Health Tip: Before You Take This Heartburn Medication...

Title: Health Tip: Before You Take This Heartburn Medication...
Category: Health News
Created: 4/5/2013 8:35:00 AM
Last Editorial Review: 4/5/2013 12:00:00 AM

View the original article here

Is it safe to take heartburn medication on a long-term basis?

Posted May 31, 2013, 2:00 am

I’ve been taking Prilosec for years to prevent heartburn. My wife doesn’t think it’s safe to take any drug for that long. What do you think?

I’ve said it before, but I think it bears repeating: No drug is 100 percent safe. That doesn’t mean that you shouldn’t take one if you need it. But you should continually weigh the risks and benefits.

Prilosec is a proton pump inhibitor (PPI), a drug that reduces stomach acid. We need stomach acid to help digest food, but in excess or in the wrong place, it’s a menace. It can inflame and irritate the esophagus, causing heartburn. (Recurring heartburn is called gastroesophageal reflux disease, or GERD.) It can also contribute to ulcers in the stomach and small intestine.

PPIs are the most commonly prescribed drugs for acid reflux and heartburn. PPIs include lansoprazole (Prevacid), omeprazole (Prilosec) and esomeprazole (Nexium).

Like you, people often take PPIs every day for years. This makes sense if you have a chronic problem with stomach acid, but the occasional case of mild heartburn does not need to be treated with a PPI. For that kind of spot duty, antacid medicines such as Tums, Rolaids and Maalox will likely do the trick. They directly counteract acid in your stomach. So will drugs like cimetidine (Tagamet), famotidine (Pepcid) and ranitidine (Zantac). Like the PPIs, these drugs cause your stomach to make less acid, but they work faster than PPIs.

You can also tackle your heartburn with changes that don’t involve taking anything. Eat smaller meals and cut back on alcohol. If you’re heavy, lose weight. Raising the head of your bed should also help.

As a long-term PPI user, you should also consider the possible drug interactions and side effects of PPIs. They may decrease the effectiveness of clopidogrel (Plavix, others), a medication that helps prevent artery-clogging blood clots. (This is controversial, and irrelevant if you’re not taking clopidogrel.)

In addition, people taking PPIs seem to be more likely to get pneumonia than those who aren’t. Why would a medicine that reduces stomach acid make you vulnerable to pneumonia — a lung infection usually caused by bacteria? Because some cases of pneumonia come from regurgitating stomach contents up into the throat and having some of these contents drop down into the lungs. Since acid kills bacteria, stomach contents that are low in acid are more likely to contain bacteria.

Stomach acid also helps you absorb calcium in your diet. Theoretically, that might mean that long-term use of PPIs would make you vulnerable to thin bones (osteopenia or osteoporosis). However, the evidence for that is weak. Experts do not recommend, for example, that people taking long-term PPIs get bone density tests, or take calcium pills.

Even if you have a prescription for a PPI, you and your doctor should review the reasons for it periodically to make sure they’re still valid. If you do need that prescription — and many people do — it should be for the lowest effective dose.

window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

View the original article here

Losing Weight May Ease Chronic Heartburn

Study found shedding pounds reduced GERD symptoms among overweight, obese patients

By Kathleen Doheny

HealthDay Reporter

MONDAY, May 20 (HealthDay News) -- Obese and overweight men and women who suffer from heartburn often report relief when they lose weight, a new study shows.

The researchers tracked the effects of weight loss over a year in patients who had a persistent form of heartburn known as gastroesophageal reflux, or GERD.

"If you lose weight, you will have improvements in your reflux symptoms," said study author Dr. Preetika Sinh, a gastroenterology fellow at the University of Kansas School of Medicine. In women, but not men, long-term exercise also helped reduce symptoms, she added.

Sinh was scheduled to present the findings Monday at the Digestive Disease Week annual meeting in Orlando, Fla.

Previous research also has linked weight loss with a decline in GERD symptoms.

Heartburn, or acid indigestion, is very common, with more than 60 million Americans having it at least once a month, according to the American College of Gastroenterology. Stomach acid flows backward up into the esophagus, and the burn begins.

GERD, the more frequent, chronic form of heartburn, can lead to complications if left untreated, including a narrowing of the esophagus or precancerous changes in the esophageal lining.

Sinh evaluated more than 200 men and women with an average age of 46. At the start of the study, all were overweight or obese, with an average weight of 220 pounds.

At the beginning of the study, 38 percent had heartburn scores severe enough to be classified as GERD. After six months, the patients' average weight decreased to 183 pounds, and only 16 percent still had GERD.

During the next six months, 172 of the patients regained weight, and the percentage of those with heartburn increased again, from 16 percent to 22 percent. Even a small amount of weight gain -- less than 5 percent of their initial weight -- led to worsening symptoms, Sinh found.

Sinh then focused on the 41 patients who didn't regain their weight and found that the percentage with heartburn continued to decline and the symptoms continued to improve.

