The People's Perspective on Medicine

Hip Fractures Linked to Heartburn Drugs

Q. I have just read that powerful acid-suppressing drugs are linked to hip fractures. My doctor wants me to stay on Prevacid even though I have expressed my concerns to him. When I told him what I had read about the dangers of proton pump inhibitors (PPIs), he said, “Don’t read so much.” I wish HE would read more!

A. The hazards of long-term use of PPIs such as esomeprazole (Nexium)
, lansoprazole (Prevacid), omeprazole (Prilosec)
, pantoprazole (Protonix)
 and rabeprazole (Aciphex) have gradually become clearer. Data from nearly 80,000 women in the Nurses’ Health Study show that women who took PPIs were 30 to 35 percent more likely to fracture a hip during eight years of follow-up (BMJ, online, Jan. 31, 2012).

This can be devastating, particularly for older people. As one reader reported, “My mother took a PPI and then had a hip fracture. She died 19 days later.”

There are other drawbacks to long-term PPI use, such as susceptibility to infectious diarrhea, pneumonia and vitamin B12 deficiency. We are sending you our Guide to Digestive Disorders, with a discussion of the pros and cons of PPIs and instructions on how to get off them, since stopping these drugs can cause rebound reflux.

No one should stop a PPI without consulting the prescriber. Some people require such drugs to protect themselves from esophageal damage. We have become convinced, however, that patients and physicians should have a detailed discussion of the benefits, the risks and the way to discontinue such drugs before a prescription is written.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Digestive Disorders

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Instead of the drugs for the reflux try eating a red apple before you go to bed, or when you feel the reflux coming on. I works for me… No more Nexium for me…

Anyone on Zegrid 40 for a year or more? Any side effects ? Did it affect your blood pressure?

Try replacing your Prevacid with aloe juice. I know several people who have tried this and have gone off of their reflux medicines.

AE, why wouldn’t Drs or drug companies mention the possibility that digestive enzymes might be needed?
Money! Drs and drug companies make a LOT of money off this problem.

The prescription my doctor gave me had side effects but I am a believer in herbs when possible. I stopped the prescription and went to a health food store owned by a lady that her niece was a nutritionist and she ordered “Stomach Acid Defense”. It is a lot cheaper than the prescription and has stopped all my acid reflux.
Mine was bad enough that I was sent to a doctor to have my esophagus stretched. Even my doctor touts it now, though he doesn’t tell anyone of it unless they ask. Also I noticed someone said not to drink vinegar but it is not acidic. I think you have than info on this site.

Bone loss studies are done on women because a) we tend to have less bone mass at our max than men, even for the same weight and height, and b) we lose it very much faster than men do after menopause. Men have the same dynamic of bone loss, but because they (usually) do more exercise than (most) women, they have stronger bones, and they don’t lose bone mass as fast as they get older.
That said, people who need to manage acid reflux may want to look at various nutritional approaches, including eliminating gluten. Whether or not you actually test positive for celiac disease, you may want to try eliminating all gluten for a few weeks to see if your reflux eases up. It won’t work for everyone, but it may help. Other foods may also be contributing; breads (gluten) are an irritant that is often overlooked.
Then, the various probiotics and digestive enzymes may be a good place to look.
Weight-bearing exercise and sufficient (= LOTS) of vitamin D3 are good for protecting bone; not clear that much will actually restore bone mass once you’re over 50.

I keep reading that some gerd is caused by too little acid in the stomach. If this were true, why is it not generally known? Certainly it would be a lot easier and healthier not to mention cheaper to take HCL than all the PPI’s. Is there anyone out there who actually had gerd and was then cured by taking HCL? Or is this just one of those “urban legends” too good to be true?

To help build the bone one needs to make sure they are getting and assimilating all the minerals they need-no, not just calcium. See my posts above about taking digestive enzymes.
Also exercise is needed to stress the bones so a rigorous daily walk would be great for rebuilding bone. If a bone is not stressed it will lose strength. So “use it or lose it”.
Start the exercise slowly and build up.

Read my statement above. Digestive enzymes are the answer.

