New Delhi: Over-the-counter medications like antacids and proton pump inhibitors (PPIs) are widely used to relieve symptoms of heartburn, acid reflux, and indigestion. While these medications offer quick relief and are generally safe for short-term use, long-term reliance can lead to potential health risks. In an interaction with News9Live, Dr Bhuvan Shetty, Consultant Medical Gastroenterologist and Hepatologist, Gleneagles BGS Hospital, Kengeri, Bengaluru, listed the side effects of using antacids in excess. The expert also shared an antidote to such situations.
How Antacids and PPIs Work
Antacids are easily accessible over-the-counter drugs that work by neutralizing stomach acid, providing quick relief from heartburn and acid reflux symptoms. They contain ingredients like magnesium hydroxide, aluminum hydroxide, or calcium carbonate, which reduce the acidity of the stomach contents.
PPIs, on the other hand, are a class of medications designed to reduce acid production in the stomach by blocking the proton pumps in the gastric lining. They are often prescribed for chronic acid reflux, gastroesophageal reflux disease (GERD), and peptic ulcers. PPIs like omeprazole, pantoprazole, and esomeprazole are extremely effective but are often misused due to their availability and immediate relief.
The Risks of Long-Term Use
Although both antacids and PPIs are effective, prolonged or indiscriminate use can have unintended consequences. Here are some key concerns associated with their long-term use:
Nutrient Deficiencies: Long-term use of PPIs can interfere with the absorption of essential nutrients like vitamin B12, magnesium, calcium, and iron. Stomach acid plays a critical role in breaking down these nutrients for absorption. A decrease in acid levels can lead to deficiencies, causing fatigue, anemia, brittle bones, and muscle cramps.
Increased Risk of Fractures: PPIs have been linked to reduced calcium absorption, which can weaken bones over time. This increases the risk of osteoporosis and bone fractures, particularly in older adults.
Gut Microbiome Imbalance: Stomach acid is a natural barrier that prevents harmful bacteria from entering and thriving in the gastrointestinal tract. Long-term acid suppression can disrupt the gut microbiome, leading to bacterial overgrowth, such as Clostridium difficile infections, which may cause diarrhea and severe gut inflammation.
Rebound Acid Hypersecretion: When PPIs are stopped abruptly after long-term use, the stomach produces acid at an increased rate, leading to worsening symptoms. This rebound effect often traps patients in a cycle of dependency.
Kidney Disease: Emerging research has linked long-term PPI use to chronic kidney disease. The exact mechanism is unclear, but the association warrants caution and monitoring for patients on prolonged therapy.
Cardiovascular Risk: Prolonged PPI use has been associated with an increased risk of cardiovascular issues, including heart attacks. Although more studies are needed, they emphasise the importance of using these medications only when necessary.
Safe Use of Antacids and PPIs
To avoid the risks associated with long-term use of antacids and PPIs, here are some recommendations:
Short-Term Use: Antacids and PPIs should only be used for short durations, under the guidance of a healthcare provider. For chronic conditions like GERD, regular follow-up is essential to monitor progress and adjust treatment.
Lifestyle Modifications: Addressing the root cause of acid reflux can reduce dependency on medications.
Avoid trigger foods like spicy, fried, and acidic items.
Eat smaller, frequent meals.
Avoid lying down immediately after eating.
Maintain a healthy weight.
Elevate the head of the bed while sleeping.
Gradual Tapering: Patients on long-term PPIs should consult their gastroenterologist for a gradual tapering plan to prevent rebound acid hypersecretion.
Alternative Therapies: H2 receptor blockers, which reduce acid production without completely blocking it, can be considered for some patients as a safer alternative.
Conclusion
While antacids and PPIs offer significant relief for acid-related conditions, their long-term use comes with risks that cannot be ignored. Nutrient deficiencies, gut imbalances, and potential long-term complications highlight the need for cautious use. Patients experiencing chronic acid reflux or indigestion should seek guidance from a gastroenterologist to explore safer, more sustainable treatment strategies. Addressing lifestyle factors and using medications judiciously can help maintain gastrointestinal health without unnecessary risks.
Antacids are easily accessible over-the-counter drugs that work by neutralizing stomach acid, providing quick relief from heartburn and acid reflux symptoms. They contain ingredients like magnesium hydroxide, aluminum hydroxide, or calcium carbonate, which reduce the acidity of the stomach contents. Health News Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
