Dangers Of Overusing Your Acidity Medicines

Acidity (heartburn) is a common problem, which has become a modern epidemic. Some people eat spicy food 'after' swallowing acidity medicines as if pre-empting the trouble. But is such overuse safe? What can go wrong?

Answer

• Using medicines called PPIs for chronic acidity-related problems is helpful and advisable.
• PPIs don't help in short-term acidity bouts.
• Overusing them for recurrent acidity issues can lead to very serious problems such as kidney and liver damage, heart disease, infections, memory loss, depression, bone fractures, some tumours, and poor nutrient absorption.

The Science

Stomach Acid

Every day, our stomach secretes about two litres of acid, which plays three important roles:

• Releasing nutrients from food for better absorption;
• Activating enzymes that break food proteins into smaller bits for digestion; and
• Killing pathogens in the food.

However:

• Excessive production of stomach acid can cause ulcers in the digestive tract.
• Another possibility is acid reflux, in which the gastric juice comes back into the food pipe (oesophagus).
• Acid reflux causes a burning sensation in the chest, which is called acidity (heartburn).
• Over the long term, repeated bouts of acid reflux damage the oesophagus causing Gastroesophageal Reflux Disease (GERD).

What Are Proton-Pump Inhibitors?

• The most prescribed medicines for acidity (heartburn) today are Proton Pump Inhibitors (PPIs).
• PPIs block an enzyme in the stomach walls that produces stomach acid.
• Lower acid levels reduce acidity symptoms. They also help heal stomach ulcers, GERD, and other disorders related to stomach acid.
• Commonly used PPIs are Omeprazole, Lansoprazole, Esomeprazole, Rabeprazole, and Pantoprazole. Which one do you use?
• The use of PPIs has exploded worldwide due to their excellent results in acidity-related problems.

Problems with Proton-Pump Inhibitors

There will be three types of problems with PPIs:

1. Side effects include abdominal pain, constipation, diarrhoea, flatulence, vomiting, and headache. However, the benefits outweigh the negatives in the case of PPIs.
2. Low acid secretion can hamper the three roles of stomach acid. Less acid reduces nutrient absorption; prevents proper digestion of proteins; and increases the risk of digestive system infections.
3. Long-term adverse effects of PPIs are slowly being found. They are: damage to the kidneys and liver, heart disease, infections in the lungs and digestive system, memory loss, depression, bone fractures, some tumours, and poor nutrient absorption. The research is still evolving and there is considerable debate about the additional risk versus the benefits.

While the problems of side effects and interactions with other medicines exist with all types of medications, PPIs face a major behavioural issue: Overuse.

Overuse Problems with PPIs

Many of the PPIs are available as Over-The-Counter (OTC) medicines. So they do not need a doctor's prescription in most parts of the world, including the USA.

In countries like India, people have a habit of self-prescription. Many are friendly neighbourhood experts who suggest some medicine to their friends or family members because it helped them. It is often noticed that a doctor prescribed a PPI for someone's acidity problem, and ten years later, the person still swallows the same tablet every time he gets an acidity spurt, without checking with a doctor. PPIs were not developed with this abuse in mind.

I have anecdotally heard from many doctors in India that patients swallow PPIs like 'peanuts' every day for years altogether. Such patients demonstrate dementia symptoms, an outcome corroborated by many studies. Beware!

Summary

Here is what you should know about using PPIs:

• Chronic or severe acidity problems: Use PPIs. However, once the problem is solved, stop them.
• Mild acidity bouts: Take simple antacids for short-term use. PPIs will not help, as they take a few days to ramp up their effect on acid secretion.
• Recurrent acidity problems: Lifestyle changes are far better than medicines, but I will write about them in another article.

This article is a shorter version of my article 'Do I Need To Worry About Acidity Medicines?' on my Health Sachet website. Its link is in the comments.

To my dismay, I found my own mother swallowing Omeprazole after every little spicy meal. I had to stop her and started her on aloe vera juice which is effective and safe. But more about that later.

I hope you are having a good day. Continuing the tradition, I will pick the word 'acidity' from this article and write a newsletter today. Tentatively, my topic will be 'Can Drinking Milk Help Relieve Acidity?'. See you tomorrow!