As The Stomach Churns

Without proton pump inhibitors, a hot dog would strike fear and loathing in my stomach.

I’m the queen of the unhappy digestive system. All my adult life, I’ve suffered through heartburn, GERD (gastro-esophageal reflux), irritable bowel, narrowing of the esophagus. . . have I left anything out? I tend to let stress go straight to my stomach. As a young woman, irritable bowel and nervous lack of appetite kept me razor-thin. Looking back at pictures of myself in my 20s, the girl in the photos appears anorexic, but she and her stomach were simply plagued by the anxieties of youth.

My Achilles stomach can still be a challenge. I’ve employed every possible remedy over the years—Maalox, Mylanta, Tums, Pepcid, Zantac, Tagamet, and Prevacid. I was—and am–never without a supply of Tums or the drug du jour in my handbag. All help to varying degrees, but nothing well and truly solved the situation until a doctor prescribed Aciphex, a heavy-duty proton-pump inhibitor (PPI). This drug and others like it  stop all acid production.

The pill that changed my life.

It allowed me to eat literally anything without side effects. Hot dog with chili and the works? Bring it on. Pepperoni pizza? I’ll have another slice, thank you. Enchiladas? Please pass the hot sauce. It literally changed my life.  (Of course, this begs the question that maybe my body is telling me I shouldn’t eat these foods. To which I reply, a few hot dogs a year aren’t going to kill me.)

Its only problem seemed to be that it is very expensive, and my drug insurance provider constantly questioned whether a different drug would do. So after a couple of years of taking the magic pill every morning, I switched to Omeprazole, the generic version of Prilosec, which is much less expensive. It works just fine.

Naturally, issues have arisen about these useful drugs. There’s been some question of increased risk of fractures in people who take PPIs. But the research is seriously contradictory. This study, for example, showed that a month of taking Prilosec didn’t decrease calcium absorption, which would lead a sensible person to believe it wouldn’t lead to fractures. http://www.ncbi.nlm.nih.gov/pubmed/20578215

I tried to find some conclusive studies, and learned that some scientists at the Division of Clinical Pharmacology and Toxicology at Switzerland’s University Hospital Basel had the same goal. They reviewed 50 years worth of studies, and this is what they reported:
“We conclude that the currently available literature does not support the notion that the use of PPIs is causally related to a materially increased fracture risk in humans.” http://www.ncbi.nlm.nih.gov/pubmed/20812769
So, at least for the moment, it seems safe to take PPIs.

I’m hedging my bets, though, and taking them every other day, unless I plan to be eating questionable foods, or am feeling particularly stressed. I’ve also turned to digestive enzymes like Multi-zyme and Zypan after a big meal. As we get older, our stomach acid decreases, and if food sits in your stomach without digesting properly, it produces acid. As long as I have my digestive enzymes handy, that will be just fine with me. A little acid goes a long way!

Be well.
Donna

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One Response to As The Stomach Churns

  1. [02-08-2012] The U.S. Food and Drug Administration (FDA) is informing the public that the use of stomach acid drugs known as proton pump inhibitors (PPIs) may be associated with an increased risk of Clostridium difficile–associated diarrhea (CDAD). A diagnosis of CDAD should be considered for patients taking PPIs who develop diarrhea that does not improve.

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