As part of the weight-loss program, the patients were told to aim for five hours a week of moderate activity such as walking or jogging. The average amount logged was a little less than four hours, Sinh said.

In women, but not men, the exercise also helped to improve heartburn.

Sinh said she can't explain the mechanisms behind either the weight loss or the exercise, or why the exercise seemed to help only women. Although the study found a link between weight loss, exercise and GERD, it did not establish a cause-and-effect relationship.

While the use of heartburn medications is common, Sinh said she can't say if the men and women improved enough to go off medication, since she didn't track those results. Only about 5 percent of the men and women were on heartburn medications in the first place, she said.

View the original article here

Chronic Heartburn May Raise Odds for Throat Cancer: Study

But simple antacids appear to lower the risk, researchers report

By Steven Reinberg

HealthDay Reporter

THURSDAY, May 23 (HealthDay News) -- People who suffer from frequent heartburn may be at increased risk for cancers of the throat and vocal cords even if they don't smoke or drink alcohol, a new study says.

Interestingly, common over-the-counter antacids seemed to protect against these cancers while prescription medications such as Prilosec, Nexium and Prevacid didn't, the researchers said.

"There has been a controversy about whether heartburn contributes to cancers of the larynx or pharynx," said lead researcher Scott Langevin, a postdoctoral research fellow at Brown University in Providence, R.I.

"And we found out that it does elevate the risk of these cancers. There is about a 78 percent increase in the risk for cancer in people who experience heavy heartburn," he said. "This is important in figuring out who to monitor more closely."

The other finding, which Langevin called "surprising," was the protective effect of common antacids in reducing the risk of cancer.

"We didn't see that protective effect with prescription medications. But it should be noted that people who take them are those who get the worst heartburn, so we shouldn't read too much into that," he said.

Langevin added that it's hard to explain that medication finding, and other studies will be needed to see if it's really the case. "It's possible that these drugs didn't have that protective effect because these were the worst cases of heartburn," he said.

The report was published May 23 in the journal Cancer Epidemiology, Biomarkers & Prevention. And while it uncovered an association between heartburn and cancer of the throat and vocal cords, it didn't prove a cause-and-effect relationship.

Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, said "the study shows that reflux is associated with an increased incidence of cancers of the larynx and pharynx."

Lichtenfeld said the role of antacids in reducing the risk of cancer needs more study. "Researchers need to determine why antacids work and, more importantly, whether antacids make a difference in also reducing cancer of the esophagus," he said.

Why other medications didn't lower the risk isn't clear, Lichtenfeld said. And it points to one limitation of this type of study: It can't take into account all the variables.

To come to their conclusions, Langevin's group compared more than 600 patients with throat or vocal cord cancer with more than 1,300 people without a history of cancer. All the patients answered questions about their history of heartburn, smoking and drinking habits, and family history of cancer.

In addition, since some head and neck cancers are caused by the human papillomavirus (HPV), the researchers tested all the participants for antigens to the virus.

The researchers found that among those who weren't heavy smokers or drinkers, frequent heartburn increased the risk for cancers of the throat and vocal cords by 78 percent.

The researchers also found that taking antacids -- but not prescription medications or home remedies -- reduced the risk for these cancers by 41 percent. The protective effect of antacids was independent of smoking, drinking or infection with HPV, they said.

View the original article here

Endoscopy Overused in Heartburn Patients

Title: Endoscopy Overused in Heartburn Patients
Category: Health News
Created: 12/5/2012 11:00:00 AM
Last Editorial Review: 12/5/2012 12:00:00 AM

View the original article here

Endoscopy Overused in Heartburn Patients

ByRita Rubin
WebMD Health News Reviewed byLouise Chang, MD

Dec. 4, 2012 -- Acid reflux is the most common reason U.S. adults undergo a procedure where a viewing tube is put down their throat. But many people don’t need it, according to new advice from one of internal medicine’s main professional groups.

“Overuse of upper endoscopy contributes to higher health care costs without improving patient outcomes,” doctors from the American College of Physicians write in the Annals of Internal Medicine. Published studies suggest that 10% to 40% of endoscopies don’t improve patients’ health, according to the authors.

In the procedure, a doctor inserts an endoscope, a thin flexible tube equipped with a camera and a light, through the mouth of a sedated patient and into the esophagus, stomach, and first portion of the small intestine.

Despite a lack of supporting evidence, the authors write, doctors routinely use endoscopy to diagnose and manage gastroesophageal reflux disease, or GERD, which develops when stomach acid leaks into the esophagus.

As many as 40% of U.S. adults report having some GERD symptoms -- namely heartburn and regurgitation.

Looking for Barrett’s

Doctors use endoscopy in GERD patients mainly to check for a condition called Barrett's esophagus, which affects about 10% of people who’ve had chronic heartburn for at least five years, says Nicholas Shaheen, MD, MPH, an author of the new advice paper. Barrett’s occurs when stomach acids damage the lining of the esophagus.

