PPI Antacids Linked to Hip Fractures in People Over 50

Proton pump inhibitors (PPIs), developed in the 1980s, were the new generation of stomach antacids. They do their job well, helping thousands of people with ulcers, acid reflux, and other stomach problems. Now, though, a new review has shown that these medications may increase the risk of hip fractures in seniors.

PPIs, including the prescription drugs Nexium and Prevacid and the over-the-counter medication Prilosec, work by suppressing the release of stomach acid. They're considered the best choice for patients with the following conditions:
- indigestion and heartburn
- gastro-esophageal reflux disease (GERD), when stomach acid backs up into the esophagus
- stomach ulcers
- gastritis, an inflammation of the lining of the stomach

It's been known for a while that PPI antacids, because they raise the pH of the stomach, can change how some drugs are absorbed. Therefore, doctors must be careful in prescribing medications like antibiotics and antifungals to patients who are also taking PPIs. But the biggest issue may be that some people have chronic stomach problems and may take these antacids for long periods of time - sometimes years. And this new research has shown that long-term use of these drugs is associated with a higher risk of hip fractures.

The recent review was conducted by physicians at the University of Pennsylvania. They looked at 16 years of electronic medical records from the United Kingdom. All the records were of people over the age of 50; the average age was 77. More than 13,000 had hip fractures; the researchers also checked the records of another 135,000 people who had not had a fracture. The research identified a 44% higher risk of a hip fracture in those who had taken PPI antacids for more than a year.

The researchers don't think that short-term use of these antacids is harmful, even if the doses are high. They believe that it's long-term use that can cause problems. They've theorized that the PPIs are interfering with the absorption of calcium, a mineral necessary for healthy bones and other tissue. They suggest that the risk of a fracture might be lessened if the patient took calcium supplements, preferably with a meal to help the calcium absorb better. And of course, the patient should take the antacids for as short a period of time as possible.

PPIs have made life a lot more comfortable for many people. But like any medication, they need to be used with care. People over the age of 50 who are taking these medications - especially if they're using the over-the-counter version, Prilosec - should keep in touch with their doctors and possibly discuss adding calcium to their diets in the form of dairy foods or a supplement. That way they can enjoy the benefits of these antacids while preventing some of their more serious complications.