Could Popular Heartburn Drugs Upset Your 'Good' Gut Bugs? By Randy Dotinga

HealthDay Reporter

TUESDAY, Nov. 25, 2014 (HealthDay News) -- Heartburn drugs such as Prilosec and Nexium may disrupt the makeup of bacteria in the digestive system, potentially boosting the risk of infections and other problems, a small new study suggests.

The research doesn't confirm that these changes make it more likely users will become ill, and study authors aren't recommending that anyone stop taking the so-called proton pump inhibitors.

However, these antacids "should be used at the lowest dose that provides adequate relief of symptoms, and attempts to discontinue their use should be considered periodically," said study co-author Dr. John DiBaise, professor of medicine at the Mayo Clinic in Scottsdale, Ariz.

According to Harvard Medical School, billions of dollars are spent annually on antacid drugs in an attempt to combat heartburn, ulcers and gastroesophageal reflux disease, also known as GERD. Old standbys such as Maalox and Mylanta have been supplanted by more effective, more expensive drugs, including proton pump inhibitors. These include Prevacid (lansoprazole) and Protonix (pantoprazole) in addition to Prilosec (omeprazole) and Nexium (esomeprazole).

"Despite years of safe and effective use, in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use," DiBaise said.

Long-term use of proton pump inhibitors has been linked to infection with a germ called Clostridium difficile, which causes severe diarrhea, he said. Researchers have also connected the medications to vitamin deficiencies, bone fractures and pneumonia, among other conditions.

In the new study, researchers sought to understand what happens to the trillions of germs in the digestive system when people take omeprazole, the generic name for the drug best known as Prilosec.

Ten participants, aged 18 to 57, took 20 or 40 milligrams of the drug a day for 28 days. Researchers analyzed the study participants' stool samples to understand the germs in their guts.

"These microbes have evolved with us to participate in our normal development and metabolism, and perform certain functions that we would not be able to accomplish without their help," DiBaise said. Many scientists believe that people's risk of disease goes up when their normal germ makeup changes, he said.