What to know about PPI’s as a treatment for gastrointestinal disorders
By: Dr Wright
Getting old is tough enough! Now we also have to worry about the use of some medications with unintended consequences that actually accelerate the aging process in ways that were unanticipated years ago when they were developed.
For patients suffering from heartburn, regurgitation, and GERD (gastroesophageal reflux disease), proton pump inhibitors (PPIs) have emerged as the treatment of choice. These medications (such as omeprazole, esomeprazole, lansoprazole, and pantoprazole) are taken by millions of Americans on a daily basis. The FDA approved the use of these medications for no more than eight weeks – check the package insert! Yet patients are on these medications for decades.
Risks of PPIs
My mother has been on a proton pump inhibitor for over twenty-five years. She is currently suffering from osteoporosis and the early stages of dementia. Last year, she had her first heart attack. Additionally, she battles chronic kidney disease which makes it impossible for her to maintain body sodium normally. She drinks a bottle of Gatorade everyday with added salt in order to maintain her sodium level in her blood. Luckily, she has been able to avoid dialysis!
All of her major medical problems have been associated with long-term use of proton pump inhibitor medications for her GERD: for those on proton pump inhibitors, dementia, chronic kidney disease and kidney failure have FOUR TIMES the risk of an average elderly patient. Osteoporosis begins earlier in life and is substantially higher risk because patients cannot absorb calcium as well. Vascular disease, including heart attacks and strokes, are also more prevalent by a ratio of 3:1.
Additionally, patients with gastroesophageal reflux disease have an increased risk of esophagus cancer and that risk is tripled with the use of proton pump inhibitors — a risk that is NOT mirrored with the use of other medications such as ranitidine, cimetidine, famotidine, the so-called “H2 blocker” class of medications.
Patients who are on proton pump inhibitors stand a substantial increase in the risk of infectious diarrhea. The normal function of the stomach acid is to kill germs that we encounter in our foods. Patients with suppressed acid secretion on an ongoing basis will end up having a significantly higher risk of diarrheal diseases, including C-difficile, Salmonella, and in other less developed countries, this can include very serious diseases such as cholera.
For patients who seem to be unable to change their lifestyle to the point of being able to wean off of proton pump inhibitors and who find H2 blockers to be ineffective, a surgical solution may be the way to go. Surgery has the advantage of correcting the underlying anatomical problem which leads to acid reflux and therefore restores the health of the stomach and normal digestion patterns, freeing the individual from proton pump inhibitors.
Dr. Wright has performed thousands of antireflux operations. Many of them are done as an outpatient procedure at Meridian Surgery Center. These operations have a low mortality rate and low likelihood of complications for most patients who are in otherwise reasonably good health. Dr. Wright is one of just a handful of surgeons in the United States who specialize in the Hill repair: this restores the normal function of the antireflux valve between the stomach and the esophagus by restoring normal anatomy, making that valve function just as God had created it with the ability to burp. These patients have good-to-excellent control of their acid reflux, come off their acid medications, and retain the ability to burp and vomit normally.
Most surgeons in the U.S. are performing an antireflux operation that has a great long-term record at preventing acid reflux. However, this operation (the Nissen fundoplication) contorts the normal anatomy and makes it difficult if not impossible to burp or vomit, which are normal functions of the stomach.
Learn more about procedures to help with GERD on our website.
Cascade Hernia & Surgical Solutions—We’re in network.
Call Dr. Wright’s office at Meridian Surgery Center in Puyallup, Washington for consultation if you feel that you would like to consider freedom from these long-term complications of proton pump inhibitors. Check us out at our website Cascade Hernia and Surgical Solutions. We’re in network with most major insurance plans.
Make an appointment for a consultation today. Call (253) 840-1999. Often, you can get an appointment on the next weekday. Learn more at www.cascadehernia.com. Stay connected with Cascade Hernia & Surgical Solutions: Follow us on Facebook.
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