DEAR DR. DONOHUE: Is it true that those of us who have to take Prilosec every day are in danger of getting a bone fracture? Should we consider stopping it? — Anon.
ANSWER: We need to give readers a clue to what we’re talking about. The subject is GERD, gastroesophageal reflux disease, something most call “heartburn.” It’s the eruption of stomach acid and digestive juices into the esophagus, a place not built to withstand those powerful fluids.
Proton-pump inhibitors are the most effective suppressants of acid production. There are eight: Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Dexilant (dexlansoprazole), Protonix (pantoprazole) and Aciphex (rabeprazole). These medicines have made life livable for people who don’t respond to other strategies or medicines for heartburn control.
All effective medicines have side effects. A side effect of proton-pump inhibitors is weakening of the hip bone with possible fracture of it. It’s not a common occurrence. When it happens, it happens to those who have taken high doses of these medicines for five to seven years. As a preventive step, take a proton-pump inhibitor at the lowest dose that controls symptoms and for the shortest time possible. You can resume taking it if and when heartburn returns.
You also can try acid suppressants that don’t have this side effect: Tums, Rolaids and Maalox. Don’t eat foods that cause you to have heartburn. Frequent offenders are excessive amounts of caffeine, chocolate, alcohol, peppermint, fatty foods, citrus fruits and tomatoes. Or try a different family of acid suppressants. Zantac (ranitidine), Pepcid (famotidine) and Tagamet (cimetidine) are examples.
I wouldn’t use the unapproved treatment mentioned in the letter you sent. It appears that its distributor is playing on exaggerated fear.
The booklet on heartburn explains this illness and its treatment in detail. Readers can order a copy by writing: Dr. Donohue — No. 501W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
Readers may write Dr. Donohue or request an order form of available health newsletters at P. O. Box 536475, Orlando, FL 32853- 6475.
©2013 North America Synd.