Indian doctors advise restraint on prescribing acid reflux pills


"We know that due to significant acid suppression, PPIs can exacerbate atrophic gastritis which may lead to gastric cancer", Sudeep Khanna, Senior Consultant (Gastroenterology, Hepatology and Therapeutic Endoscopy) at Indraprastha Apollo Hospitals in New Delhi, told IANS.

Commonly used PPIs in India include Omeprazole, Lansoprazole, DEXlansoprazole, Pantoprazole, Esmoprezole, Rabeprazole. "Doctors should review the indications and needs of long-term PPIs in these patients".

The 12 year study was conducted by the University of Hong Kong and University College London with the most shocking element being that the chances of stomach cancer were still increased whether the bacteria Helicobacter pylori was present or not, which was suspected to increase the illnesses development.

The participants were monitored individually until they died, developed stomach cancer or the study ended in December 2015. During this period, 3,271 people continued to take PPIs for nearly three years.

The researchers acknowledge that this is only an observational study, so we can't assume from the data that PPIs are the cause here - but nonetheless, it's an alarming finding that shows there's more going on than scientists previously realised. Also, the longer a PPI was used, the greater the risk.

During this time, more than 3,200 people took PPIs for almost three years, while almost 22,000 took H2 blockers (Pepcid, Zantac, Tagamet).

In all, 153 (0.24 per cent) people developed stomach cancer after triple therapy.

"The researchers lacked information on some risk factors such as diet, family history and socio-economic status".

The risk also increased the more frequently a PPI was used.

The risks are associated with a bacterium called Helicobacter pylori, carried by more than half of the world's population - most often harmlessly, but in a small percentage of people, the bug has been tied to the development of stomach cancer.

Moreover, while H2 blockers have the potential to reduce the amount of acid made by the stomach as well as curtail the side-effects, it can not be used as a substitute for PPIs, the experts stated.

PPIs and H2 blockers are widely available over the counter.

The study said: 'Taking PPIs was associated with a more than doubling in the risk of developing stomach cancer, while taking H2 blockers was not associated with any such heightened risk'.

Even with this new study, "there are medical situations in which PPI therapy is necessary and the risk of side effects is lesser than the risk of developing bleeding or cancer of another area in the GI [gastro-intestinal] tract", Andrawes said.

This research focused and analyzed the jeopardy of developing gastric/stomach cancer in a sizable group of people who had undergone antibiotic treatment for the H. pylori infection caused by a bacteria found in the stomach lining.

What's more, greater frequency of PPI usage and longer-term treatment with the medication appeared to up the likelihood of developing cancer further.