Acid reflux disease is a condition where the stomach acid flows backward into the esophagus, causing heartburn or regurgitation (a sour or bitter-tasting acid in the throat or mouth). Over-the-counter medications to treat acid reflux include antacids, H2-receptor blockers and proton pump inhibitors. A recent article in the New York Times Ask Well blog addresses potential side affects associated with long-term use of acid reflux medications.
According to Dr. Shoshana J. Herzig of Harvard Medical School, PPIs such as Nexium, Prilosec and Prevacid may carry serious side effects and “are not the benign drugs the public thinks they are,” NYT reports. The U.S. Food and Drug Administration (FDA) has warned about the long-term use of PPIs numerous times over the past five years. The agency cautions that using these drugs for a year or more can increase the risk of hip, wrist and spine fractures. Some studies have shown that bone fractures can occur in even less time. Additionally, using PPIs long-term can result in low levels of magnesium in the blood, potentially leading to seizures, arrhythmia and muscle spasms. This magnesium deficiency may not always be fixed with supplements.
Using PPIs long-term is also linked to a rise in intestinal infections and a higher risk of Clostridium difficile-associated diarrhea, which can be fatal. According to an FDA advisory, patients taking these medications should contact their health care provider immediately if they develop persistent diarrhea.
According to Dr. Herzig, research indicates a higher risk of pneumonia in hospital patients taking PPIs compared to those taking H2-receptor blockers (such as Pepcid or Zantac). Taking PPIs for a long period of time may also impair the absorption of other non-magnesium nutrients, such as calcium, iron and vitamin B12.
It’s also important for patients taking PPIs to be aware of any drug interactions. The FDA has warned, for example, that Prilosec (omeprazole) can reduce the effectiveness of Plavix, an anti-clotting drug.
The risks of the aforementioned side effects is less likely when taking antacids (such as Tums, Rolaids, Pepto-Bismol or Milk of Magnesia) occasionally to alleviate heartburn. The side effects of H2 blockers include headaches, constipation and nausea, but the long-term effects is not as well-studied as PPIs. “Certain people with conditions like Barrett’s esophagus should be on long-term acid suppression,” Dr. Herzig said, referring mostly to P.P.I.s, according to NYT. “but the majority of people with heartburn and reflux should not be on these drugs long-term.”