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  #1   ^
Old Wed, Nov-01-17, 09:50
JEY100's Avatar
JEY100 JEY100 is online now
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Default 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:

An Increased Risk of Stroke:

Last edited by JEY100 : Thu, Nov-02-17 at 04:10.
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  #2   ^
Old Wed, Nov-01-17, 10:56
Ms Arielle's Avatar
Ms Arielle Ms Arielle is online now
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Thanks for posting.

As there are many reasons for acid stomach issues, finding the right solution can be trial and error. But worth the effort IMO.

My step father acquired esophageal cancer due to acid reflux. After treatment his life was sitting in a comfy chair for 5 years. NOT FOR ME.

Eating the right foods can help USE the naturally occurring acids designed to chop up our foods, keep the valves (the psyphintors, spelled totally wrong) working properly to prevent reflux, etc.

Stress management is also critical. I lived on tums/breads all thru my high school years.... never ending stomachaches stressing over grades, 92 not good enough in my mind, and difficult home life.

H.pylori can be controlled by many fermented foods, so I have read. Always trying to increase fermented foods in our diets here at home. Trying to point out there is more than drug only options to a healthy GI. Certainly antibiotics are beneficial, I dont want to convey otherwise; rather trying to say support the GI before H.pylori and other "bad bugs" take hold and do damage.

Sorry . Im not the best poster.....
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  #3   ^
Old Wed, Nov-01-17, 15:08
JLx's Avatar
JLx JLx is offline
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Can't remember where I read it, or heard it, but the gist was that apple cider vinegar before a meal is helpful for acid reflux. Some people said after years of taking this or that, ACV did the job in no time. And yes, it seems counterintuitive. I rarely have heartburn anymore, but if I did, I would try it.
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  #4   ^
Old Wed, Nov-01-17, 17:11
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GRB5111 GRB5111 is offline
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The reason ACV is supposed to provide relief is that it is less acidic than the stomach's acid, so it raises the pH in the environment. This reasoning seemed plausible to me, but I haven't confirmed it. I used to take PPIs, but haven't taken them in about 4 years. It's a good thing to stay away from, and they seem to be prescribed as much if not more than statins nowadays.
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  #5   ^
Old Thu, Nov-02-17, 04:09
JEY100's Avatar
JEY100 JEY100 is online now
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Back home to edit...added first part of the Health Alert above.

But the second part also addresses esophageal cancer, with links to their previous articles.

What About Acid-Suppressing Drugs and the Esophagus?
Most gastroenterologists believe that PPIs are absolutely essential in preventing pre-cancerous changes in the esophagus (Barrett’s esophagus) from turning into esophageal cancer. They may well be right. But there are some confusing and conflicting data. You may find our prior article on this topic of interest:

Will PPIs Protect You From Esophageal Cancer?

There is also this:

Do Acid Suppressing Drugs Protect Against Cancer or Increase the Risk?

The People’s Pharmacy Perspective on Acid-Suppressing Drugs:
PPIs are very helpful for curing stomach ulcers. A strong acid environment can wreak havoc on a lesion in the wall of the stomach that has been triggered by pain relievers like aspirin, ibuprofen or naproxen. With luck, the ulcer should heal within a few weeks.

Long-term use of PPIs for garden-variety heartburn worries us. It’s not just the cancer controversy. PPIs have been associated with a number of serious side effects including heart attacks, strokes, kidney damage, dementia, weakened bones, fractures and infections. We agree with the Hong Kong investigators who urge their colleagues to exercise caution in prescribing PPIs long term.

Will PPIs Protect You From Esophageal Cancer?
Many people take PPIs like omeprazole for heartburn. Others have been diagnosed with Barrett's esophagus. Will PPIs block conversion to esophageal cancer?
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  #6   ^
Old Thu, Nov-02-17, 13:21
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Nancy LC Nancy LC is offline
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I suspect reflux has a lot to do with food intolerances.
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