In recent weeks concerns have been raised about the safety of some anti-reflux medications. A generic formulation of a common H2 antagonist, has been found to contain higher-than-safe amounts of N-Nitrosodimethylamine (NDMA), a known carcinogen. Consequently, global production and distribution has halted and Novartis has begun recalling its generic Zantac drugs.
Other antireflux medications, such as certain PPIs, are correlated with conditions as diverse as poor iron uptake and dementia, yet are still on the market and are some of the most prescribed medications globally.
Anti-reflux meds have been a blessing for many suffering from reflux. But as Dr. Tom DeMeester asks “At what cost?” Back in 2013, Dr. DeMeester foresaw this cascade of challenges with PPIs and shared in an editorial in the Huffington Post:
“PPI-treated GERD patients who have mild or absent symptoms while on the medication, were 60 percent more likely to have Barrett’s esophagus, a precancerous condition, than those with more severe symptoms while on the medication. Disappointedly, a good response to the medication does not eliminate the risk of cancer.
In another ongoing long-term study conducted in Europe, researchers determined that today’s treatment model, which is predominantly focused on drug therapy, does not stop the progression of the disease. More importantly, of all the risk factors studied, which included diet, obesity, smoking, alcohol use and family history, the one factor with the highest odds ratio associated with progression from mild to severe disease and leading to Barrett’s Esophagus was daily PPI use. So why are reflux disease patients treated with today’s routine clinical care standard most at risk for pre-cancerous conditions or esophageal cancer?”
If patients under a doctor’s care fare so poorly, what about those who self treat without the benefit of any oversight or surveillance? For reflux sufferers using over-the-counter medications, the FDA has compiled a useful treatment guide to help you self-treat more safely and effectively.
For many patients under a physician’s care, the big question will be why they were subjected to potentially harmful drugs, sometimes for years at a time, without an objective test confirming a diagnosis of reflux and the necessity of medicative treatment. Some insurers require a round of PPI therapy before approving a pH test for a patient. Using a therapy to confirm a diagnosis is marginalized, in that 30% of patients thought to have reflux actually have normal levels of pH when given an objective test. Placing these patients on a medication they don’t need carries the possibility of actually creating rebound acid hypersecretion (RAHS) when the medication is discontinued. Aside from confusing the diagnosis, this sometimes leads to the chronic use of a PPI which was never necessary.
If you have questions about your medication regimen, its efficacy, or necessity, contact your physician today and ask for an objective test – such as Restech’s Dx-pH test. It is a simple, painless test that lasts only 24 hours, and helps your physician accurately diagnose or rule out reflux – so you know exactly where you stand.
If you have questions about your reflux, visit our website or give us a call at 800.352.1512. To find a doctor who performs Restech pH testing, please check out our physician finder.