to recognize that a spiral-shaped germ called Helicobacter pylori caused stomach ulcers and cancer. Dr. Barry Marshall was awarded the Nobel Prize in Physiology or Medicine for his discovery that Helicobacter pylori infection caused stomach ulcers.
The medical establishment was convinced that acid was the culprit behind ulcers. Spicy food and stress were thought to increase acid production and trigger ulcer formation. Antacids were the treatment of choice. The mantra was “no acid, no ulcer.” The loudest shouters pooh poohed Dr. Marshall’s research. Eventually, though, he and a colleague were able to prove that Helicobacter pylori was the real problem.
This is a nasty bacterium. It burrows into the tight junction between stomach mucosal cells where it makes an enzyme (protease) that destroys the mucus protecting our stomach lining. This can cause inflammation, irritation, indigestion, gastritis and ulceration. Untreated, it can lead to stomach cancer.
Eradicating Hel Is No Easy Matter:
Doctors often shorten Helicobacter pylori to H. pylori. We call it Hel. Getting rid of this bacterial infection in the stomach is challenging. Doctors use triple or even quadruple therapy with a variety of drugs. The American College of Gastroenterology recommends first-line treatment with the antibiotics clarithromycin, amoxicillin and metronidazole plus a proton pump inhibitor (American Journal of Gastroenterology, online, Jan. 10, 2017).
There are problems with this approach. First, it doesn’t always work to eradicate Hel. Second, even when antibiotics work to kill off this germ, the PPIs that are included in the regimen may cause more harm than good if taken for long periods of time. That’s the conclusion of a brand new study from Hong Kong.
Acid-Suppressing Drugs and Stomach Cancer:
The new research compared people taking PPIs long term to those taking other acid reducing drugs, such as cimetidine, famotidine or ranitidine. These histamine-2 receptor antagonists (H2RAs) are known respectively as Tagamet, Pepcid and Zantac. Such drugs also block acid formation, but not as strongly as PPIs.
The scientists found that even after H. pylori was successfully treated, long term users of PPIs were more than twice as likely to get stomach cancer. People who took PPIs daily for more than three years were eight times more likely to develop gastric cancer than people who never took these drugs. People who took H2RAs had no increased risk of stomach cancer.
Story continues at:
You could say the Graedons have not been fans of PPIs...starting with articles and section in a book they wrote over a decade ago. Good explanation of Dose Response to explain their concerns about this study.
Long-term PPI Use Tied to Doubled Risk for Gastric Cancer
Use of a proton-pump inhibitor (PPI) after Helicobacter pylori eradication more than doubles the risk for gastric cancer, according to a population-based study from Hong Kong.
The "clear dose-response and time-response" trend in PPI use and gastric cancer risk observed suggests the need for "caution when prescribing long-term PPIs to these patients even after successful eradication of H. pylori," write Wai Keung Leung, MBChB, MD, from Queen Mary Hospital, Hong Kong, and colleagues. The study was published online October 31 in Gut.
The researchers point out, however, that this was an observational study, which can't prove cause and effect.
The new results also conflict with a recently published, US Food and Drug Administration–mandated follow-up study conducted with pantoprazole, said David A. Johnson, MD, chief of gastroenterology at Eastern Virginia Medical School in Norfolk (Aliment Pharmacol Ther. 2016;43:73-82).
"No increased risk [for gastric cancer] was observed with prolonged PPI exposure," he said.
Dr Johnson, who was asked for comment, also stated that the study has a "geographic bias" because it is from Hong Kong and "specific risks for gastric cancer are well recognized in Asian patients."
In the new study, Dr Leung and colleagues partly focused on H pylori infection and its relationship with gastric cancer."
And if this study isn't bad enough...Mainly because so many people are put on PPIs for So Many Years, rather than the original short-term treatment of heartburn ... some other recent threads here link PPI use to:
A risk of Chronic Kidney Disease: http://forum.lowcarber.org/showthread.php?t=470502
An Increased Risk of Stroke: http://forum.lowcarber.org/showthread.php?t=475542
Last edited by JEY100 : Thu, Nov-02-17 at 03:10.