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Stomach Acid Drugs May Raise Pneumonia Risk

Risk From Acid-Suppressing Drugs Greatest in Frailest Patients

Who Needs Acid-Suppressing Drugs continued...

"PPIs are appropriate for people who truly have GERD [acid reflux], where their symptoms are affecting their quality of life," Peura tells WebMD. "These are people who have difficulty sleeping, who are altering their lifestyles for the better and still are not able to control their symptoms. Most of these people have serious heartburn three or more times a week."

The H2 antagonists are "ideally suited" for people with only occasional heartburn, Peura says. Most people need these drugs only once in a while.

"If you were going to eat a pizza and thought you would have a problem, you'd be better off taking Zantac or Pepcid before going out instead of taking the drugs on a regular basis," Peura says. "But there are others who when they just bend over, acid comes up into their esophagus. These people need regular acid suppression."

Lifestyle changes can reduce the risks of heartburn, such as:

  • Avoid foods and beverages that contribute to heartburn: chocolate, coffee, peppermint, greasy or spicy foods, tomato products, and alcoholic beverages.
  • Stop smoking.
  • Lose weight.
  • Eat slowly.
  • Do not lie down after eating.

How Acid-Suppressing Drugs Promote Infection

How might these drugs cause infection? Exactly the same way they work: by suppressing stomach acid. While it sounds bad, stomach acid is the body's first line of defense against swallowed germs. The acid can kill bacteria and viruses that cause pneumonia.

The bodies of healthy people have plenty of other ways to fight germs. But elderly people and those with chronic diseases need all the germ-fighting help they can get. This is exactly who is at most risk for pneumonia when using acid-suppressing drugs.

Laheij's team found the risk of severe pneumonia to be highest in the elderly. Children and people with weakened or suppressed immune systems were also at higher risk. And there was a greater risk of pneumonia in users of acid-suppressing drugs who had asthma or lung disease.

It's not clear how germs from the stomach get into the lungs to cause pneumonia. But the new link to pneumonia means doctors will keep a closer eye on patients who take acid-suppressing drugs, says lung specialist Greg Martin, MD, MSc. Martin teaches pulmonary, allergy, and critical care medicine at Emory University and is director of the pulmonary clinic and the medical intensive care unit at Grady Memorial Hospital in Atlanta.

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