from the so-much-for-the-spicy-meatball-sub dept.
Arthur T Knackerbracket has found the following story:
Taking popular heartburn drugs for prolonged periods has been linked to serious kidney problems, including kidney failure. The sudden onset of kidney problems often serves as a red flag for doctors to discontinue their patients' use of so-called proton pump inhibitors (PPIs), which are sold under the brand names Prevacid, Prilosec, Nexium and Protonix, among others.
But a new study evaluating the use of PPIs in 125,000 patients indicates that more than half of patients who develop chronic kidney damage while taking the drugs don't experience acute kidney problems beforehand, meaning patients may not be aware of a decline in kidney function, according to researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System. Therefore, people who take PPIs, and their doctors, should be more vigilant in monitoring use of these medications.
[...] More than 15 million Americans suffering from heartburn, ulcers and acid reflux have prescriptions for PPIs, which bring relief by reducing gastric acid. Many millions more purchase the drugs over-the-counter and take them without being under a doctor's care.
[...] "Doctors must pay careful attention to kidney function in their patients who use PPIs, even when there are no signs of problems," cautioned Al-Aly, who also is the VA's associate chief of staff for research and education and co-director of the VA's Clinical Epidemiology Center. "In general, we always advise clinicians to evaluate whether PPI use is medically necessary in the first place because the drugs carry significant risks, including a deterioration of kidney function."
Journal Reference:
Xie Y, Bowe B, Li T, Xian H, Yan Y, Al-Aly Z. Long Term Kidney Outcomes among Proton Pump Inhibitors Users without Intervening Acute Kidney Injury. Kidney International. Feb. 22, 2017. DOI: 10.1016/j.kint.2016.12.021
-- submitted from IRC
(Score: 0, Informative) by Anonymous Coward on Saturday February 25 2017, @05:37AM
Eat sensibly, then you may not need this class of drug. What better way to save money for everyone than to not use a drug -- cuts everyone's insurance cost two ways. First for the co-pay...and then for the very expensive dialysis and/or kidney transplant.
(Score: 2) by JoeMerchant on Saturday February 25 2017, @06:12AM
What better way to save money
Shhhh, you'll kill the economy. First, people won't pay crazy prices for prepared foods that taste good but are bad for them, then you'll shrink a reliable established income stream in the medical industry. Servers, cooks, restaurant owners, processed food companies, doctors, nurses, billers, coders, administrators, construction workers, device manufacturers, drug manufacturers, the insurance industry, investment bankers, the stock market, all going down the tubes if people just kick back and eat more healthy.
Think of the depression, think of the upheaval, what would become of our great society?
🌻🌻 [google.com]
(Score: 2) by VLM on Saturday February 25 2017, @12:15PM
Eat sensibly
Glad we narrowed that right down, so there won't be any resulting debate.
My carb intake had drifted up and I cut back fairly suddenly the day after shopping day, and had heartburn for oh I donno 3 days until my innards got used to the new intake and adjusted the acid output appropriately, I don't remember if it was exactly 3 days but I had most of the box left over. I gather from the link that 2 or 3 pills won't cause my kidneys to asplode but around 3000 or so pills it starts getting hazardous.
There seems to be many categories of (ab)use of those substances. Kinda like opiates.
(Score: 2) by MichaelDavidCrawford on Saturday February 25 2017, @05:48AM
the risk to one's kidney's may be worth it.
Yes I Have No Bananas. [gofundme.com]
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @07:14AM
Better to stop eating food that gives you heartburn. Seriously.
Careful about the acid rebound thing though: http://www.refluxmd.com/what-to-expect-if-you-reduce-ppi-use/ [refluxmd.com]
This might be another way people get "hooked" on the drug - they stop taking the drug, they experience the rebound so they go back on the drug.
