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Heartburn Drugs May Raise Fracture Risk in Older Women
Date:2/1/2012

percent of the women used PPIs regularly; by 2008 that had jumped to 18.9 percent. This could mean that more fractures will be seen in years to come, they added.

Women who stopped using PPIs saw their risk of hip fracture return to normal within two years, Khalili's group noted.

In calculating the risk of hip fracture, the researchers tried to account for weight, age, exercise, smoking, calcium in the diet and supplement use.

Dr. Olveen Carrasquillo, chief of general internal medicine at the University of Miami Miller School of Medicine, said that, "I have really been concerned about doctors dispensing too many PPIs and people taking these for life."

"A lot of the time, PPIs are used for things that are controlled better with diet," he said.

PPIs should be given for a few months and then tapered off, Carrasquillo said. "The problem is that if you stop them suddenly you get acid rebound, and patients start having symptoms again, so you need to taper them off the medication slowly," he explained.

Carrasquillo noted that smokers are at higher risk of gastric problems and complications from PPIs. So, quitting smoking is a good start in controlling these issues, he said.

Often, calcium supplements are used to bolster bone strength, but because PPIs affect the absorption of calcium, taking calcium supplements may not be effective, he said. The researchers did take calcium supplement use into account and the risk remained, he added.

"It looks like, even among women who are smokers, taking calcium supplements doesn't seem to make a difference," he said.

There is a small group of patients whose symptoms will persist and for these patients one has to balance the risk of fracture with the benefit of the drug, Carrasquillo said. "But in the vast majority of cases these patients should not be on PPIs," he said.

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