Proton pump inhibitors (PPIs) are one of the most common recommended drugs in the treatment of GERD and acid reflux. Specifically formulated to reduce gastric acid production, PPIs are essentially prescribed to patients with severe GERD and even other conditions like peptic ulcer disease, Barrett’s esophagus, and gastrinomas.
What makes PPIs truly effective is its ability to irreversibly block the production a particular enzyme in the digestive system. Lack of the enzyme and stomach acid essentially paves way for speedy recovery, especially among those with GERD and duodenal ulcer. Clinically used proton pump inhibitors include omeprazole (Prilosec, Omepral), lansoprazole (Prevacid, Zoton), and Pantoprazole (Protonix, Pantozol).
Because of its efficacy, PPIs is now considered as the standard GERD treatment. According to Dr. Goutham Rao of the National Heartburn Alliance, PPIs are not only used for the treatment of their patients with GERD or heartburn but for the more precise diagnosis of the latter. PPIs essentially work against the natural production of stomach acids, its effect on the digestive system essentially reduces or totally eliminates GERD or heartburn symptoms. The administration, therefore, should work to those who have an actual case of GERD. The lack of improvement in the patient only tells that the symptoms, which is similar to what GERD bring about, is caused by something else.
But as of 25 May 2010, the FDA warns about the possible adverse effect of PPIs to bone density after the result of the joint study conducted by the U.S. and Canadian research firms has been made public. The administration of PPI antacids, such as Dexilant, Vimovo, Protonix, and Prilosec, among others, has been linked to an increased risk of bone fracture, especially among users who have been on PPI for a year or more. While the long-term effects of PPIs have been less studied, recent data suggests that people age 50 or older using proton pump inhibitors for a year are 2.6 percent more likely to break a hip. Those, on the other hand, who take smaller doses for one to four years have been said to be 1.2 to 2.6 times more likely to break a hip.
The culprit? Experts pay close attention to two theories: One, the reduction of absorbed calcium by the body because of the inability of the digestive system to breakdown such nutrient or, two, that PPIs essentially interfere in the production of osteoclasts, a bone cell essential to the process of rebuilding of bones. FDA warned consumers that the continuous administration of PPIs essentially increases their risk of bone fractures in spine, hip, and wrist. The action taken by the FDA essentially stresses the importance of information dissemination. After their announcement, the FDA ordered that all PPI drugs, both nonprescription and prescription versions, must bear an appropriate warning in their package labels.
At present, PPIs are essentially regarded as the most powerful class of antacids. Its efficacy is exhibited by the fact that it is one of, if not, the most recommended GERD and heartburn medicine in the market today. It is the highest selling class of drugs in the market today, with at least 113.4 million prescriptions written for it in U.S. alone.
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