Once upon a time, treating chronic heartburn problems often required a visit and a healthy amount of monitoring by your family doctor.

That was certainly true until a few years ago when the FDA deregulated specific classes of heartburn drugs to over-the-counter (OTC) status: Proton pump inhibitors (PPIs) like esomeprazole (Nexium) omeprazole magnesium (Prilosec) and H2 blockers like famotidine (Pepcid).

As their prices have fallen, heartburn drugs have become some of the most overused and over-prescribed products on the U.S. pharmaceutical market.

With this overreliance on heartburn meds – Americans spend about $11 billion annually on PPIs alone — reports of related health problems have risen too, especially for people have taken these drugs in large doses for more than year.

Some of the more widely reported problems with taking PPI heartburn meds have been related to unhealthy disruptions of gut bacteria that leave patients vulnerable to serious C. diff superbug infections.

A pair of recent studies have raised new and possibly deadly concerns about the health risks of taking PPIs.

Altering gut bacteria worsens liver disease risks

In previous research conducted at the University of California San Diego School of Medicine, scientists observed changes in the composition of gut bacteria that affected a patient’s risks of chronic liver disease.

Their latest study on mice featured in Nature Communications took it one step further, adding gut-disrupting PPIs that suppress gastric acid in the stomach to the mix.

UCSD researchers discovered suppressing gastric acid that triggered an overproduction of Enterococcus in the guts of mice. (Health problems related to Enterococcus include urinary tract infections, diverticulitis and meningitis.)

This increase of Enterococcus promoted a worsening of three types of chronic liver disease: Alcohol-induced liver disease, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).

In a second phase of their study, scientists confirmed a connection between PPIs use and alcohol-related liver disease in a review of more than 4,800 human patients who abuse alcohol. Of that total, about 1,000 took PPIs actively and nearly two-thirds didn’t.

Not only did PPIs increase the amount of Enterococcus in stool samples, the risk of alcoholic liver disease soared by more than 20 percent among patients who used them regularly. Plus, for people who had used PPIs but stopped taking them, the risk for alcoholic liver disease was still elevated at about 16 percent.

Can PPIs kill you?

The health outcomes collected from the U.S. Department of Veterans Affairs database of nearly 350,000 American vets who used PPI or H2 blocker heartburn drugs, then reviewed by researchers at Washington University School of Medicine revealed even more sobering results.

Compared to an H2 blocker, using PPIs for at least a year increased the risk of death among vets by 25 percent. In very simple terms, that’s one extra death for every 500 patients taking a PPI, according to the study appearing in BMJ Open.

In addition, that risk of death was nearly as high among patients who took a PPI drug versus an H2 blocker at 24 percent even though they didn’t have the proper symptoms.

Also, the longer patients took a PPI, the greater their mortality risks. For people taking them for 1-2 years, the risk of death spiked by 50 percent.

Unfortunately, too many patients just keep taking PPIs even though the recommendation duration of treatment shouldn’t exceed 8 weeks. “A lot of times people get prescribed PPIs for a good medical reason, but then doctors don’t stop it and patients just keep getting refill after refill after refill,” says senior study author Dr. Ziyad Al-Aly, according to a press release.

The good news is that you can take safe steps to reduce your need for heartburn drugs by taking some simple healthy steps:

  • Eat smaller meals with reduced amounts of fat.
  • Avoid alcohol, tobacco and rich foods that trigger heartburn.
  • Work on keeping your weight down.
  • Make sure you leave a two-hour gap between eating an evening meal and bedtime.
  • Take a multi-species probiotic like EndoMune Advanced Probiotic that maintains the beneficial bacteria in your gut.