Proton pump inhibitors are one commonly prescribed treatment for gastroesophageal reflux disease, or GERD. They have been used for almost 2 decades and few studies have found any long term consequences until now.
A study released this month in the Journal of American Medical Association found evidence that chronic use of proton pump inhibitors in men and women over the age of 50 greatly increases the risk for hip fracture.
Proton pump inhibitors work to block the production of hydrochloric acid (HCl) in the stomach. They are effective for treating GERD because it is often the result of excess HCl. But because the production of HCl is decreased, digestion and absorption of important nutrients, including calcium, may be hampered.
This is the theory behind the findings, as presented by the lead researchers. Decreased HCl causes decreased calcium absorption. Therefore the bones must release more of their calcium, or less bone is rebuilt, both of which result in lowered bone mineral density.
Bone mineral density begins to decline naturally with advanced age. When it is declining too rapidly, in response to poor nutrition or medication side effects individuals can develop osteopenia or osteoporosis. These conditions are characterized by weak or thin bones.
Individuals with osteoporosis or osteopenia have an increased risk for fracture.
In this particular study more than 13,000 men and women over the age of 50 were assessed for use of proton pump inhibitors including duration and incidence of hip fracture.
They found that use of a proton pump inhibitor such as Prevacid, Prilosec, or Protonix for more than one year increases the risk for fracture by 42 percent. The longer a person is on the proton pump inhibitor and the higher the dose the greater the risk. The highest doses carry a risk greater than two and a half that of a healthy person.
This is the first study to find results that highlight a negative effect on bone health by proton pump inhibitors. These medications have provided positive treatment to many people, and if you are currently on any of these medications you should always discuss treatment options including risks and benefits with your healthcare provider.
Posted by Dr. Christina Gutierrez on December 28, 2006 04:47 PM
