Do Acid Blockers pose health risks

In 2008, Americans spend over $14 billion on proton pump inhibitors.  These heartburn treatments such as Nexium, Prevacid, and Protonix may put millions of patients at risk.

According to Scientific American, long-term use of these medicines has been linked to “withdrawal symptoms, an increased risk of bacterial infection, hip fracture and even possible nutritional deficiencies.”  Additionally, Doctors sometimes give PPIs to prevent gastrointestinal bleeding or stress ulcers, even though such prescribing is of questionable medical value.  On study by a professor at the University of Michigan Hospital found that their facility spent over $100,000 per year on unnecessary PPI prescriptions.

Surprisingly, a 2009 study in Gastroenterology found that “long-term use of PPIs may cause the very symptoms the drugs are designed to treat.”  After 12 weeks of treatment, 22% of the treatment group receiving PPIs experienced heartburn compared to 2% of the group receiving a placebo.  In fact, St. Paul’s Hospital in Vancouver cut daily medication costs in half by redcing PPI prescribing patterns and did not worsen clinical outcomes whatsoever.

Why are PPIs so popular if they are ineffective?  One doctor claims that they may be addictive.

Should PPIs be prohibited?  I would say not.  However, given the evidence of the ineffectiveness of PPIs, private insurance companies, Medicare and Medicaid should not cover these types of medicines.  Under this logic, patients could still take the medicines if they wished, but this would come at their own cost.  This is one case where President’s Obama’s push for the use of more cost-effectiveness analysis within government health insurance programs could bear cost savings without harming patient health.


  1. There is a caveat here. The incidence of surgery for bleeding ulcers, once one of the most common surgical procedures, has dropped to almost zero. During my residency days, we used to average about one surgery for acute GI bleeding every other day. Now, they do one maybe every 4 months. Go look up the records on the old vagotomy and pyloroplasty procedure. Will surprise you.


  2. It does have some sort of a negative effect according to me: whether you are using acid blockers or perspiration blockers, the thing is that you are actually trying to curtail the original formation of bodily secretions which just does not seem right. If the problem has to be cured, it should be done holistically, i.e. dampen the secretion levels and not “block” them temporarily.

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