Thursday, September 17, 2009

Acid Reflux Medication Can Increase Your Risk of Osteoporosis

Choosing the right acid reflux medication for your needs isn't always easy. After all, there are many causes and symptoms to consider. Furthermore, you need to find the right one that works for you. And that process just got more challenging as researchers have found that some Heartburn drugs put users at a greater risk of osteoporosis.

Osteoporosis is a condition where the bones begin to lose their density (bone mineral density or BMD), placing the sufferer at increased risk of a fracture or break. It's a condition that typically occurs as we age when the body is less able to regenerate healthy new bone.

Although it may not look it, bone is actually living tissue that is constantly renewing itself. It's made up of a hard outer shell that contains collagen, minerals and blood vessels, as well as a softer core of bone marrow.

Bones are kept healthy and renewed by a supply of proteins and minerals absorbed from the blood, including calcium.

Specifically, it is proton pump inhibitors (PPIs) among the commonly prescribed acid reflux medications that put people at a higher risk of osteoporosis, according to a 2008 Canadian study. Proton pump inhibitors are drugs that stop the production of hydrochloric acid in the stomach in order to reduce damage caused by acid reflux or GERD.

The study examined 63,000 people aged fifty or older and looked into their medical records, prescription records, and other relevant elements. Among the group, 15,300 had fractures from osteoporosis, including those of the hip, spine, and wrist.

The participants in the study who had histories of fractures from osteoporosis were almost two times more likely to have used proton pump inhibitors for a minimum of seven years in comparison with other study participants. And sixty two percent of those participants in the study with hip fractures had used proton pump inhibitors for a minimum of five years. However, there was no evidence that the short-term use of proton pump inhibitors would increase the risk of osteoporosis-related fractures.

It should be noted that it is not the proton pump inhibitors that actually cause the fractures.

The study showed only that there is a link between the acid Reflux medication and fractures due to osteoporosis. The researchers believe that as the PPI's block the stomach's hydrochloric acid, the body's ability to absorb calcium may be impaired, leading to - or worsening - osteoporosis. However, more study is required to either prove or disprove this hypothesis.

Though the precise link between the long-term use of proton pump inhibitors and osteoporosis-related fractures has yet to be determined, there is enough evidence that should encourage you to discuss the risk of osteoporosis and related fractures with your doctor before starting to use proton pump inhibitors - especially over a longer period of time. Commonly prescribed PPI acid reflux medication includes: Prisolex, Aciphex, Nexium, Protonix, and Prevacid.

If you're currently prescribed a PPI to control acid reflux it important to continue with your medication unless otherwise advised by a medical professional. If you have concerns over the long term use of PPI's then raise your concerns at your next doctors visit.

When you speak with your doctor, you will need to work together to decide whether the benefits of taking PPIs outweigh the risk of osteoporosis-related fractures. You may decide to take proton pump inhibitors as a temporary acid reflux medication while other potential life changes or drugs are decided upon.

Those who are most at risk of being effected by this issue are people who are taking or who are about to begin taking PPIs and either have osteoporosis or are at risk of the disease.

Less powerful acid reflux medication may be a better solution for these people. For example, histamine blockers (also known as H2 anatgonists) are able to effectively treat GERD and its related symptoms. Though they are often less effective than proton pump inhibitors, they are not linked to osteoporosis fractures when used over the long term.

Alternatively you may wish to do away with acid reflux medication altogether (don't forget to speak to your doctor first). This approach is successful for many thousands of people who rely on nothing more than small changes in their diet and some simple home remedies to keep symptoms at bay.

Wednesday, September 16, 2009

Medication Treatment of Gastroesophageal Reflux Disease (GERD)

Over-the-counter medication is the first line treatment of GERD is with over the counter antacids like aluminum hydroxide (Amphojel, Maalox) or magnesium combinations include Phillips' Milk of Magnesia, Gaviscon and Riopan. Aluminum can cause constipation, and magnesium diarrhea. These compounds work by coating the stomach and provide protection against the corrosive effects of stomach acid. Ulcers need more aggressive treatment, since bleeding from ulcers can be life threatening.

The original medications for the treatment of both GERD and ulcers were the histamine-2 (H2) blockers, like cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid). These worked by decreasing the amount of acid in the stomach, which promotes healing of ulcers and reduces gastric reflux. Patients with reduced kidney or liver function can develop confusion with H2 blockers. Side effects include diarrhea, dizziness, nausea, and headache. Tagamet can impair sexual function.