(Score: 1) by purple_cobra on Sunday February 26 2017, @02:30PM
I've probably bored people here with this in the past but yes, long-term reflux can cause a condition called Barrett's Oesophagus; while you aren't guaranteed to get oesophageal cancer from that, it is a pre-cancerous change so it does mean that cancer is more likely to form from those cells. Barrett's patients should be on some form of acid suppression and should also have routine surveillance gastroscopy (I think the recommendation is every 2-3 years, but I'm not a doctor). A blood test to check for anything untoward from the medication, or even an ultrasound, might well also be recommended to ensure the acid suppression isn't causing any harm. Medicine is about doing what harms the patient the least, when you think about it; there's usually a trade-off in any treatment in terms of side-effects and that's why a good doctor will help you make an informed choice, not just send you away with a prescription or a date for surgery.
(Score: 0) by Anonymous Coward on Monday February 27 2017, @04:37PM
I have Barrett's, and I got to say, this kidney news has been rather depressing. Everything you say is correct. At my last endoscopy I asked my doctor about the kidney evidence and he said basically, well, pick your poison, but esophageal cancer is one of the pretty horrible ones to get, so you go with the lesser of two evils.
(Score: 1, Interesting) by Anonymous Coward on Saturday February 25 2017, @07:35AM
To all those people posting about how you don't need drugs if you just eat healthy: you are ignorant.
There are many people who have an inherited condition (usually shows up in middle age, or at least adulthood) where you get terrible acid no matter what you eat or don't eat. For these people, life is hell without the relief drugs bring to stop acid overproduction.
Now, PPIs (mentioned in the article) are not the only drug class to reduce acid, although they are the "strongest."
The other drug class is H2 antihistamines like Zantac. They are not as strong as PPIs, but they are much safer to take long term. I take Zantac because it works for me and is safer.
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @09:22AM
Thank you for this. I read the first few comments and realized those posters just don't understand the problem. I've been taking Prilosec for over a decade, first by prescription then later OTC when I lost my insurance. My life is a living hell without something to control the acid, and I eat very healthy and drink plenty of water. Guess I'll give Zantec a try...
(Score: 1) by purple_cobra on Sunday February 26 2017, @02:39PM
Generic Zantac is ranitidine, available OTC here in the UK at a low dose. ISTR that's what my dad takes in relation to his stomach ulcer (I've been trying to convince him to get an H. Pylori test for an age now but he isn't interested), something like 300mg per day in a split dose. There may be a surgical option: a fundoplication (details here: https://en.wikipedia.org/wiki/Nissen_fundoplication [wikipedia.org]) or LINX insertion (info here: http://www.surgery.usc.edu/uppergi-general/gastroesophagealrefluxdisease-linx-howitworks.html [usc.edu]) might be indicated, but if you're in the US then it might be cost-prohibitive. There may have been other options publicised while I've been off work, but the latter of those surgical options is still fairly new, at least in the NHS.
I hope you can get some relief from your reflux as I had that for a short time 20 years ago and it was hellish.
(Score: 2) by dyingtolive on Saturday February 25 2017, @09:41AM
I've had chronic heartburn since I was a teenager. Doctor put me on prescription medicine for it back then and in response I completely cut out soda when I was about 19 and I realized how much I liked unsweetened iced tea. The soda was the single biggest thing, but acidic/spicy food will still trigger it for me it seems, hours after eating. If you have problems, minimise those as much as you can stand to. My preferred diet is kimchi, spicy stir fry and curry, and pasta, so I have to manage in other ways.
My solution for that, as I think I've posted before, has always been ph balance. Antacids like tums work well enough to get through the issues, and are much safer on the body than PPIs. Girlfriend cooks vegan too, so I don't eat a lot of calcium rich foods unless she's making cabbage or I'm cooking something for myself, so it's doubleplusgood for me. Pepto is good too, but I think it has salicylic acid in it, so it might not be for everyone, particularly teenagers.
Protip: If you have no tums/rolaids/pepto and you're suffering, drop a couple teaspoons of baking soda into about 4-6 oz of water and chug. Repeat in about 5-10 minutes if you're still feeling horrible. Sounds gross. Tastes gross. Fixes the issue though. It can upset your stomach a little, and you're going to get the burps, but quick and dirty chemistry gets the job done. Don't do much more than that unless you're tried it a couple times to get the proportions down unless you want to be a human 6th grade science fair project though. I've gotten to the point where I shake it in, but I won't drink it more than a tablespoon. Shit is hard on the stomach if you get too much of it.
