New developments raise questions about “heartburn” drugs

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Cambridge (Massachusetts, USA): «Middle East»

New information about heartburn medications could affect the approach of millions of people who turn to prescription drugs or buy them directly from pharmacies when dealing with heartburn caused by gastroesophageal reflux disease or other stomach ailments. But the desire to treat heartburn by taking different medications and prescriptions may leave a “sour taste in your mouth”, and some drugs may have health risks. Here’s what you need to know about the two essential drugs to treat, and how recent advances could affect our lives.
H2 blockers «
histamine 2 receptor antagonists» known as H2 blockers such as famotidine (Pepcid) and cimetidine (Tagamet) are available over the counter or by prescription.
These drugs block a chemical that stimulates the stomach to produce acid, and they are the ones we usually resort to when antacid drugs such as calcium carbonate or aluminum hydroxide are not strong enough.
Carcinogenic substances
Last year, drug manufacturers began to take back all the ranitidine drugs, which are antihistamine 2 drugs, after the Food and Drug Administration discovered the presence of a chemical called N-nitrosodimethylamine (NDMA) that causes cancer in many Brand-name drugs (Zantac) and generic drugs (of the same gender).
In April 2020, the US Food and Drug Administration called for the withdrawal of all ranitidine products from pharmacies and urged consumers to stop consuming them.
The same administration also urged the voluntary recall of nizatidine (Axid oxid) after discovering the presence of the carcinogen “NDMA” in it.
Therefore, if you have been taking ranitidine or nizatidine for a long time, you should consult your doctor about other options.
Dr. Kyle Stoller, a gastroenterologist at Harvard University’s Massachusetts General Hospital, said, “We did not find any other unsafe histamine 2 blockers until April 2020, and the carcinogen NDMA was not found in famotidine. Or cimetidine.

Risks of use
Are there risks associated with the use of histamine 2 blockers? Cimetidine may interfere with the absorption of anticoagulants (blood thinners), antidepressants, and blood pressure medications. But Dr. Staller reports that, in general, there are no long-term or short-term health risks from using histamine-2 blockers. “The biggest problem,” he explains, “is that histamine 2 blockers are not always effective at suppressing acids, and over time they may not work as well as the body gets used to them.”
Proton
-pump inhibitors Proton-pump inhibitors PPIs, such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium) are more powerful than histamine 2 blockers. They prevent certain cells from “pumping” the acid into the stomach, which reduces acid levels and the pain of heartburn.
These drugs are available over the counter or by prescription and are considered medically safe in the short term. However, long-term risks have been a concern for years.
Unjustified fears
In the past, these drugs have been linked to low levels of vitamin B12, magnesium and calcium, and some studies have indicated that they may increase the risk of hip fractures, pneumonia, kidney or cardiovascular disease, and dementia.
However, these concerns raised by those studies may actually harm people. “People who actually need to use proton pump inhibitors because of severe heartburn, ulcer disease, or Barrett’s esophagus [a possible precursor to esophageal cancer] have stopped,” says Dr. Stoller. Take medicines, but we do not have evidence that justifies their doing so. ”
Safe drugs
Fortunately, the best evidence suggests that PPIs are safe. A randomized trial published online on May 29, 2019 by the American Gastroenterological Association – involving 17,000 older adults who underwent observation over a three-year period – showed that There is no link between use of proton pump inhibitors and increased rates of pneumonia, fractures, type 2 diabetes, chronic kidney disease, dementia, COPD, or cancer.
More recently, a study of more than 640,000 people, published online on January 2, 2020, in the American Journal of Gastroenterology found no increased risk of dementia among PPI users.
So what’s the reason for a relationship between taking proton pump inhibitors and other health problems in the past? Dr. Staller says, “The majority of people who take PPIs have had poorer health before than those who do not, but the majority of studies were observational studies, which means that researchers have not proven that PPIs have caused specific other conditions.”
Danger of treating acidity
However, there is one known risk of using proton pump inhibitors. We know that stomach acid helps prevent bacteria from entering your body. Therefore, if the stomach acid is lower, this means that you face an increased risk of developing an intestinal infection. However, Dr. Stoller stated that this is not a sufficient reason to stop taking a proton pump inhibitor if that drug was beneficial and the user felt better.

Heartburn … Health steps
> If you have new symptoms of heartburn, do not initiate yourself using proton pump inhibitors, as Dr. Stoller says: “First, try making some changes to your life from countries of resorting to drugs by quitting smoking. You lose some weight and avoid the food and drink that cause you heartburn.
And if this does not lead to adequate rest, start with antacids. If this is not effective, you can use 2 antihistamines for a few weeks. If that doesn’t work, try proton pump inhibitors.
And if you still have heartburn after two weeks of using proton pump inhibitors, see your doctor to get to the root cause of the problem, as you may need more diagnostic tests and various treatments.
Don’t suddenly stop taking proton pump inhibitors, as this can cause reflux and worsening heartburn.
Harvard Health Mission,
Tribune Media Services

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