DR. OZ: Get smart about heartburn

Dr. Mehmet Oz Dr. Mike Roizen King Features

Proton pump inhibitors, or PPIs — taken by an estimated 20 million Americans to douse heartburn pain — are associated with a 44 percent increased risk of dementia, according to a new German study. That’s the latest in a string of health problems associated with taking these drugs. It seems they decrease the absorption of nitrites, so your arteries (think cardiovascular system) do not dilate as well (think erectile dysfunction). So before you fill another PPI prescription or reach for a bottle of over-the-counter pills, here’s what you should know.

PPIs quash acid production in your stomach by blocking a digestive-system enzyme. These “wonder drugs” are great at dialing down acidity so that painful raw spots in your esophagus either don’t develop or heal if you’ve got a serious acid-backwash problem called gastroesophageal reflux. Trouble is, up to two-thirds of people who take PPIs don’t really need them. That may be you if your doctor is not monitoring your use of an OTC version (such as Nexium, Prilosec or Prevacid), or if your doc prescribed one but hasn’t checked to see if you’ve healed.

Used right, PPIs help, but they’re also big business ($14 billion a year), have big advertising budgets and big side effects. If you believe that an overweight comedian in a bad shirt knows enough medicine for you to follow his advice, you need to read the fine print. That’s where you’ll find important info about the very real risks of PPIs.

Heart attacks: A Stanford University study of 2.9 million people found that PPI users were 16 percent more likely to have a heart attack and twice as likely to die from one, when compared with nonusers. Researchers believe that PPIs reduce levels of nitric oxide in artery linings, so they become less flexible.

Infections: PPI users are more susceptible to pneumonia and Clostridium difficile infections. Stomach acid normally helps kill the bacteria that cause these illnesses.

Brittle bones: Using high doses and staying on PPIs for over a year seems to put bones at highest risk. In the Women’s Health Initiative study, fracture risk was 25 percent higher for older women who used PPIs.

Chronic kidney disease: In a Johns Hopkins study that tracked 10,482 adults for 15 years, PPI users were 20-50 percent more likely to develop chronic kidney problems than nonusers. A second study, out of SUNY Buffalo, tracked more than 240,000 patients for 17 years with similar results. Both studies also reported that people who used H2 blockers (a different type of medication that blocks acid reflux, but lasts only 12 hours) didn’t increase the risk for CKD or decrease nitric oxide levels in blood vessels.