[tri-med] FYI - Heartburn Drugs Linked to Diarrhea
- From: "Karen" <karens@xxxxxxxxxxxxxxxx>
- To: "Tri-Med" <tri-med@xxxxxxxxxxxxx>
- Date: Wed, 21 Dec 2005 12:26:54 +1100
****I am forwarding this article or URL for your information (FYI) as I
believe it may be of interest and is from a reliable source. As always, check
the information with your own doctor or health care professional before
starting or changing any treatments.****
Heartburn Drugs Linked to Diarrhea
December 20, 2005
CHICAGO (AP) -- Holiday revelers beware: Seasonal indulgences like eggnog
and fruitcake might give you heartburn, but the acid-fighting medicine you take
for relief might lead to something worse, researchers say.
People on popular prescription heartburn drugs -- Prilosec, Prevacid and
Nexium -- seem more prone to getting a potentially dangerous diarrhea caused by
the bug Clostridium difficile, new research shows. C-diff, as it's known, can
cause severe diarrhea and crampy intestinal inflammation called colitis.
Dr. Sandra Dial and colleagues at McGill University in Montreal examined
data on more than 18,000 patients in the United Kingdom from 1994 to 2004.
During that time, 1,672 cases of C-diff were diagnosed, and the numbers
increased from less than 1 per 100,000 in 1994 to 22 per 100,000 last year.
Patients with prescriptions for powerful acid-fighters called proton pump
inhibitors, which include Prilosec and Prevacid, were almost three times more
likely to be diagnosed with the bug than those not taking the drugs. Those on
less potent prescription drugs called H2 receptor antagonists, which include
Pepcid and Zantac, were two times more likely than nonusers to get C-diff
infections.
The widely used and heavily promoted drugs reduce levels of gastric acid
that can keep C-diff germs at bay.
Dr. L. Clifford McDonald, a researcher at the federal Centers for Disease
Control and Prevention, said proton pump inhibitors recently were implicated in
a C-diff outbreak at a hospital and nursing homes in Maine.
"It's not surprising in my mind that there could be some association"
with acid-fighting drugs, said McDonald, who was not involved in Dial's study.
If there is, "I do think it would be very important because, boy, everyone and
their brother seems to be on them."
Most study patients hadn't been recently hospitalized and weren't taking
antibiotics, which both can increase risks for C-difficile infections.
Also, most patients hadn't been diagnosed with ulcers or acid reflux, so
it's possible many simply had heartburn, Dial said.
"Heartburn in and of itself isn't dangerous," and can often be treated
with less potent drugs, Dial said.
Her study appears in Wednesday's Journal of the American Medical
Association.
A co-author is a consultant for AstraZeneca PLC, which markets Prilosec
and Nexium, and Altana Pharma, which makes and markets another prescription
heartburn drug, Protonix, in Europe. A spokesman for Wyeth, which markets
Protonix in the United States, said the company hadn't seen the research and
declined comment.
AstraZeneca spokeswoman Cindy Callaghan said patient safety is the
company's top priority and that the findings are not the final word.
"Further research is needed in this particular area to determine the
validity of a potential link," she said.
C-diff bacteria historically have been found in patients on antibiotics
or with underlying illnesses, especially those in hospitals or nursing homes,
but infections increasingly have been reported in the community.
Doctors think the growing trend is due in part to overuse of antibiotics
but the new data suggest overuse of acid-fighting drugs may be another reason,
said Dr. Michael Brown, a gastroenterologist at Rush University Medical Center
in Chicago, who was not involved in the study.
The drugs are popular because they are so effective at fighting stomach
acid, and are generally very safe, Brown said.
Brown said short-term use of potent acid-fighting drugs for occasional
over-imbibing is unlikely to increase infection risks in otherwise healthy
people, but that the results suggest doctors and patients "have to think twice
about using such heavy acid suppression" over the long term.
Copyright 2005 The Associated Press. All rights reserved.
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