Omeprazole: Cancer Risk and Alternatives

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Proton pump inhibitors (PPIs) are the most commonly prescribed drugs in the United States. PPIs such as omeprazole (Prilosec), rabeprazole, lansoprazole, and esomeprazole are used to treat Helicobacter pylori infection , acid reflux , and gastroesophageal reflux disease (GERD) .

New data from several studies suggest that there is a link between long-term use of proton pump inhibitors and the development of stomach cancer. Alternatives to PPI are available as needed.

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PPI and cancer

When food is digested, the stomach uses stomach acid to break down the food. During this process, cells in the stomach called G cells release a hormone called gastrin, which signals other cells to pump acid. PPIs prevent acid build-up .

The body reacts by realizing that there is not enough acid and struggles to produce more, producing more gastrin. Too much gastrin has been found to promote the growth of gastrointestinal tumors .

Some studies have shown that gastric acid suppression by PPIs leads to :

  • Increase in gastrin levels.
  • Inflammation of the stomach lining.
  • Bacterial growth

This, in turn, may play a role in the development of gastrointestinal cancer.

A 2019 study found that even when Helicobacter pylori infection was eradicated, long-term PPI use was still associated with a two-fold increased risk of stomach cancer .

Other risks associated with PPIs

Long-term use of PPIs has been associated with :

  • Reduced B12 level
  • Increased risk of pneumonia.
  • Increased risk of hip fractures.
  • Increased risk of dementia.
  • Increased risk of heart attack.
  • Increased risk of chronic kidney disease.

Should I stop using Prilosec?

PPIs such as lansoprazole (Prevacid) and omeprazole (Prilosec) are available without a prescription. But long-term use can be problematic.

The U.S. Food and Drug Administration (FDA) states that over-the-counter PPIs should only be taken for a 14-day course, up to three times a year.

In some cases, medications called H2 blockers such as Pepcid or Tagamet may be appropriate. After a week of taking an H2 blocker instead of PPI, the PPIs will clear from the system. Then you can switch to over-the-counter antacids if necessary.

However, some people can still experience severe symptoms after stopping proton pump inhibitors and may need to go back to taking them at a higher dose.

Before making any changes to medication or dosage, patients taking PPIs should discuss with their healthcare provider whether they should continue taking the medication or whether other options may be appropriate.

Stopping PPI abruptly can cause rebound effects

If you have been taking PPIs for at least a few weeks, you should not suddenly stop taking the medicine. This can cause a rebound effect of gastric juice .

Alternatives to PPI

Although PPIs are the most common prescription drug in the United States, there are alternatives. This can include lifestyle changes, alternative treatments, and other medications.

Other medications

There are other medications that can be used in place of PPIs to treat conditions such as acid reflux.

H2 blockers are drugs that reduce the production of hydrochloric acid in the stomach. They are absorbed quickly and as a result, acid suppression persists for several hours after medication. H2 blockers can also counteract the effects of acid in the esophagus, which causes heartburn .

H2 blockers include:

  • Cimetidine (Tagamet)
  • Ranitidine (Zantac)
  • Nizatidine (Axid)
  • Famotidine (Pepcid)

In some cases, antacids may be appropriate. These drugs work by neutralizing gastric juices. It is the oldest heartburn remedy on the market. Most antacids are a mixture of magnesium and aluminum hydroxide. Some may also contain baking soda .

Changes in lifestyle

In addition to medications, lifestyle changes can sometimes help conditions that are treated with PPIs, such as acid reflux or GERD.

Lifestyle changes that can help include:

  • Avoid spicy, fatty or acidic foods.
  • Slim down
  • Give up smoking
  • Eat small meals
  • Get enough sleep
  • Raise the head of the bed at night to sleep.
  • Avoid foods and drinks that can cause reflux, such as citrus fruits, chocolate, mint, coffee, alcohol, and tomato-based foods .

Alternative therapy

Some alternative treatments that may be helpful as alternatives to PPIs include:

  • Acupuncture
  • Hypnotherapy
  • Medicinal herbs

Herbal remedies that may be helpful include :

  • Chamomile: Chamomile tea soothes the digestive tract, but should not be taken by people allergic to ragweed.
  • Licorice: It is believed to help coat the esophagus, protecting it from irritation from stomach acid.
  • Ginger – Has been used for centuries to improve digestion and relieve heartburn.

Prophylaxis

There are a number of steps that can help you avoid acid reflux or GERD and can help you avoid the need for medications.

Some ways to prevent acid reflux or GERD in the first place include:

  • Maintain a healthy weight: Gaining weight can increase your risk for acid reflux and GERD. Losing overweight weight and maintaining a healthy weight can prevent this.
  • Don't smoke – Nicotine is an addictive ingredient in tobacco. Nicotine is also believed to relax the esophageal sphincter, which can lead to reflux or heartburn.
  • Avoid Certain Foods and Drinks: As mentioned above, avoiding spicy, greasy, or irritating foods and drinks like tomatoes, peppermint, or coffee can help prevent reflux.
  • Avoid carbonated drinks – Carbonated drinks and carbonated water can cause belching, which sends acid into the esophagus. Drinking sodas like water can help prevent this.
  • Stay upright after eating: Sitting upright or standing up after eating helps keep acid in your stomach. Eating food three hours before bed will help prevent reflux.
  • Avoid fast activity after meals – Vigorous exercise or workouts that involve squatting can cause acid to move up your esophagus. Wait a couple of hours after eating before actively exercising.
  • Sleep with your head up – When you sleep, your head should be six to eight inches higher than your legs. This can be accomplished by using a foam wedge to support the upper body or by using studs on the legs of the bed next to the headboard.
  • Monitor your medications – Some medications can relax the sphincter and cause reflux. Others can irritate the esophagus. Always talk to your doctor before stopping or changing any medicine.

Get the word of drug information

If in doubt about whether proton pump inhibitors are right for you, talk to your doctor. It is important not to stop taking these medicines suddenly if you have been taking them for a while. Your healthcare provider can suggest alternative PPI options if needed. It is important that GERD is monitored and monitored by a healthcare provider, as uncontrolled GERD can pose a serious health risk.

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