Heartburn drugs may raise risk of stomach infections: study

January 5, 2017 by Amy Norton, Healthday Reporter

(HealthDay)—People who take heartburn drugs such as Prilosec and Nexium may be at increased risk of two potentially serious gut infections, a new study suggests.

The study, of nearly 565,000 adults, found those on certain heartburn drugs had higher risks of infection with C. difficile and Campylobacter bacteria.

Both bugs cause abdominal pain and diarrhea, but can become more serious—especially C. diff. According to the U.S. Centers for Disease Control and Prevention, almost half a million Americans were sickened by the infection in 2011, and 29,000 of them died within a month.

The heartburn drugs in question included both proton pump inhibitors (PPIs)—brands like Prilosec, Prevacid and Nexium—and H2 blockers, such as Zantac, Pepcid and Tagamet, the study authors said.

All suppress stomach acid production, and the researchers suspect that may make some people more vulnerable to gastrointestinal infections.

The new findings, published Jan. 5 in the British Journal of Clinical Pharmacology, aren't the first to raise such concerns.

The U.S. Food and Drug Administration has already warned about a risk of C. diff infection linked to .

"This study offers more evidence that there's an association," said Dr. F. Paul Buckley, surgical director of the Heartburn and Acid Reflux Center at the Scott & White Clinic in Round Rock, Texas.

Buckley, who was not involved in the study, said it's also important to see the results in a bigger context. Long-term use of PPIs, in particular, has been tied to a number of health risks, including nutrient deficiencies, bone loss and heart attack, he said.

Because PPIs are so common and available over-the-counter, people may assume they're "100 percent safe," Buckley pointed out.

"There's still a myth that these drugs are benign," he said. "It's not true."

The new findings don't actually prove that either PPIs or H2 blockers raised the risk of gut infections.

But it is plausible, according to the researchers, led by Dr. Thomas MacDonald, a professor of pharmacology at the University of Dundee in Scotland.

They suspect that drugs that suppress stomach acids can change the balance of "good" and "bad" bacteria in the gut, which may make people more susceptible to infections.

Dr. David Bernstein, a gastroenterologist who was not involved in the study, agreed that stomach acid suppression could be the culprit.

But he also stressed that alone do not directly cause gut infections.

For one, C. diff most often strikes people who are sick and on prolonged courses of antibiotics. And Campylobacter infections are foodborne—usually caused by eating raw or undercooked poultry, or foods contaminated by those products.

"So it's not just that you take a PPI and you get C. diff," said Bernstein, who is chief of hepatology at Northwell Health in Manhasset, N.Y.

Still, he said, patients and doctors should be aware that the drugs might contribute to the risk of certain infections.

For the study, MacDonald's team analyzed medical records from close to 565,000 Scottish adults. More than 188,000 had been given at least one prescription for a PPI or H2 blocker; the rest had no prescriptions for the drugs, researchers said.

On average, people on the drugs were roughly four times more likely to develop a Campylobacter infection between 1999 and 2013.

They were also 70 percent more likely to be diagnosed with C. diff outside of a hospital. Their odds of being diagnosed in the hospital were 42 percent higher.

The researchers accounted for other factors, such as people's age and medical history. And they still found an association between the heartburn medications and higher infection risks.

Bernstein stressed that the study is reporting group averages.

"The risk to any individual patient would actually be quite small," he said.

But people should be sure they truly need a PPI or H2 blocker before taking one, Bernstein said.

"And you should be reassessed over time, to see if you really need to continue the medication," he added. "The potential problems are with long-term use."

Buckley made the same point. Even if a doctor prescribes a PPI, he said, ask questions. "Ask why it's being prescribed, and whether there are any alternatives," he advised.

H2 blockers are one alternative, Buckley said. Even though this study tied them to , he said, the drugs don't seem to carry the other risks linked to PPIs, including heart problems.

People with only occasional heartburn don't need PPIs at all, Buckley said. They may do well with diet and lifestyle changes alone.

For people with more severe acid reflux, he said, surgery might be an option.

Explore further: Acid suppression medications linked to serious gastrointestinal infections

More information: The U.S. National Institutes of Health has more on treating heartburn.

Related Stories

Acid suppression medications linked to serious gastrointestinal infections

January 5, 2017
In a population-based study from Scotland, use of commonly-prescribed acid suppression medications such as proton pump inhibitors (PPIs) was linked with an increased risk of intestinal infections with C. difficile and Campylobacter ...

Popular heartburn medication may increase ischemic stroke risk

November 15, 2016
A popular group of antacids known as proton pump inhibitors, or PPIs, used to reduce stomach acid and treat heartburn may increase the risk of ischemic stroke, according to preliminary research presented at the American Heart ...

Heartburn medicines associated with chronic kidney disease risk

January 18, 2016
A type of heartburn medication called proton pump inhibitors (PPIs) may be linked to long-term kidney damage, according to a new study published in JAMA Internal Medicine.

Avoiding over-the-counter heartburn meds could save cancer patients' lives

December 16, 2016
Something as seemingly harmless as a heartburn pill could lead cancer patients to take a turn for the worse. A University of Alberta study published in journal JAMA Oncology discovered that proton pump inhibitors (PPIs), ...

Acid reflux medications may increase kidney disease risk

October 27, 2015
Certain medications commonly used to treat heartburn and acid reflux may have damaging effects on the kidneys, according to two studies that will be presented at ASN Kidney Week 2015 November 3-8 at the San Diego Convention ...

Acid-reducing medications sharply raise risk of C. diff. bacteria infection in kids

June 17, 2015
Infants and children who are given prescription acid-reducing medications face a substantially higher risk of developing Clostridium difficile infection, a potentially severe colonic disorder. The findings, reported by Columbia ...

Recommended for you

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.