In 1998 AstraZenica introduced Prilosec (omeprazole), the first of a new class of medications for GERD called Proton Pump Inhibitors (PPI). PPIs on the market include lansoprazole (Prevacid), pantoprazole (Protonix), rabeprozale (Aciphex), esomeprazole (Nexium), and omeprazole (Prilosec). They act by blocking the H+ (hydrogen) K+ (potassium) ATPase pump in the stomach, which has the effect of decreasing acid secretion in the stomach. The PPIs have been shown to be more effective than placebo in promoting the healing of ulcers and decreasing symptoms of GERD. PPIs lead to a 33% improvement in ulcer healing compared to the older H2 blocker medication, ranitidine. The PPIs decrease acid secretion to a greater degree than H2 blockers, and are more Effective in treatment, although they cost more than the older drugs because they are only available by prescription.

PPIs have a low side effect profile, with side effects in less than 5% of patients. The most common side effects are headache, diarrhea, stomach pain, fever, sore throat, and nausea. The diarrhea may be related to suppression of acid formation, which alters the natural bacteria content of the gut. Overall PPIs are fairly safe.

A review of 21 randomised controlled trials of PPIs in patients with proven peptic ulcers showed no effect on mortality, but a reduction in re-bleeding and repeat surgery of about 50%.

There is no evidence that any of the PPIs are superior to one another in efficacy or safety. Since omeprazole (Prilosec) is now available as a generic, it is the cheapest, and therefore recommended PPI.

You have probably seen the man on TV talking about the "purple pill" or Nexium (Esomeprazole magnesium). This particular purple pill is a replacement of the original purple pill, Prilosec. Both should probably be called the green pill because of all the money they have made and continue to make for the manufacturer, AstraZenica. They are both widely popular and equally effective medications. After its introduction in 1998, sales of Prilosec continued to rise year after year until it reached sales of one billion dollars a year in 1995 and peaked at 4 billion dollars a year in 2000 when it was the most popular drug in the world, as reported by National Public Radio (April 18, 2002).

In 2002 AstraZenica convened a team to assess the impact of their blockbuster Prilosec going off patent. In response to the potential revenue loss that generics would cause, they decided to take a variation of the drug (a metabolite) and put it on patent, and then marketed the new version as an improvement on the original. You see, all molecules come in one version, and an identical version that is a "mirror version" (i.e. if you held it up to a mirror it would look the same). In the case of Prilosec, it was a mixture of left and right, but it turned out that the left hand variety worked better. So the company took the left hand version and called it Nexium; they tested a higher dose of the "new" drug against the "old" drug to "prove" that it was better, and sent out an army of sales people to convince doctors that this was the case. Needless to say if you took higher doses of the older Prilosec you would get a regular dose of Nexium, the "purple pill." It was an effective campaign: by 2002 the company had weaned one in six former Prilosec users off of Prilosec and onto Nexium. At $1,500 a year it is much more expensive than the generic versions of Prilosec ($150/year). Why not just take higher doses of Prilosec - it will eventually get your Nexium fix for a lot less money.

Stress is Not to Blame For Stomach Ulcers

For many years, ulcers were blamed on stress, Unhealthy lifestyle or too much spicy food. Today, doctors know the true cause of this painful digestive order. You may not always be able to control whether or not you will suffer from ulcers, but you can find successful treatment, both from your doctor and at home.

How Do You Know It's An Ulcer?

Peptic ulcers are sores in the lining of the stomach or small intestine. The most common symptom is burning pain, felt anywhere from your belly button to your breast bone. The pain is caused by stomach acid coming in contact with the ulcerated area. It can last for just a few minutes or several hours, and it may be worse when your stomach is empty. Ulcer pain may flare up at night, and it tends to go away for a few days only to return. Acid-reducing medicines may temporarily relieve the pain, but do not treat the underlying condition.

If stress and diet are not the root causes of ulcers, what is? The most common culprit is a bacterium called Helicobacter pylori, or H. pylori. It exists around the world and is estimated to be found in 50% of people over 60 years of age. H. Pylori live in the mucous that protects the tissue lining the stomach and small intestine. Often, it will cause no problems at all.

Trouble occurs when H. pylori causes inflammation in the mucous layer, resulting in ulcers. Why this happens in some individuals and not others is uncertain. It is not completely clear how H. pylori spreads, but may be transmitted through contaminated food and water. It can pass from person to person via close contact, like kissing or drinking from the same glass.

