Recently reported research shows that taking certain antacids, called proton pump inhibitors (PPI), increases the chance of hip fractures by 44% in people over 50. Prilosec, Nexium, and Prevacid are just three popular PPI’s commonly prescribed for ulcers and gastroesophageal reflux disease (GERD).
December 27, 2006 the Journal of the American Medical Association reported the results of a study conducted by researchers at the University of Pennsylvania School of Medicine which showed that PPI’s increase the chance of hip fractures and that the risk is significantly increased with higher doses and with prolonged use.
How Antacids Work
There are three primary types of antacids, and each works in a different way.
- Calcium carbonate Products like Tums and Rolaids are made of calcium carbonate which neutralizes acid on contact. These products are used for immediate relief of symptoms including heartburn, indigestion, and upset stomach. They are sometimes prescribed as a calcium supplement, and are fairly safe. However, the antacid effects only last about 30 minutes to three hours, and when they wear off users often experience acid rebound, prompting patients with chronic digestive problems to seek other types of medication for more full-time management of acid.
- Histamine receptor antagonists (H2 blockers) Zantac and Tagamet are examples of H2 blockers. Histamine is naturally occurring in the body. Most people are familiar with antihistamines to combat allergic reactions. Histamines cause allergic reactions when they bind with H1 receptors. When histamines bind with H2 receptors they stimulate the production of stomach acid. H2 blockers prevent histamines from binding with these receptors, thereby reducing the production of digestive acids. They can be used for immediate relief of an attack or taken as a preventative measure before eating. The effects can last for several hours, and doctors sometimes prescribe their use for several weeks or months.
- Proton pump inhibitors (PPI) Drugs such as Prilosec, Nexium, and Prevacid are proton pump inhibitors. They are the most powerful of the three types of antacids. Some stomach cells, called proton pumps, pump acid into the stomach. PPI’s deactivate these cells, reducing acid production. They are typically prescribed for long-term use (several months) in patients who have attacks once a week or more, and have been unsuccessful when attempting to control stomach acid with diet and lifestyle or milder medications.
Proton Pump Inhibitors and Calcium
One problem with PPI’s is that they are so powerful that they can reduce stomach acids to the point that calcium is no longer absorbed. They may also damage bones in another way. Proton pumps do more than produce stomach acid. They are critical in a process called bone resorption where the body basically recycles essential materials which it already has, including calcium, by releasing them into the bloodstream, reclaiming them, and using them where they are needed. It is part of the body’s natural maintenance which keeps bones strong and healthy preventing injuries such as hip fractures. With age the body relies more heavily on resorption than on new intake of calcium, whenever possible. PPI’s can weaken bones by simultaneously limiting the use of calcium already existing in the body and reducing the absorption of new calcium.
In an already weakened hip, fractures are very difficult to heal. About 20% of elderly people who suffer a hip fracture die within one year. Of the surviving 80%, one in five wind up in nursing homes. For those who recover there is surgery, significant pain, and extensive rehabilitation.
For people with GERD, severe ulcers, and other digestive problems associated with the over-production of acids, PPI’s are sometimes the only relief. However, they are often prescribed to people who could find relief in more appropriate drugs. Those who do need them often take them for a much longer period of time than necessary. Those who must take PPI’s should take a calcium supplement and have annual bone density tests.
If you or a loved one has suffered a hip fracture after taking antacids talk to an experienced pharmaceutical injury attorney today.