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PPIs May Increase Heart Attack Risk

Researchers at Stanford reviewed the medical records of nearly three million people and found that those who took a type of ulcer medication called Proton Pump Inhibitors (PPIs) were almost 20 percent more likely to suffer heart attacks than those not taking these drugs (PLoS ONE. June 10, 2015). PPIs reduce excess stomach acidity that can cause burning in the belly and chest, belching, burping, and a sour taste in the mouth. They include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), and others. Last year, 20 million Americans had more than 100 million prescriptions for these drugs, and world-wide sales exceeded $13 billion. No increased risk for heart disease was found in those taking other types of ulcer medications such as H2 blockers: cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine (Zantac).

How PPIs May Increase Heart Attack Risk
Previous research has shown that PPIs reduce the production of nitric oxide by blood vessels to damage the inner linings of blood vessels to start plaques forming in arteries. Thus people who take PPIs could be at increased risk for heart attacks. We do not know how long a person has to take these ulcer medications to incur increased heart attack risk.

Over-the-counter PPIs should not be taken for more than 14 consecutive days, no more than three times a year. People who take prescription PPIs usually stay on them for six months, and often take them for years. In 2012, the FDA warned that PPIs can cause muscle spasms, irregular heartbeats, seizures, bone fractures and chronic diarrhea from a bacteria called Clostridium difficile. Caution: Never take PPIs if you are taking a blood thinner called clopidogrel (Plavix).

Lifestyle Changes to End Stomach Problems
Most people who suffer chronic belching and burning do not have serious causes such as esophageal cancer, stomach cancer or ulcers. They can often be cured with lifestyle changes. If you have belching and burning in your belly or chest, check with a gastroenterologist to rule out serious disease, and get a blood test for a bacteria called Helicobacter pylori that causes belching, burning and stomach ulcers. If you have Helicobacter pylori, you can be cured with a week of antibiotics.

If these causes are ruled out, try these lifestyle changes:
• Eat smaller meals more frequently.
• Eat slowly.
• Avoid all forms of alcohol.
• Avoid smoking and smokers.
• Try to exercise every day.
• Lose weight if overweight.
• Avoid lying down right after you eat.
• Do not eat within four hours before you go to bed.
• Raise the head of your bed so that your head and chest are higher than your feet.

Some people find that indigestion is triggered by certain foods, and avoiding those foods may solve the problem. Frequent triggers of belching and burning include fried foods, onions, peppermint, citrus fruits and their juices, chocolate, caffeine-containing beverages such as coffee, tomatoes, high-fat foods or spicy foods.

July 12th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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