Study results have been mixed as to whether taking Nexium increases risk of bone fracture. Most people do not need to stop taking Nexium, but it’s important for everyone to look after their bone health and ask their doctor if they are concerned about bone loss.
An estimated 60% of adults in the United States experience some type of gastro-esophogeal reflux in any 12-month period, and 20 to 30% of the population have symptoms weekly.
Stomach acid is critical to digestion and absorption of nutrients, but when the sphincter valve between the esophagus and stomach doesn’t close properly, stomach contents can leak back up into the esophagus, causing what is commonly known as “heartburn,” or acid reflux. Over time, this acid can damage the lining of the esophagus.
What Are Proton Pump Inhibitors?
A class of drugs called proton pump inhibitors inhibits the release of stomach acid, providing relief for heartburn sufferers. Nexium is one of the most popular drugs in this class. Researchers have found that long-term use of these drugs may hinder the digestion and absorption of important nutrients like iron, magnesium, vitamin B12, folic acid, zinc, and calcium. Because proton pump inhibitors alter the pH balance in the digestive system, absorption of other nutrients may be affected too. Some studies have found correlation between long-term or high-dosage use of proton pump inhibitors and increased risk of fractures due to osteoporosis.
Studies on Proton Pump Inhibitors and Fractures
In 2011, The Annals of Family Medicine reported the link between long-term or high-dosage use of proton pump inhibitors and fractures of the wrist, spine, and hip. Increased risk of osteoporosis and fractures is believed to be related to a dramatic drop in calcium absorption in people who take these medications long term. Therefore, it is important that people who take proton pump inhibitors to ensure they’re getting enough quality, bio-available calcium to make up for potentially lower absorption of calcium in the digestive system. Ideally, calcium along with vitamin D3 and vitamin K are consumed to promote better bone health.
Other Important Studies Concerning Proton Pump Inhibitors and Fractures
A study carried out as part of the Canadian Multicentre Osteoporosis Study found that users of Nexium and similar drugs had lower bone mineral density during baseline measurements than comparable patients who did not use the drugs. However, 10-year follow-up measurements controlling for other osteoporosis risk factors did not find an association between proton pump inhibitor drugs and accelerated bone mineral density loss.
Another study carried out in Spain reviewed 358 patients with hip fractures matched with 698 control subjects from 2007 to 2010. The study team collected data on proton pump inhibitor use five years before hip fractures as well as other factors, like body mass index and alcohol and tobacco consumption, plus known hip fracture risk factors. These patients were all at least 50 years old. The researchers found no association between proton pump inhibitors and osteoporosis-related hip fractures, even when adjusting for age and gender.
So Should You Stop Taking Nexium?
Another study from 2009, published in the journal Gastroenterology, found that when people stop taking proton pump inhibitors, the result can be rebound secretion of excess acid. Often, this causes the patient to immediately resume taking the proton pump inhibitor, and a vicious cycle can ensue as the patient tries to stop taking the drug.
Patients who have been taking Nexium or other proton pump inhibitors long term should work with their doctors on a plan to gradually quit taking the drug to avoid problems with rebound secretion of excess stomach acid.
What Should Consumers Do?
People who have taken proton pump inhibitors long term should speak with a physician about blood tests that can determine if he or she is deficient in important nutrients. If the patient is deficient in certain nutrients, a physician can advise on how to make up for these deficiencies to avoid problems related to them.
There are many other ways people prone to acid reflux can help control symptoms, so that long-term or high-dose proton pump inhibitor use can be avoided. Lifestyle changes — including eating more slowly, eating less at one sitting, and avoiding fried food, sodas, caffeine, smoking, and excess alcohol consumption — can also help with acid reflux. Avoiding eating within three hours of bedtime can help prevent nighttime acid reflux, and maintaining a healthy weight can help with acid reflux problems too.
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