One type of acid reflux drug associated with doubled incidence of stomach cancer

Originally published at: https://boingboing.net/2017/11/01/one-type-of-acid-reflux-drug-a.html

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Oh, great. As if my reflux isn’t bad enough, now I have to fret over developing stomach cancer because of Nexium. Wheeeee…

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I used to get reflux something awful. Then I stopped drinking scotch so damned much. Then my reflux went away. Goddamn you reflux.

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OH shit - please don’t let me ex read this, please don’t let my ex read this.

My kids sphincter didn’t close properly for the longest time, but now shes better. But she was on Prilosec for a long time.

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Fuck. I was on omeprazol for more than a full year, time to fret!

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I used to use this stuff. But then I did what @atl said, and started drinking a lot less. Also, I try not to eat late in the evening (past 8 or 9), or eat any sugary stuff late, skip dessert, only have a drink or two, or if I am celebrating something, expect the reflux and plan accordingly to stay up later to let things settle. Those kinds of things tend to make my stomach unhappy and I start to reflux.

I stopped all PPIs and dealt with the reflux in other ways because I was getting terrible leg cramps at night from the PPIs making my muscles lactic. I would wake up in an excruciating calf cramp every night, so I couldn’t continue taking them and realized, I’ll have throat cancer from the reflux if I don’t take care of that, too.

The other thing I do is if I sense reflux might be happening that night, I will go sleep on the couch propped up by pillows or will sleep in the Lazy Boy chair, mostly upright, with a blanket if I’m cold. Staying more upright puts a little strain on the lower back, but the reflux won’t jump up my throat.

Hope that helps. PPIs are awful. Only use them if you MUST. Otherwise, it’s worth adjusting the lifestyle to accommodate & compensate for GERD.

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I take omeprazole. And I don’t drink alcohol at all. I try occasionally to not take it, but after 2 days, I am hating life. Zantac does not work for me. Shit.

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They are very hard to get off. But you can talk to your doctor about how if that’s what you want. When you stop taking your pills for a day or two, the acid will rage. So, you can try chewing a mountain of TUMS and Rolaids for a week, trying to wean yourself. Or eat very, very little, like going on a temporary fast, just to keep your stomach as empty as possible, even though you’ll be wicked hungry. But talk to your doc. Don’t take what I wrote as advice, just possible suggestions.

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The note about ‘patients on PPIs are sicker to begin with’ is interesting, it matches the anecdotal experience in my family. I get very good symptom control on a minimal dose of famotidine, my wife needs a whopping great dose of lansoprazole or esomeprazole to keep Barrett’s at bay. I think it’s obvious, irrespective of drug choice, which of us is at greater risk for GI cancer.

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Double of small odds is still small odds. But it’s going to alter when physicians prescribe it.

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Eat nothing but whole foods grown withing ten miles of your house without pesticides or other ag chemicals.

You’ll starve to death and then you won’t have acid reflux any more.

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I was able to quit omeprazole by slowly lowering the dosage I was taking over a month or two. There was still a bit of withdrawal, but it was much easier to handle than the sudden massive ass rage that stopping cold turkey caused after a day or two.

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Chill.

Here’s a very good NHS explanation page about this very Guardian article:

"Conclusion

PPIs are commonly used medicines for acid reflux. This may seem like alarming news for the many people in the UK who take them, but it’s important to remember that the overall risk of stomach cancer is still very low.

This study has several limitations that mean we should be cautious about the results:
This type of study can’t prove PPIs caused the increased risk of cancer. The increased risk could be down to other factors.

Researchers were unable to adjust their figures to take account of some relevant confounding factors, such as alcohol and tobacco use, as these weren’t routinely recorded.

Almost all the patients in the study were Chinese. Asians are known to have a higher risk of developing stomach cancer than other populations, so the results may not be applicable to the general UK population.

But PPIs, like most drugs, do have side effects. They’re not usually intended to be taken long term.
If you’re taking them regularly, it may be worth discussing with your doctor whether you still need to. There could be alternative treatments that would be of more benefit."

Here’s a link to the article abstract:

http://gut.bmj.com/content/early/2017/09/18/gutjnl-2017-314605

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I am concerned that your method would insufficiently compensate the pharmaceutical industry CEOs. Is there a Go Fund Me page for them that you contribute to instead?

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PPIs are generally very cheap.

Getting older feels like a constant stream of choices re how I would prefer to die. Heart attack or car crash? Cancer, or (different kind of) cancer?

I’ve tried to fight this law of unintended consequences, but increasingly the law wins.

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I once paid over $200 out of pocket for a Nexium prescription before it was OTC. My doc said to do it, so I did it. I went back to him and said, look mannnnnnnn, this shit is $200 bucks, can I use something else? He said, “Sure, use Omeprazole, but Nexium has fewer side effects. That’s why I prescribed it.” He wasn’t lying to me. But goddamn it!!!

I look at my kids and silently say to myself, “You guys have no idea what you’re in for.”

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Had a stint on Prilosec in my early 20’s, I swear to the great satan that it saved my life (or, at least, let me get some sleep god dammit.)

My doc only had me on it for three months, and things have worked out well in the decade since. Ofc, I keep a roll of tums on me at all times, but that seems insignificant, plus I’ve grown to love that chalky goodness.

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Esomeprazole, pantopratzole, omepratzole and lanzopratzole are out of patent now. At least here. 100 pills cost (with a script) about 15 euros locally.

I’ve recently been diagnosed with GERD, and was told to start taking these, to see if they have the desired anti-inflammatory effect. I don’t have the usual acid reflux symptoms, such as heartburn, which I am told is true for ~40% of people with GERD.

This article is quite timely and appeared to be very relevant to me, until I read this thread. Not to be tacky, but I guess it’s a good thing I am not Chinese or otherwise in very poor health, I suppose.

Since there are enough people here with personal experience, which drug should I take? My doctor’s NP suggested I take either Nexium or Omeprazole (Prilosec and generics), my choice. I don’t currently take any medications, unless you count beer, so no drug interaction issues.

Don’t worry, I’ll ask my pharmacist, too.