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Stomach Acid Drugs Come with Dangers, Studies Show
Date:5/10/2010

tions are for "inappropriate indications," such as indigestion or heartburn without ulcers, according to the editorial.

Instead, those patients should be prescribed proton pump inhibitors for only brief periods or not at all, according to the editorial. Patients could instead try eating smaller meals, especially before bed, losing weight, quitting smoking, reducing stress and raising the head of the bed.

Proton pump inhibitors may also be over-prescribed among hospital patients, said Dr. Michael Howell, author of another report on the drugs in the journal.

Hospital patients, especially those in intensive care units, can be prone to developing ulcers, possibly because of changes to blood flow to the stomach. Decades ago, doctors tried to prevent ulcers with antacids. Today, about half of hospital patients, even those not in ICUS, are given proton pump inhibitors as a preventive measure, said Howell, who is director of critical care quality at Beth Israel Deaconess Medical Center and an instructor of medicine at Harvard Medical School.

The problem is that there is little reason to believe all of those people are at risk of ulcers and would benefit from medication, Howell said. Many of those patients continue taking proton pump inhibitors after leaving the hospital.

"Stress ulcers almost only happen in the sickest of the sick ICU patients," Howell said. "There has never been a trial that shows others would benefit. What our study adds to this are some of the concrete risks."

Howell and his colleagues analyzed data on more than 100,000 patients discharged from the hospital over a five-year period and found that taking a proton pump inhibitor each day increased the chances of a C. difficile infection by 74 percent. Patients who took proton pump inhibitors longer than that had more than double the chance. That translates to about one additional case of C. difficule for every 533 people taking pr
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