H. pylori are not the only cause of ulcers. Regular use of pain relievers, both prescription and over-the-counter varieties, can weaken the stomach lining and make you vulnerable to ulcers. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, naproxen (Aleve) and ketoprofen (Orudis KT) can lead to ulcers. Taking NSAIDs with food can reduce the risk of damage to the stomach lining.

Smoking is also a risk factor for ulcers. Nicotine causes your body to produce more stomach acid, making you vulnerable. Smoking can also slow down your recovery after being treated for ulcers. Excessive alcohol consumption is thought to contribute to ulceration, but other factors such as H. pylori may need to be present to cause an ulcer.

Types Of Treatment

If H. pylori is the cause of your ulcer, your doctor will treat you by killing the bacteria and reducing the levels of stomach acid in your body. Antibiotics are required to eliminate H. pylori. You will only need to take them for one to two weeks, along with a proton pump inhibitor or PPI. PPIs reduce stomach acid, allowing the ulcer to heal. Examples of PPIs are Prilosec, Prevacid, Aciphex, Protonix and Nexium. If you do not have H. pylori, PPIs will be used on their own.

If an ulcer has become aggravated to a certain point, bleeding may occur. In this case, an upper endoscopy is performed. In this procedure, the doctor inserts a small scope through your mouth to repair the ulcer. If an ulcer has created holes in the stomach lining, surgery may be necessary.

Home care for ulcers is fairly straightforward. Avoid acidic and spicy foods, which may increase discomfort. If you have an ulcer, it is necessary to see a doctor for treatment so complications like bleeding may be avoided.

Some natural remedies to try include licorice, manuka honey and bananas. Found in health food stores.

Licorice should be consumed as De-Glycyrrhizinated Licorice (DGL). Glycyrrhizin increases water retention and blood pressure. A double-blind, placebo-controlled trial reported that 16 people with significant stomach discomfort showed an average improvement of 78% when given 360 mg of DGL thrice daily, compared to 34% in the placebo group. Other trials have compared DGL to prescription drugs showing that 760 mg DGL 3 times daily is as effective as the popular prescription drug cimetidine. Deglycyrrhizinated licorice causes no water retention or increase in BP.

Taking one to two tablespoons of manuka honey each day may inhibit growth of the bacteria responsible for ulcers. Eating two bananas per day may neutralize the acidic gastric juices that cause irritation to ulcers.

You can speed your recovery by avoiding things that produce excess stomach acid like cigarettes and alcohol. Do not over use NSAIDs for pain. Medications like containing acetaminophen (Tylenol and others) are a good alternative. Some people believe milk helps ulcers, but this is not the case. It temporarily soothes pain by coating the stomach, but it can end up making the ulcer worse.

If you suspect an ulcer, stay calm and see your doctor as soon as possible. It is likely that he or she will be able to treat this common condition quickly and easily. Although we now know ulcers are not caused by stress, worrying about your health is still harmful! Seek treatment so you can return to feeling better as soon as possible.

How to Treat Acid Reflux - What Are the Medicines Your Doctor May Give You

Learning how to treat acid reflux or GERD (Esophageal Reflux Disease) as it is sometimes referred to, can be a long and complicated process with different people telling you different things.

One of the first things that you should do when suffering from this rather painful condition is to visit your Doctor who will be able to inform you of the ways in which you can treat the problem.

Generally, a doctor will prescribe three Types of medication to treat the acid reflux and these could be H2 blockers, promotility agents or proton pump inhibitors. Most of these will need to be prescribed by a doctor and you should inspect to make regular visits back to the healthcare professional to make sure that they are working for you and also that there are no adverse side effects that you are experiencing.

Starting with the H2 blockers and learning how to treat acid reflux in this way, it is safe to say that they work in the same way as the proton pump inhibitors and this is by blocking certain histamines that are well known to cause the acid reflux.

Generally, gastric acids are the reason behind this acid reflux and the transportation of it from the stomach, where it belongs, up the oesophagus and causing a pain that is generally described as heart burn.

Mild cases of this are generally treated by H2 blockers and some of the most well known brands that you may have heard of are Zantac, Pepcid and Tagamet which are available world wide. These can normally be obtained from a Pharmacy without the need of a prescription.

Promility agents are generally given to those that have a digestive system that is functioning rather sluggishly and the agents themselves are used to help the transportation of the gastrointestinal content to the stomach and intestines.

When you look at learning how to treat acid reflux with these agents you will find out that the stomach will often produce less of an acid reflux when it is empty, so when the digestive system is moving slowly, there are more contents in the stomach to cause more acid.

