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Proton-pump inhibitors (PPIs) such as Nexium, Prevacid and Protonix are widely prescribed for heartburn and gastroesophageal reflux disease (GERD). But recent studies suggest their rampant overprescription and misuse are leading to serious health problems. Here are some PPI facts worth knowing:

In 2008 Americans bought more than $14 billion worth of PPIs, making them second only to lipid regulators (statins) as the best-selling drug class in the country.

A 2009 study published in the American Journal of Medicine suggests that up to 60 percent of PPI prescriptions for hospitalized patients are unnecessary.

A 2009 study published in the journal Gastroenterology suggests that extended use of PPIs may worsen the symptoms the drugs are designed to treat, leading to counterproductive, continued treatment. At the end of a 12-week trial, 22 percent of 120 healthy subjects who had received the acid-blocking drugs reported suffering from heartburn and acid reflux, while only 2 percent of the placebo group reported such problems.

A 2006 study in the Journal of the American Medical Association (JAMA)reported that people taking long-term, high-dose PPIs (which inhibit calcium absorption) are 2.65 times more likely than controls to experience hip fractures.

Studies published in JAMA in 2004 and 2005 reported that subjects on acid-suppressing drugs are nearly twice as likely as unmedicated subjects to develop pneumonia.

In March 2010, researchers reported in Clinical Gastroenterology and Hepatology
that, at an Italian hospital, half the subjects taking PPIs suffered from an infection of the small intestine caused by H. pylori bacteria from the colon, compared with only 6 percent of healthy subjects not taking the drugs.

Looking for an alternative approach to treating heartburn problems? Many with chronic digestive distress are aided by treating H. pyloribacterial overgrowth, making dietary changes and taking digestive enzymes, according to Mark Hyman, MD, chairman of the Institute for Functional Medicine and founder of the UltraWellness Center in Lenox, Mass. Read more of Dr. Hyman’s recommendations at

For more information on medications for heartburn and GERD, read “The Other Drug Problem,” from our April 2011 issue.

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