Side effects from Pantoprazole 40MG (Protonix) caused increased stomach problems, and I was unable to sleep. I was told that the RX stopped the absorption of calcium, which is necessary for sleep.
On my second attempt, I was able to stop taking Pantoprazole (very difficult) and started taking Liquid Calcium, 1000 mg with Magnesium 400 mg, plus other included vitamins, each day – from my health food store. I feel this has helped the sleep issue, somewhat.
I, too, had stomach spasms and they were stopped by taking RX Belladonna Allkaloids W/PB (Donnatal) as needed – from my MD. This RX seemed like magic, when I first took it.
Here are other measures I’ve taken to get my stomach issues under control:
Stop eating at least 4 hours before going to bed + drink very little liquid.
Eat absolutely nothing containing acid … soft drinks, alcohol, vinegars, salad dressings, mustard, ketchup, catsup, grapefruit, oranges, lemons, limes, (apples, unless they’re cooked), etc.
Do a little physical activity after eating – don’t sit or lie down.
Chew my food well – chew, chew, chew.
Limit drinking liquids while eating.
I purchased a wedge to go under my pillow, which keeps my stomach at a lower level. It did require my adjusting to this device – took a few nights, but now I like the raised position.
My latest effort has been to greatly reduce my dairy intake; but if I do have dairy, or a product containing dairy, just prior to eating, I take a Walgreens’ store-brand product called Chewable Vanilla LACTOSE, which is a Lactase Enzyme Digestive Supplement. This, too, works very well. (it’s the only product I’ve tried)
If anyone has other suggestions, I’m open to trying them.

I am truly concerned about the news on the PPI’s. I am supposed to be taking them but have completely stopped due to all the adverse reaction these drugs seem to cause. I would like to learn more about a safer substitute, since not taking anything for my Gerd concerns me too. I had the Nissen done about 12 years ago but Gerd has returned. I am at my wits end. Please someone advice me on how to manage this disease with safer alternatives. It would be greatly appreciated. When I mentioned to my specialist about the depletion of minerals while taking PPI’s he stated that he had never heard of it. I think maybe that I should find a new doctor.

If you stop taking the drug will it reverse the hip bone problem?

Do these hip fractures also occur in men? My husband is 56 and has been taking Nexium for about 5 years for acid reflux. I’m concerned about his risk.

Do you still recommend Prelief? I found it very helpful. Is it safer or do the dame thing?

Years of Prevacid (which worked better for me than others) destroyed my ability to process food normally. I suffered with constipation problems that landed me in the emergency room more than once. I never realized my acid suppressor was depriving my body of calcium and magnesium.
Efforts to get off the drug aggravated my Barrett’s esophagus so I am still on it but thankfully have found a combination of calcium, magnesium and a good probiotic that has helped me rebalance my body. My regret is that I didn’t understand what the drug does early in my experience when I could still get off it.
I agree that no one should try to get off their acid suppressor without consulting and working with their doctor… but if their doctor dismisses their concern and won’t address the problem with them, I suggest they find a doctor who will.

I want to know if men are as susceptible to the bone fracture side effect of taking PPI’s. Why are so many studies done using women only? My husband has been taking a PPI for about three years after esophageal acid damage. His doctor tells him he’ll have to take this drug for the rest of his life but we are very concerned about life-threatening side effects.

The solution is to stop taking the drugs, but do it very gradually and start taking digestive enzymes. Acid stomach, especially in older folks, is usually from too little acid, not too much.
Yes, I have also seen this in children and also younger adults who often get upset an stomach. Normally it happens in older people because the production of Hydrochloric Acid becomes less as we get older.
I know this because when I was in my mid 30s I had a very smart Dr who ordered a hair analysis and discovered I was deficient in minerals-even though I was taking mineral supplements. His advice was to try different combinations of digestive enzymes to find ones that work for me.
Over the last 30 years I have had to periodically do a “challenge” test to see if I needed more, which I usually did. I have had no problem growing fingernails and my hair never suffers from split ends since then.
My son and nephew also needed digestive enzymes.

interested in any follow up to this. trying to get off nexium, down from 40 mg to almost 20mg. but often get mild spasming as try to go down further.

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