RODALE NEWS, EMMAUS, PA—Daily use of acid-reducing heartburn drugs may keep the burn under control, but new research suggests that popping those pills may jeopardize the health of your bones. Even short-term use of popular heartburn drugs can raise your risk of hip fracture, according to researchers who spoke at last week’s Digestive Diseases Week conference in Chicago. In their study, people taking prescription and over-the-counter proton pump inhibitor medications (or PPIs, such as Prevacid, Nexium, and Prilosec), or histamine-2 receptor antagonists (H2RAs, such as Zantac) for even one year were more likely to suffer a hip fracture. These drugs work by suppressing gastric acid, which is important for calcium absorption, so the theory is they cause bones to become thinner and more brittle due to a lack of calcium in the body.
THE DETAILS: Researchers at Kaiser Permanent in San Francisco looked at the records of 164,223 patients, and found that those who had suffered a hip fracture were 30 percent more likely to have taken PPIs for at least 2 years, and 18 percent more likely to have taken H2RAs for 2 years. The higher a patient’s dosage of these medications and the longer they were used, the further increased his or her risk of hip fractures became. Some increased risk was even observed in patients who took these drugs for just 1 year.
WHAT IT MEANS: This isn’t the first study to suggest a link between brittle bones and heartburn medications; previous research found that long-term use (5 years or more) leads to an increased risk of hip fracture. It is the first to show, though, that even short-term use of PPIs and H2RAs significantly raises a person’s risk. Overall, these drugs are very well tolerated (which is why many are offered over-the-counter) and very safe, according to Nicholas J. Talley, MD, PhD, chair of the department of internal medicine at the Mayo Clinic in Florida. If you must take these medications, he advises taking a supplement with at least 1,200 milligrams of calcium and 800 International Units of vitamin D (which aids the body’s absorption of calcium), as together they may help prevent brittle bones and breakage. Dr. Talley suggests that people who are over 65, particularly women, should be most concerned about taking these medications and protecting their bone health.
To further lower your risk of fractures, try taking the lowest possible dose of these meds that still effectively treats your heartburn symptoms. You can also talk to your doctor about going on a drug holiday, suggests Dr. Talley. If you stop taking these medications and find that your symptoms are slight or nonexistent, you probably don’t need to be on them long-term and can instead treat occasional symptoms with antacids.
A few other tips for preventing and managing heartburn to reduce your need for medication:
• Lose weight. Shedding a few pounds is great for your overall health, but it can also help decrease acid reflux. The weight of any excess belly fat can put pressure on your stomach, pushing acid up into your esophagus. Losing even 10 pounds can make a big difference in how you feel.
• Avoid heartburn-triggering foods. High-fat foods, as well as chocolate, acidic juices, and even alcohol can precipitate heartburn symptoms.
• Raise the head of your bed. If you experience heartburn at night, put gravity on your side by elevating your head while you sleep. A good six to nine inches should do the trick—try putting blocks under the head of your bed, or insert a wedge (found at drugstore or medical supply stores) between your mattress and box spring.
• Stay stress free: Anxiety can worsen heartburn so try deep breathing, yoga, or any other relaxation technique to help cope with stress.
Published on: June 8, 2009
Updated on: May 11, 2010