heartburn drugs

Older man selecting medication from a store shelf.

Relying on Heartburn Drugs Too Much?

You may have experienced a big jolt when you saw the news about the FDA alerting consumers to the presence of a human carcinogen in the over-the-counter (OTC) heartburn drug ranitidine, most commonly known by its brand name, Zantac.

N-nitrosodimethylamine (NDMA) is the very same carcinogen that prompted a recall of some prescription medications containing the generic drug valsartan (used to treat heart failure and high blood pressure).

Although the FDA was quick to say the amounts of NDMA found in ranitidine were barely above what may be found in common foods, that didn’t stop Sandoz/Novartis from halting the distribution of Zantac, pending a deeper investigation.

In the meantime, national drug store chains — Walgreens, Rite Aid and CVS — have removed Zantac and its generic counterparts off their shelves.

A lot of heartburn drugs are sold via the OTC route, including proton pump inhibitors (PPIs) like omeprazole magnesium (Prilosec) and lansoprazole (Prevacid) and H2 blockers like ranitidine and famotidine (Pepcid).

It’s no stretch to say that many of the 15 million Americans who are prescribed these heartburn drugs and the countless numbers of people who take them via the OTC route, do so for far longer than they should, even after their health problem has cleared up.

Even years!

Previously, we’ve warned you that taking PPIs creates unhealthy imbalances in the bacteria in your stomach that can leave you vulnerable to serious Clostridium difficile (C. diff) superbug infections.

Imagine side effects that are far worse…

Death due to heartburn drugs

A recent report featured in The BMJ tracked the mortality rates among more than 200,000 U.S. soldiers who had been newly prescribed either a PPI or H2 blocker drug for a decade.

Overall, long-term use of PPIs was associated with a 17 percent greater risk of death compared to H2 blockers. The uptick in mortality rates among PPI users was attributed to cardiovascular disease, stomach cancer and chronic kidney disease.

Two more factoids that should catch your attention, especially if you take PPIs or other heartburn drugs, either over-the-counter or by prescription:

  • More than 80 percent of PPI users were taking low doses of their prescribed drug, about the same as doses offered in OTC versions.
  • More than half of the patients were taking a PPI for no medical reason, even though it was prescribed to them.

“Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them,” says Dr. Ziyad Al-Aly, senior author of the study and assistant professor at Washington University’s School of Medicine. “Overuse is not devoid of harm.

“For those who have a medical need, PPI use should be limited to the lowest effective dose and shortest duration possible.”

What can you do?

Are you taking heartburn drugs based on your doctor’s advice or doing it on your own?

Have you been taking them longer than two weeks?

Do you schedule breaks between rounds of taking a heartburn drug by at least four months?

If you aren’t able to answer those questions immediately, it’s time to see your doctor for some advice.

In the meantime, here are some steps you can take to ease your heartburn symptoms without taking a drug:

  1. Cut out smoking for good.
  2. If you’ve been putting off losing weight, the time is now.
  3. Leave about two hours between the time you eat an evening meal and the time you go to bed.
  4. Before hitting the sack, elevate your pillow slightly to avoid a nighttime surge of stomach acid.
  5. Prevent disruptions in the critical balance of healthy bacteria in your gut — and avoid superbug infections — by taking a probiotic like EndoMune Advanced Probiotic containing 20 billion CFUs and 10 strains of beneficial bacteria.
illustration of C Diff bacteria

Protecting Your Child From C. Diff Diarrhea

When health experts talk about Clostridium difficile (C. diff) infections in the news — the most common superbug that causes life-threatening diarrhea — it’s largely associated with overprescribing antibiotics to older people in hospitals and long-term care facilities.

Those concerns are warranted, considering about 500,000 Americans are sickened by C. diff infections and nearly 30,000 die from them annually.

However, C. diff infections are equal-opportunity offenders that can be a serious problem for young children too, according to findings published recently in Infection Control & Hospital Epidemiology.

Based on a meta-analysis of 14 studies and 10.5 million children, prior exposure to antibiotics was the main culprit, nearly doubling the risk of C. diff infections in young children, compared to kids who hadn’t taken antibiotics.

But that’s not all…

Researchers also cited exposure to heartburn drugs — better known as proton-pump inhibitors (PPIs) — as another C. diff risk factor for children. That’s not surprising given many adults rely on them too often and for too long at the expense of disrupting the healthy balance of their gut bacteria.

A study published last fall in the Journal of Microbiology, Immunology and Infection backs up this link between severe cases of C. diff related to children taking PPIs.

The concerns about PPI use are so critical and obvious that the National Institute of Diabetes and Digestive and Kidney Diseases (connected with the National Institutes of Health) felt it was important enough to devote a detailed section to treating acid reflux in children and teens.

The good news: There’s growing consensus among health experts that taking a daily probiotic can be a very safe and effective solution for preventing C. diff infections altogether.

Additionally, recent scientific evidence has shown the benefits of treating patients with probiotics made with multiple strains of beneficial bacteria were very effective in preventing C. diff infections.

One safe and natural way to protect your young child from C. diff infections, especially if they are taking an antibiotic: Talk to your doctor about giving him/her a probiotic, like EndoMune Jr. Powder (recommended for children to age 3) or EndoMune Jr. Chewable Probiotic (ages 3-8).

Both varieties of EndoMune Jr. contain four strains of beneficial bacteria, along with a prebiotic (FOS).

Heartburn Drugs Harm Your Health

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.
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