If you are looking at how to treat acid reflux by the way of proton pump inhibitors, some of the most common names that you may associate with this problem is Prevacid, Protonix and Aciphex.

These will be prescribed to patients who has a stomach that is producing far too much acid and thus being the reason behind acid reflux. These drugs will often lessen the amount of acid that is produced and therefore treating the acid reflux.

If you are looking at how to treat acid reflux, either because you are suffering from the condition or you know someone that is, visiting the doctor is one of the best things that you can do, not only to find out more about the condition but also to find a way to treat it.

Tuesday, September 15, 2009

Medication Treatment of Gastroesophageal Reflux Disease (GERD)

Over-the-counter medication is the first line treatment of GERD is with over the counter antacids like aluminum hydroxide (Amphojel, Maalox) or magnesium combinations include Phillips' Milk of Magnesia, Gaviscon and Riopan. Aluminum can cause constipation, and magnesium diarrhea. These compounds work by coating the stomach and provide protection against the corrosive effects of stomach acid. Ulcers need more aggressive treatment, since bleeding from ulcers can be life threatening.

The original medications for the treatment of both GERD and ulcers were the histamine-2 (H2) blockers, like cimetidine (Tagamet), ranitidine (Zantac) and famotidine (Pepcid). These worked by decreasing the amount of acid in the stomach, which promotes healing of ulcers and reduces gastric reflux. Patients with reduced kidney or liver function can develop confusion with H2 blockers. Side effects include diarrhea, dizziness, nausea, and headache. Tagamet can impair sexual function.

In 1998 AstraZenica introduced Prilosec (omeprazole), the first of a new class of medications for GERD called Proton Pump Inhibitors (PPI). PPIs on the market include lansoprazole (Prevacid), pantoprazole (Protonix), rabeprozale (Aciphex), esomeprazole (Nexium), and omeprazole (Prilosec). They act by blocking the H+ (hydrogen) K+ (potassium) ATPase pump in the stomach, which has the effect of decreasing acid secretion in the stomach. The PPIs have been shown to be more effective than placebo in promoting the healing of ulcers and decreasing symptoms of GERD. PPIs lead to a 33% improvement in ulcer healing compared to the older H2 blocker medication, ranitidine. The PPIs decrease acid secretion to a greater degree than H2 blockers, and are more effective in treatment, although they cost more than the older drugs because they are only available by prescription.

PPIs have a low side effect profile, with side effects in less than 5% of patients. The most common side effects are headache, diarrhea, stomach pain, fever, sore throat, and nausea. The diarrhea may be related to suppression of acid formation, which alters the natural bacteria content of the gut. Overall PPIs are fairly safe.

A review of 21 randomised controlled trials of PPIs in patients with proven peptic ulcers showed no effect on mortality, but a reduction in re-bleeding and repeat surgery of about 50%.

There is no evidence that any of the PPIs are superior to one another in efficacy or safety. Since omeprazole (Prilosec) is now available as a generic, it is the cheapest, and therefore recommended PPI.

You have probably seen the man on TV talking about the "purple pill" or Nexium (Esomeprazole magnesium). This particular purple pill is a replacement of the original purple pill, Prilosec. Both should probably be called the green pill because of all the money they have made and continue to make for the manufacturer, AstraZenica. They are both widely popular and equally effective medications. After its introduction in 1998, sales of Prilosec continued to rise year after year until it reached sales of one billion dollars a year in 1995 and peaked at 4 billion dollars a year in 2000 when it was the most popular drug in the world, as reported by National Public Radio (April 18, 2002).

In 2002 AstraZenica convened a team to assess the impact of their blockbuster Prilosec going off patent. In response to the potential revenue loss that generics would cause, they decided to take a variation of the drug (a metabolite) and put it on patent, and then marketed the new version as an improvement on the original. You see, all molecules come in one version, and an identical version that is a "mirror version" (i.e. if you held it up to a mirror it would look the same). In the case of Prilosec, it was a mixture of left and right, but it turned out that the left hand variety worked better. So the company took the left hand version and called it Nexium; they tested a higher dose of the "new" drug against the "old" drug to "prove" that it was better, and sent out an army of sales people to convince doctors that this was the case. Needless to say if you took higher doses of the older Prilosec you would get a regular dose of Nexium, the "purple pill." It was an effective campaign: by 2002 the company had weaned one in six former Prilosec users off of Prilosec and onto Nexium. At $1,500 a year it is much more expensive than the generic versions of Prilosec ($150/year). Why not just take higher doses of Prilosec - it will eventually get your Nexium fix for a lot less money.