Proton Pump Inhibitors (PPI)

Purple Pill Redux (or is that multiplied?)

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Remember when I wrote about the deadly purple pill?  Where I warned you that it often led to kidney failure?  I mentioned also that affects (negatively) bone density and probably causes gut infections.   Well, that last fact is becoming extremely obvious.

Drs.  Li Wei and Thomas McDonald, along with Drs. L Ratnayake, G Phillips, CC McGuigan, SV Morant, RW Flynn, and IS Mackenzie (all fromm various UK establishments) published their study “Acid suppression medications and bacterial gastroenteritis: a population-based cohort study” in the British Journal of Clinical Pharmacology.

This study examined some 564969 folks over a wide range of ages; about 1/3 of them were taking an acid-suppression medicine.  These medicines are either proton-pump inhibitors (these stop acid secretion by inhibiting the proton pump in the parietal cell membranes) or H2-receptor antagonists (these block histamine action, which is a primary regulator of acid secretion.

Dangers of Acid Suppressing Meds

The study parriticipants were part of the MEMO database (Tayside Medicines Monitoring Unit), covering primarily White (97%) patients (rural and urban settings) serviced by the National Health Service in Scotland. Over the 14 y period of study (January 1999 through February 2013), some 22705 cases of GI (gastro-intestinal) infections (bacterial gastroenteritis) were observed among those 188323 taking the medicines, plus the 376646 control subjects.  The offending microbial infections arose from salmonella, E coli, campylobacter, and Clostridium difficile populations.  C difficile was the most prominent microbial problem, present in 15273 of the 22705 cases.  This turns out to be about thrice (2.7X, to be exact)  as likely as those not taking the drugs.  The reasons seem to be that the gut microbiome is altered when one takes these two  drugs.

One of the problems is the proton pump inhibitor, by lowering the acidic milieu of the GI system, affords the C difficile (which is acid resistant) an environment in which it is more likely to thrive.  (This microbe operates in the vegetative state and not resort to spore preservation.)

 

So, as I stated before, we already know that about 70% of the folks taking these drugs don’t need them.  Given that, and all the potential problems from taking them, maybe it’s time to reconsider their use- especially if you are one of those popping the pills!

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21 thoughts on “Purple Pill Redux (or is that multiplied?)”

  1. Our timing could not have been better if we planned it, Roy. I posted a recipe for Chili-Dogs today. 🙂 hahahaha 🙂 But in all seriousness, I was interested to see you mention the kidney issues, will be clicking over to read your post on that now. My mom had to be hospitalized with kidney problems, and it was eventually determined to be be this med. Interestingly, the doctors didn’t want to consider it a possibility because there were no official studies that proved the connection. (This was probably 10 years ago). We did, however, find a number of studies published in other countries. Nice to see we are finally catching on here. Good read.
    Susan Landry recently posted..All-Star Hot Dog Chili

    1. Glad to provide you the data, Susan.
      The link to kidney issues developed about a decade ago- but, you are right, those developments were more noted by those in nephrology than in gastroenterology. That also is a function of the fact that we seem to have expanded the number of specialized journals; while that lets data get published sooner, it may leave others outside the parochial interests of the publication in the dark!
      Enjoy your chili-dogs.

  2. I have been taking Zantac til I can get back into my doctor. As I am one having those gut issues. It is horrible. I wish I could throw away the pill but my GERD is really bad. Even avoiding the foods I need to doesn’t help every day from me getting sick.

    1. Hopefully, your physician will be able to provide you alternative choices, Sandy.
      Yes, GERD is horribly painful- and when it is an acute condition, the short-term choice of drugs create fewer issues. It is the long-term use; given that situation, dietary changes and even surgery may be better alternatives. Unless and until we develop different drugs.
      I hope you feel better SOON.

  3. I’ve read about those pills before, and I do take them sometimes… but I am working to not need them as often, by eating smaller meals, not eating right before bed, avoiding things that cause my reflux, etc.

    1. So, Alana, the 30% that really need the drugs can be more fully monitored. Or, perhaps, provided an alternative dietary regime that would lessen the symptoms. Surgery- the introduction of a new valve- would have to be considered on a cost-benefit basis.
      But, I’m worried about the 70% that have occasional- and not permanent- symptoms. Choosing a better diet or using OTC items like Tums (that are not as powerful) may prove to be the better alternatives.

  4. WOW, what great timing! I have a problem with the little valve at the end of my esophagus to stomach and have been on prescription strength purple pill for a few years. My latest upper GI showed infection in my stomach. May be time to talk to the doc again. Thanks for the great post.
    Martha recently posted..Today is January 31

  5. Oh, OK. You have me convinced. No purple pills. They sound awfully toxic now. Who could believe that a pill that is such a lovely color could be toxic? But it is. I won’t take random and unnecessary pills. I do try to avoid eating before I go to bed, however.

    1. I think that’s why they chose the color, Alice. And, the advice to eat long before we go to bed not only cuts down on potential acid reflux, it’s better for our weight control and metabolism. (This is part of the “do as I say and not as I do” curriculum.)

    1. Wow. Sorry about that, Jeff. I try to keep the technical jargon to a minimum, just enough to explain the concept. Thanks for making me more aware of the need to examine my verbiage more carefully!
      Hmm. Losing weight. There’s a bandwagon that’s calling my name!

  6. I’m fortunate that I’ve never had to take more than an antacid (usually during pregnancy) for stomach issues. The old tried and true baking soda in water did the trick years ago. However, a certain cholesterol medication enabled my body to become diabetic. I personally think that Big Pharma is in the business of keeping us sick so we need to keep buying their drugs
    .
    They (some professionals) do say that GERD and such aren’t caused by too much acid, but by too little acid. There’s been some research around that as well.
    Jane Porterfield recently posted..History and Background of Affiliate Marketing

    1. I think that many of the issues are related to weak gastric valves and the foods we choose (as well as their timing). More than how much or little acid. Recognizing that almost any hydrochloric acid is toxic to the mucosa that line our esophagus, the degree of acidity becomes less of an issue.
      Liked you idea about baking soda, too, Jane. I have always been a fan of sodium bicarbonate. (Check out the composition of dialysate and colon lavage solutions!)

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    Bill recently posted..Bill

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