GERD and Barrett's esophagus have been linked to an increased risk of a type of cancer called esophageal adenocarcinoma.

Although the overall risk for the cancer is still low, esophageal adenocarcinoma, which used to represent only a small minority of cancers in the esophagus, has increased 500% since the 1970s. It now accounts for more than half the cases in the U.S., says Shaheen, a gastroenterologist who directs the Center for Esophageal Diseases and Swallowing at the University of North Carolina, Chapel Hill.

While smoking and drinking are stronger risk factors for another cancer type of the esophagus, the rise of esophageal adenocarcinoma is thought to be tied to the U.S. obesity epidemic, Shaheen says. That's in part because overweight and obese people are more likely to have GERD, he says.

“Given the rising prevalence of chronic GERD symptoms, it is perhaps not surprising that the use of upper endoscopy for GERD indications is also rising,” the authors of the advice paper write. In fact, over the past decade, there's been an increase of greater than 40% in the use of upper endoscopy among Medicare patients.

Scoping for Dollars

Fear of a malpractice lawsuit over a missed cancer, financial incentives, and expectations on the part of GERD patients and their primary care providers, who refer them to gastroenterologists for evaluation, are among the factors behind the overuse of upper endoscopy, the authors write. “We have always equated better care with more care,” Shaheen says. "That’s just the American way.”

1 | 2 Next Page > #url_reference {display: none};#url_reference { display: block; line-height: 150%; margin-bottom: 10px; }#logo_rdr img { visibility: visible; }.titleBar_rdr .titleBarMiddle_fmt { padding-top: 1.5em !important;} Top Picks Eating Out? How to Cut Calories and Heartburn Heartburn Bothering You at Night? The Truth About Heartburn Acid Reflux? What You Can Eat GERD and Sleep Apnea: What's the Link? Cooling Heartburn Year-Round Heartburn/GERD Home News Reference Videos Questions and Answers Glossary Medications Digestive Disorders Community Heartburn/GERD Guide 1 Basics & Triggers 2 Symptoms & Prevention 3 Diagnosis & Tests 4 Treatment & Care 5 Living & Managing 6 Support & Resources See what others are asking about

Visit WebMD Answers

Related to Heartburn/GERD Barrett's Esophagus Esophagitis Gas, Bloating, and Burping Hiatal Hernia Indigestion Living Healthy Pregnancy Reflux and Bad Breath Smoking Cessation Ulcers More Related Topics What's Causing Your Heartburn? Take WebMD's FREE Heartburn Assessment to find out,and get help for your symptoms. Today in Heartburn/GERD Slideshow Heartburn: What It Is, How to Stop It Assessment Heartburn or GERD? Check Symptoms   Slideshow Foods to Eat and Avoid for Heartburn Article Diagnosing Acid Reflux   Slideshow Heartburn Relief & Other Digestive Tips Video Heartburn or Heart Attack? How to Tell   Article Gas,Bloating,and Burping Article Top 10 Heartburn Foods   Video Is It Heartburn or GERD? Slideshow 7 Years to Digest Gum & Other Myths   Slideshow Heartburn-Inducing Restaurant Meals Article Acid Reflux Varies by Gender   Subscribe to WebMD Newsletters

WebMD Daily Women's Health Men's Health Weight Loss Wisdom I have read and agree to WebMD's Privacy Policy. Submit Sign up for more topics! WebMD Special Sections Fight the Fire: Cool Ways to Manage Heartburn Tips for Year-Round Heartburn Relief How Well Are You Handling Your Heartburn? Health Solutions From Our Sponsors Vaccine Questions? Low Testosterone? Bipolar Disorder Facts Birth Control for Moms Blood Sugar Control Bent Fingers? Diagnosed With Low T? Fibromyalgia & Exercise Depression & Adults Child with Diabetes? Vaccines for All Ages Knee Pain Relief Itchy, Scaly Skin? Hearing Aid Alternative Relapsing MS Help In-depth coverage: Psoriasis Treatment on Target?|Healthy Mouth Help|RA Assessment|Living Healthy Guide|Family & Pregnancy Toolbox|Check Your Heartburn Symptoms Find us on:URAC: Accredited Health Web SiteHonCode: Health on the Net FoundationAdChoicesAbout WebMD Advertise With Us Terms of Use Privacy Policy Sponsor Policy Site Map Careers Contact UsMedscape Reference eMedicineHealth RxList Medscape MedicineNet BootsWebMD WebMD CorporateMedical Dictionary-->First Aid WebMD Magazine WebMD Health Record WebMD Mobile Newsletters Dictionary Physician Directory

©2005-2012 WebMD, LLC. All rights reserved.

WebMD does not provide medical advice, diagnosis or treatment. See additional information.

View the Original article