Stomach acid exists for good reasons
July 25th, 2007
The saying goes that when all you have is a hammer, everything looks like a nail. Doctors may not be carpenters, but when it comes to heartburn, the hammer they wield most frequently is an acid-suppressing drug.
Drug companies have been very good at creating medications that shut down stomach-acid production. Medications like Aciphex, Nexium, Prevacid, Prilosec and Protonix are among the most frequently prescribed drugs in the country. Prilosec OTC, available without a prescription, has become one of the most popular heartburn pills in the pharmacy.
Indigestion is unpleasant. It can turn a delightful dining experience into a bad memory and wake you in the middle of the night. Repeated reflux can scar the esophagus and possibly even increase the risk of cancer.
Suppressing acid seems like a logical solution. But why do we have acid in the first place? Most animals (dogs, cats, cows, snakes, sheep and sharks) make a lot of stomach acid. In fact, paleontologists have found sophisticated systems for creating stomach acid in just about every vertebrate species for the past 350 million years.
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Could something that has survived for so long be a cosmic mistake? Just because we can now suppress acid production so effectively does not mean that this is the perfect solution to heartburn.
Controversy about the long-term effects of acid suppression has been swirling in the medical community for decades. Concerns have been raised about reduced absorption of important nutrients such as vitamin B-12 or an increased risk of stomach cancer.
In recent months, scientists reported that long-term use of proton pump inhibitors (PPIs) like Nexium, Prilosec or Prevacid is associated with an increased risk of hip fracture (Journal of the American Medical Association, Dec. 27, 2006). The authors suggested that the PPIs might interfere with absorption of calcium so that a deficit develops over time.
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