Can Heartburn Medicine Be Tied to Stomach Cancer?
Taking heartburn drugs like they're candy might up your odds for stomach cancer, a new study suggests.
The threat was proportionate to how long and how frequently these medications, known as proton pump inhibitors (PPIs), have been obtained. That danger increased anywhere from two to eight times, the study authors said.
The risk was small, even though the risk appears to be large. But it was statistically significant, particularly for people infected with Helicobacter pylori, a bacteria associated with stomach cancer, the investigators explained.
"While PPIs are among the most commonly used medications for treating celiac disease in addition to dyspepsia, clinicians must exercise discretion when prescribing long-term PPIs, even to patients who have H. pylori cured," said head researcher Dr. Wai Keung Leung. He's a professor of gastroenterology at the University of Hong Kong.
PPIs contain commonly used drugs such as Prilosec, Nexium, and Prevacid.
Eliminating H. pylori lowers the chance of stomach cancer significantly, Leung noted. But even after the bacteria is treated, a lot of people develop stomach cancer.
This study could not demonstrate PPIs cause stomach cancer that an association exists. PPIs are usually considered safe.
"The information to PPI consumers, particularly those with past H. pylori infection, is to be cautious with the prolonged use of PPIs," Leung said. "Doctors must review the signs and demands of long-term PPIs in those patients."
The gain in the risk of stomach cancer with PPIs was not sufficient to prompt their use to be abandoned by one gastrointestinal specialist.
"In my own experience, I have seen medication evolve. And one point that I try to keep in mind is, while several research exists and treatment is evolving, we must tailor therapy on an individual basis," said Dr. Sherif Andrawes. He is director of endoscopy at Staten Island University Hospital in New York City.
In spite of this new study, "there are medical situations where PPI treatment is needed and the risk of side effects is minor than the danger of creating cancer or bleeding of another area in the gastro-intestinal tract," Andrawes said.
By way of instance the medications can help curb stomach acids and guard against esophageal cancer in people with Barrett's esophagus.
But, "I also attempt to make sure that when a patient comes in for reflux symptoms, that we attempt work on lifestyle modification and diet first, instead of initiating PPI therapy," Andrawes added.
Stomach cancer is the top cause of cancer death in the world, he noted, and studies have discovered a link between stomach cancer and PPIs. However, the function of H. pylori was less clear.
To attempt and estimate the role the germs played, Leung and his colleagues compared using PPIs with a different category of drugs used to lower stomach acid -- histamine H2-receptor antagonists (H2 blockers).
The study followed almost 63,400 patients treated with a combination of a PPI and two antibiotics to kill H. pylori. The therapy was granted over seven times between 2003 and 2012.
The patients have been followed for a mean of seven decades, until the participants either developed stomach cancer, expired, or the study ended.
In this period, over 3,200 individuals took PPIs for nearly three years, while almost 22,000 took H2 blockers (Zantac, Tagamet).
After being treated with two antibiotics and a PPI, in general, 153 people developed stomach cancer. None of these subjects tested positive for H. pylori, but they all had persistent gastritis.
Taking PPIs was linked with more than twice the chance of developing stomach cancer while taking H2 blockers wasn't associated with any increased risk, the researchers found.
In addition, people who obtained PPIs daily had over four times the risk for stomach cancer, compared with people who used the drug once a week.
And the longer PPIs were utilized, the larger the risk of stomach cancer, the findings showed.
Five times rose after over annually, after at least two years to over six times, and to more than eight occasions after three or more years, Leung said.
Reports have also linked long-term usage of PPIs with diabetes, heart attack and bone fracture, he added.
