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    Heartburn Drugs Linked to Hip Fractures in Women

    Study Helps Clarify Who Is at Risk for Fractures With Long-Term PPI Use
    WebMD Health News
    Reviewed by Laura J. Martin, MD

    Jan. 31, 2012 -- Postmenopausal women with a history of smoking who take heartburn drugs called proton pump inhibitors (PPIs) for two years or longer may be more likely to sustain a hip fracture.

    And the longer women take PPIs, the greater their risk.

    That said, the risk does disappear after women stop taking these drugs for two years. The new findings appear in the journal BMJ.

    These drugs, which are available by prescription and over the counter, work by reducing the secretion of stomach acid. PPIs such as Nexium, Prevacid, Prilosec, and Protonix are commonly recommended for people with gastroesophageal reflux disease (GERD), peptic ulcers, erosive esophagitis, and a precancerous condition known as Barrett's esophagus. They are among the most widely used medications worldwide.

    Changing the acid environment in the stomach may reduce the absorption of calcium, which is needed for healthy bones. This is not the first study to link long-term PPI use with bone fractures, but it does help narrow down who is at greatest risk. Women who never smoked were not at increased risk for hip fracture even if they took PPIs regularly, the study showed.

    The message is clear: Postmenopausal women with history of smoking who take PPIs for longer than two years have more than a 50% chance of sustaining a hip fracture, says researcher Hamed Khalili, MD. He is a gastroenterologist at Massachusetts General Hospital in Boston.

    It is also time to take a long, hard look at who is taking these pills chronically and why. “There are very few indications that require long-term and regular use of PPIs,” he says.

    His advice? “Consider stopping if there are no real indications, and among those that require long-term use, you may try to switch to less potent acid-suppressive medications.”

    Make Lifestyle Changes First

    Robynne Chutkan, MD, says these medications must be used judiciously, not indiscriminately. She is an assistant professor of medicine at Georgetown University Hospital in Washington, D.C.

    We may all want to pop a pill and make our heartburn go away, but “the cornerstone treatment for GERD is still lifestyle modifications.”

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