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Jane's Blog Increased Dementia Risk with Heartburn / Reflux Medication

Posted by Jane Jansen on

A study reported in the February 15th 2016 medical journal JAMA Neurology, older users of the popular Proton Pump Inhibitor (PPI) were 44% more likely to develop dementia when taken regularly than those who did not.

A newer study published in the November 2019 European Journal of Clinical Pharmacology suggested the same. Six studies were included, which contained a total of 166,146 participants. The overall result demonstrated a significant increase in dementia risk with proton pump inhibitors use.

It is important to note a study published in the September 2017 journal Therapeutic Advances in Drug Safety found that 46.7% of patients taking PPIs were 65 years of age and older, a significant number given there were 919 million ambulatory visits in 2009. Additionally, the majority of cases indicated questionable PPI use with 62.9% of patients having no documented gastrointestinal complaints, gastrointestinal diagnoses, or concomitant high-risk medications necessitating use of a PPI. The study also suggested emerging adverse effects such as kidney disease and dementia have not been previously addressed in current published reviews. These potential adverse effects are of particular concern in older adults because this population is already at an increased risk of these conditions and is more likely to suffer from significant morbidity and mortality as a result.

These include Prevacid (lansoprazole), Nexium (esomeprazole), and Prilosec (omeprizole).

The patients in the study had taken at least one prescription of the drugs every four or five months over an 18-month period. (These drugs are also known to do carry an increased risk of kidney disease, fracture, low magnesium & Vitamin B12 levels, gastrointestinal infections, Clostridium difficile infection and pneumonia.)

Earlier studies have linked long term use of another type of Heartburn/Reflux medications called H2 blockers (Tagamet, Pepcid and Zantac), with an increased risk of dementia. Acid inhibitors make it difficult for the digestive tract to absorb nutrients from food, supplements and will even decrease absorption of prescription medications.

Reported in the July 2013 issue of Circulation found that acid inhibitors may also cause cardiovascular disease. The research from the Houston Methodist Hospital and two other institutions, found PPIs caused the constriction of blood vessels in mouse models and human tissue. This would affect in particular the brain and heart.

According to a study published in January 2016 issue of JAMA Internal Medicine, as many as 70% of PPI prescriptions in the United States have been inappropriately handed out by doctors. They are the third highest-selling class of drugs in the United States, after antipsychotics and statin drugs.

It can be extremely difficult to stop PPIs after long term use and must be done very very slowly!

Dr. Shoshana J. Herzig of Beth Israel Deaconess Medical Center in Boston once stated, “Studies have shown that once you’re on them, it’s hard to stop taking them, it’s almost like an addiction. PPIs work by blocking the production of acid in the stomach, but the stomach revs up production of acid-making cells. You get excess growth of those cells in the stomach, so when you unblock production, you have more of the acid-making machinery.”

Before even attempting to decrease your PPI you need to find out why you have acid reflux and make some lifestyle changes.

  1. Change your eating habits and your diet. Don’t eat large meals or lie down right after a meal. Don’t woof down you meal, eat slowly and chew well. Don’t skip meals. Keep meals light and preferably non-acidic, low in spice and no fried foods. Coffee is very acidic even if decaffeinated. Alcohol particularly wine and beer can be problematic too. Curb your late night snacking.
  2. Have regular easy bowel movements every day. Constipation backs up the plumbing and messes up the stomach’s ability to process. Try a natural stool softener such as magnesium before bed.
  3. Are you stressed? Chronic stress &/or anxiety stirs up acid production.  Calm & Calmer (Lifetime Vitamins) is a very popular anti-stress/anxiety supplement.
  1. Check out your medications. Aspirin, ibuprofen, some blood pressure medicati medications for osteoporosis causes reflux.
  2. Supplements such as Digestive Enzymes, DGL, and Probiotics can help improve digestive function & decrease acid reflux.

Digestive Enzymes: When you eat a meal, the food that enters your stomach is subjected to a mixture of acid and enzymes that help to break it down into smaller particles that can eventually leave the stomach and enter the small intestine, where more enzymes continue the digestive process. In conditions in which insufficient gastric acid is present to activate your digestive enzymes, or when digestive enzymes are not produced in sufficient amounts, gastric emptying is delayed, the food sits and ferments in the stomach causing gas and bloating. This sometimes causes more acid to be produced in the stomach. To see if your stomach needs acid try taking ½ tsp of Apple cider vinegar in 4 oz water and drink with a meal. If symptoms are better then you are actually lacking acid to digest your food! If so then get a digestive enzyme with hydrochloric acid. If your symptoms are worse then you are producing too much acid and should look for a digestive enzyme without acid.

DGL (deglycyrrhizinated licorice) stimulates and accelerates the natural protective factors in the digestive tract by increasing the number of mucus-secreting cells, improves the quality of mucus which acts as a protective coating against acids and enhances microcirculation in the gastrointestinal lining. One study found that 350 mg of chewable DGL taken before consuming aspirin reduced the occurrence of aspirin-induced gastrointestinal bleeding.  Other studies have actually shown DGL to be as effective as the pharmaceuticals Tagamet and Zantac for the treatment of peptic ulcers without the side effects. The glycyrrhizin compound found in licorice and associated with high blood pressure has been removed. Chew 1-2 tablets 15 minutes before meals and before bed.

Probiotics (Dr. Ohhira’s Probiotics) - Probiotics or "friendly" bacteria process nutrients and maintain a balance in the digestive system between good and harmful bacteria. A study published in the September 2011 "Scandinavian Journal of Gastroenterology" found that participants who took probiotic supplements for 14 days experienced fewer of the common GERD/Reflux symptoms compared to those who did not take probiotics. Another study reported in the March 2014 "Journal of the American Medical Association" noted that infants who were given probiotics for their first three months had fewer gastrointestinal problems, including reflux, constipation and colic. For Adults (Dr. Ohhira’s probiotic) chew & then swallow 1 capsule 2 x day ( best ½ hour before a meal).

If you are having difficulty weaning off PPIs, Telephone appointments with a Holistic Practitioner are available at the Tree of Life Wellness Center. For more information call 508-336-4242.

Jane Jansen Holistic Practitioner Tree of Life Wellness Center

Host Holistic Healthline Radio

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