Don't blame me, I voted for moose wang!
(Score: 2) by dyingtolive on Saturday February 25 2017, @09:44AM
Also, pertaining to my last paragraph, too basic a stomach can be just as bad an issue as too acidic. Something worth thinking about.
Don't blame me, I voted for moose wang!
(Score: 1) by Shub on Saturday February 25 2017, @10:51AM
There are other issues that may necessitate the use of PPI's too. Anyone that's had heart/lung surgery may have had their vagus nerve severed. This can lead to acid reflux which can, over time, damage the lungs of patients.
It's often the case that these patients have kidneys under stress, and it looks like the PPIs mightn't be helping the issue.
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @03:07PM
> ...if you just eat healthy: you are ignorant.
First poster here. I'm old enough to realize that there are a wide variety of people and medical issues, so I was careful to say:
"... then you may not need this class of drug."
The pharma industry has provided a giant tool kit, we need to figure out how to use it wisely...
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @06:12PM
If you suffer acid reflux, dump the american diet. The acid reflux goes away on it's own. IT. IS. JUST. THAT. SIMPLE!
Eat real food. Nothing processed. Don't eat fast foods, ever!
Oh, and your restaurant food supply system is lower grade that the processed garbage on your store shelves. Don't eat out either unless it's a quality restaurant.
You don't need any american pharmaceuticals. Just cut out the shit that makes you sick, and that again is the american diet.
I won't tell you what to eat. You have to learn that for yourself as I had to do.
I will tell you how good it feels to the body to beat cancer in it's tracks and add vitality by simply eating more fruits and vegetables and less GMO.
You must also go organic to avoid the pesticides and other systemic carcinogens added to your food by them.
I find my local Co-op and farmers markets are best for quality produce and meats.
It's your life. You can feel like shit. Or you can feel like you turned the clock back 20 years. It's your choice.
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @06:22PM
Hey "doctor": When I came down with excess acid, I was pretty much on a health food diet--not junk. I found out later that my uncles had it, my grandpa had it, and even my great grandpa had it. All of them grew up on a farm eating the freshest food long before the invention of processed junk food.
(Score: 0) by Anonymous Coward on Sunday February 26 2017, @03:01AM
You just don't know what is healthy to eat and what is not.
But if you're content having a pity party and be a bitch, your choice.
(Score: 0) by Anonymous Coward on Sunday February 26 2017, @04:40PM
(Score: 0) by Anonymous Coward on Sunday February 26 2017, @04:42PM
Oh yeah, and how much did you eat of the items- quantity/weight.
(Score: 0) by Anonymous Coward on Saturday February 25 2017, @08:07PM
To all those people posting about how you don't need drugs if you just eat healthy: you are ignorant.
There are many people who have an inherited condition
Many have inherited bad dietary habits you mean.
See: http://www.medscape.com/viewarticle/826831 [medscape.com]
Gastroesophageal reflux disease (GERD) accounts for a substantial number of physician office visits, with a very high prevalence in Western countries.[1] In the United States, it is estimated that 44% of the adult population experience heartburn at least once a month, with 7% experiencing symptoms daily.[2]
I strongly doubt that such a high percentage (5-7%) of the population should chronically require PPIs daily. Their problem is not their genes but bad diets. Only a much smaller percentage would require PPIs so regularly.
Because there are plenty of countries where the PPI consumption is lower and the GERD etc problems aren't as high. They just aren't eating and drinking large amounts of crap the way the US folk are.
Eat stuff that's better for your digestive system and body. Leave the heartburn food/drink that you really like for once every month or two.
Pay closer attention to what you eat and the effects, if it causes you indigestion, stop eating it ( I know some people who have problems with grape skin or eggplant skin, some have problems with oranges - pulp or peel).
It's like filling up your car with crap fuel and finding it doesn't run well and then you add some damaging (in the long term) additives just to make the car tolerate the crap fuel better.