The problem of chronic heartburn is common. In fact, tens of millions of Americans – and even more worldwide – suffer from a condition, known as gastroesophageal reflux disease or “GERD.”
For about 30 years now, reflux disease sufferers have relied on Proton Pump Inhibitors (PPI) to provide relief to the painful burning sensation in their esophagus. In 2013 alone, more than 15 million Americans used prescription PPIs like Prilosec® and Nexium®, and spent a combined $10 Billion purchasing the drugs at retailers across the U.S. Such numbers are great for the manufacturers of common, over-the-counter heartburn drugs, but may not be so great for patients.
As it turns out, using PPIs may not be worth the risk for the everyday case of heartburn. A recent study published in The Journal of the American Medical Association (JAMA) found "mounting observational evidence" that PPIs may be damaging to the kidneys, increasing the risk of conditions such as chronic kidney disease (CKD) and acute kidney injury (AKI) by up to 20-50 percent.
Those aren’t small numbers.
PPIs and the Risk Associated with Using Them
The JAMA study investigated 2 separate groups of PPI users. One group of 16,900 patients in the Geiringer Health System in Pennsylvania experienced a 15.6 percent increased risk of kidney disease over 10 years. This was surprising to doctors who had previously expected that, at most, only 13.9 percent would have been at an elevated risk.
Another study group, composed of 322 PPI users experienced a risk elevation of 11.8 percent when doctors only expected an increase of 8.5 percent. The study goes on to suggest that PPIs may increase the annual number of kidney disease cases from 10.7 cases per 1,000 people to 14.2 per 1,000 people. Considering that over 15 million people used the drug in a single year, simple math tells us that PPIs could be potentially contributing to roughly 60,000 cases of chronic kidney disease annually.
While the results remain inconclusive, researchers emphasize that their findings could spell trouble for long-term users of over-the-counter heartburn meds. Professionals throughout the medical community suggest that patients limit their use of PPIs to reduce the chances of kidney damage along with other possible side effects. Previous studies suggest that PPIs increase the chances of broken bones, heart attacks, and a damaged immune system, which can spur serious illnesses like pneumonia.
The study in JAMA points out that PPI users are statistically likely to be clinically obese and on hypertension medication. This combination of health risks can make PPIs even more dangerous. On a more positive note, medical professionals point out that many patients don't actually need PPIs – neither over-the-counter nor prescription varieties.
Instead, doctors encourage patients to first try dietary changes such eating less-acidic food (berries, chocolate, and caffeine), drinking less alcohol, and making time for more frequent exercise. If these lifestyle changes work, patients can not only reduce their health risks, but also save money at the pharmacy.
Which Heartburn Meds Should You Keep an Eye on?
The list isn’t yet exhaustive, but regular users of the following PPIs should start paying attention as the study further develops:
- Prilosec®
- Nexium®
- Protonix®
- Prevacid®
