Dispatch: Sticks and Stones (and PPIs) May Break Your Bones

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A report published in the Archives of Internal Medicine suggests that Proton Pump Inhibitors (PPIs) like AstraZeneca’s Nexium and Prilosec — which treat inflammation of the esophagus, gastroesophageal reflux disease, ulcers and several other conditions by suppressing acid production in the stomach — can raise the risk of fractures in post-menopausal women and are associated with an increased risk of an uncommon bacterial infection in hospitalized patients.

“The researchers found a 74 percent increase in cases of a recurrence of an infection with the bacterium Clostridium difficile, which causes severe diarrhea,” says ACSH’s Dr. Gilbert Ross. “Since ‘C-dif’ infections are quite uncommon, it’s impossible to say how significant this is. They also found no change in bone mineral density among the women who were at a higher risk of fractures, so I’m curious about the mechanism that increases this risk.”

“On the basis of these studies, we’re not yet at the point where we would ask people who use these to stop using them every day,” says ACSH’s Dr. Elizabeth Whelan. “This report is perhaps more useful to alert doctors to possible negative side effects when they are prescribing PPIs — or when they learn that the patient is using an over-the-counter version of a PPI — especially for patients that take them long term.”