Is this common medication raising your stomach cancer risk?

For heartburn sufferers, certain medications may frequently prove to be a lifesaver.

But new research published in the journal Gut points to a potential danger from taking the drugs – an increased risk of stomach cancer.

Both proton pump inhibitors (PPIs) and H2 blockers are commonly used in order to reduce a patient’s production of gastric acid, the cause of acid reflux and stomach ulcers; but they do so in different ways. In the longitudinal study, more than 60,000 participants took either PPIs or H2 blockers. H2 blockers include medications such as Pepcid and Zantac, while common PPIs are Prilosec, Nexium and Prevacid.

The results indicated that PPIs were associated with a more than doubled risk of developing stomach cancer, while taking H2 blockers did not indicate any increased risk. Researchers also noticed that the more frequently and the longer participants took PPIs, the greater their risk; those who took PPIs every day had four times the risk of developing stomach cancer compared to those who took PPIs once a week.

Dr. Kabir Julka, a gastroenterologist with Advocate Medical Group, says that millions of people take these medications. “Many at high doses chronically,” he adds. “From a public health standpoint, it is crucial to know if there are problems with these medicines.”

Dr. Julka says the question of risk from PPI/antacid medications has been a hot topic of discussion for the last couple of years in the GI world.

“These medications are widely prescribed (some would say overprescribed) by physicians. Most are also available over the counter. These have generally been considered extremely safe, but several studies have raised questions about their long-term safety profile.”

He says that other studies have pointed to an increased risk for osteoporosis, diarrhea, dementia, kidney disease, strokes and issues absorbing nutrients like Vitamin B12 and Magnesium from taking the medication.

So just how harmful are they?

“We aren’t completely sure,” Dr. Julka says. “Generally speaking, most of these studies have flaws and are not designed well enough to prove a cause-and-effect. My take is the same as it would be for any medicine. What I tell my patients is that the studies are not the highest quality, but we can’t simply dismiss them.”

Dr. Julka says it makes sense to take the lowest dose possible to take care of symptoms. “If there is not a good medical reason to take the antacid, or if we can get away with less medicine, that is always preferred – that way, we get the benefit of the medicine while reducing any potential for long-term side effects. Some people can’t function without the medicine due to severe acid reflux; in that situation, they continue taking it while being aware of this.”

According to the American Cancer Society, in 2017, around 11,000 Americans will die from stomach cancer.

“This is a relatively rare cancer in our country, and the risk of getting it is extremely low – with or without antacids,” Dr. Julka says.

So what’s the bottom line?

“If you need the antacid, it should be okay to take it. If you can get away with a lower dosage, that makes good sense. There are new studies coming out all the time that will hopefully clarify some of these issues for us, but in my opinion, there isn’t enough compelling data out there at this time to stop using the medication in appropriate settings,” he says.

Dr. Julka recommends that those with questions speak with their gastroenterologist or primary care physician.