By: Megan Copeland, MS, CNS, LDN
Are you included in the growing number of Americans that have experienced episodes of acid reflux or heartburn? Were you prescribed a Proton Pump Inhibitor, also known as a PPI, in an attempt to combat the burn? Research shows that you are not alone. An estimated 117 million prescriptions were filled in the United States during 2016; with that number increasing each year. According to a new study by Grand View Research, Inc., the global Gastroesophageal Reflux Disease therapeutics market is proposed to reach 4.34 billion USD by 2025. If you didn’t have heartburn before reading those statistics, you might now.
PPI’s, are amongst the most widely used medications in the United States. Pharmaceutical manufacturers initially developed this class of drugs for short term usage to counter the effects of acid-related diseases including gastroesophageal reflux disease (GERD) and the prevention of ulcers induced by Aspirin/NSAID use. At that time, the FDA approved the acid-suppressing medication for a timeframe of 4-8 weeks, however, it is now a common occurrence for patients to be on them for years.
The most commonly used PPIs include:
- Prilosec (Omeprazole) (over-the-counter version available)
- Protonix (Pantoprazole)
- Nexium (Esomeprazole)
- Prevacid (Lansoprazole)
- Kapidex (Dexlansoprazole)
- AcipHex (Rabeprazole)
Total Prescriptions in (2016)
In 2016: 116,706,521 American’s were prescribed PPI’s. This does not include over the counter usage.
Prescription data source: Medical Expenditure Panel Survey (MEPS) 2006-2016. Agency for Healthcare Research and Quality (AHRQ), Rockville, MD. ClinCalc DrugStats Database version 19.1. Read more about the ClinCalc DrugStats database.
The American Board of Internal Medicine (ABIM) states, “More than half of the people who take PPIs probably do not need them. Simple heartburn can be treated with antacids or other drugs, plus diet and lifestyle changes.” Both Harvard Health and the American Academy of Family Physicians go on to list the possible side effects of long term PPI use. Adverse events reported include:
- Osteoporosis and/or fractures
- Micronutrient deficiencies (i.e. B12, Mg, Iron, etc.)
- Gastrointestinal infections such as Clostridium difficile (C-diff), Small Intestinal Bacterial Overgrowth (SIBO), Campylobacter enteritis
- Gastric Acid Rebound
- Cancer ( i.e. Gastric, Colon)
- Cardiac events- if used with other medications (i.e. Plavix or clopidogrel)
- Hepatic Encephalopathy
If you or a loved one have been prescribed PPI’s, it is recommended that you discuss these risks with your primary care physician. Consulting with a board certified and licensed nutritionist would also be helpful to learn the necessary dietary and lifestyle interventions that are necessary to balance the gut microbiome and ensure adequate acid production for nutrient absorption. Feel free to schedule a free 10-minute consultation if you have further questions or concerns.
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