Heartburn medications may cause more harm than good, study reveals

Heartburn
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It is something that most people experience during their lifetime, some more frequently than others - that uncomfortable feeling of heartburn. And a study released December 10, 2013 in the Journal of the American Medical Association reports that the use of common heartburn and ulcer medications is resulting in vitamin B12 deficiencies.

A number of lifestyle factors can contribute to heartburn — being overweight, excess stress, eating large portions or certain foods, drinking certain beverages and eating right before going to bed. Ulcers are often the result of infection by the bacteria Helicobacter pylori or long-term use of non-steroidal anti-inflammatory medications. Lifestyle factors also contribute to the risk of ulcers, including smoking, excess stress, consumption of caffeine or alcohol and eating an unhealthy diet.

When you swallow food or drink, a circular band of muscle around the bottom of the esophagus called the lower esophageal sphincter (LES) relaxes to allow food and drink to enter the stomach. Once the food or drink has passed to the stomach it tightens and closes again to keep stomach acid in the stomach. However, if the LES doesn't close properly or relaxes abnormally stomach acid can reflux into the esophagus causing the burning sensation known as heartburn.

To manage these symptoms individuals often take antacids or medications that reduce or block acid production. Previous studies associated the long term use of proton pump inhibitors — medications that block acid production — with an increased risk of hip, wrist and spine fractures, particularly among those 50 and older, and an increased risk of bacterial pneumonia.

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The most recent study from the Kaiser Permanente Division of Research adds to the growing list of concerns suggesting physicians should exercise caution in prescribing proton pump inhibitors and consumers should be cautious in taking over-the-counter antacids. Currently acid-suppressing medications are among the most commonly used pharmaceuticals in the United States, with about 15 million Americans using proton pump inhibitors during 2012.

The study authors analyzed the health records of almost 26,000 adults diagnosed with B12 deficiency during a 15-year period and compared them to over 184,000 adults without B12 deficiency during the same time period. The researchers determined that patients who took proton pump inhibitors for more than two years were 65 percent more likely to experience a B12 deficiency. Those taking histamine H2 antagonists (Zantac, Pepcid, Tagamet) also experienced an increased risk though less pronounced at 4.2 percent, compared to 3.2 percent of control patients.

For those who suffer from heartburn, fortunately a natural alternative exists in deglycyrrhizinated licorice root (DGL). Not only does DGL inhibit the adhesion of helicobacter pylori to the stomach, , it also soothes and helps repair the mucous lining that protects the stomach. , , Antioxidant flavonoids found in DGL work by helping to heal digestive tract cells, which produce the mucous lining that protects the stomach.

Chewing DGL before or between meals often helps prevent heartburn and it can also be taken after heartburn is experienced to alleviate symptoms. DGL has the glycyrrhizin removed to reduce the possibility of elevated blood pressure. The typical dosage is 380 to 400 mg per tablet.

Reference

  • Yu EW, Bauer SR, Bain PA, Bauer DC. Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies. Am J Med. 2011 Jun;124(6):519-26.
  • Eom CS, Jeon CY, Lim JW, Cho EG, Park SM, Lee KS. Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis. CMAJ.2011 Feb 22;183(3):310-9.
  • Wittschier N, Faller G, Hensel A. Aqueous extracts and polysaccharides from licorice roots (Glycyrrhiza glabra L.) inhibit adhesion of Helibacter pylori to human gastric mucosa. K Ethnopharmacol. 2009 Sep 7;125(2):218-23.
  • Wittschier N, Lengsfeld C, Vorthems S, et al. Large molecules as anti-adhesive compounds against pathogens. J Pharm Pharmocol. 2007 Jun;59(6):777-86.
  • Rees W, Rhodes J, Wright J, Stamford L, Bennett A. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol. 1979;14(5):605-7.
  • Dehpour AR, Zolfaghari ME, Samadian T, Vahedi Y. The protective effect of liquorice components and their derivatives against gastric ulcer induced by aspirin in rats. J Pharm Pharmacol. 1994 Feb;46(2):148-9.

Image by Dave Austria, used under Creative Commons License.

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