Are PPI pills safe?

Are PPI pills safe?

Gastro-Eophageal Reflux Disease (GERD) is very common worldwide. Here are some prevalence estimates: “18.1%-27.8% in North America, 8.8%-25.9% in Europe, 2.5%-7.8% in East Asia, 8.7%-33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in pediatric patients aged 1-17 years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p<0.0001), particularly in North America and East Asia.” In the Philippines, GERD had significantly increases in 2000-2003 compared to 1994-1997.

The current standard of care includes the use of Proton Pump Inhibitor (PPI) medications, which blocks the acid production in the stomach which reduces heartburns and corrosive esophagitis (inflammation and scarring of the lower food pipe at its connection to the stomach. PPI drugs are marketed as esomeprazole, pantoprazole, omeprazole, lansoprzole and reberprazole.

A study published in the British Medical Journal Open suggests that PPI increased general mortality rate. Researchers evaluated data from the US Department of veterans Affairs among new and nonusers of acid suppression treatment. The study did not include non-PPI anti-acid drugs.
Their findings revealed that “during a median 6 years’ follow-up, use of PPIs was associated with increased risk for death, relative to use of H2 blockers (adjusted hazard ratio, 1.25). Risk was also increased among patients taking PPIs, compared with those not taking acid suppression therapy, and among those taking PPIs who did not have a gastrointestinal condition that would warrant a PPI prescription.”
There are other preliminary studies, which need further research and large scale confirmation, reported that the long term use of PPI could possibly lead to higher risk of chronic renal disease, dementia, osteoporosis, low magnesium blood level, Clostridium deficile infection, community-acquired pneumonia and shortening of the telomere, suggestive of shorter life span. All these are postulates that require more extensive clinical studies to be accepted a valid. Also, each individual has a unique genetic constitution and will therefore generally react differently.
The researchers have this advice: “Although our results should not deter prescription and use of PPI where medically indicated, they may be used to encourage and promote pharmacovigilance and emphasize the need to exercise judicious use of PPI and limit use and duration of therapy to instances where there is a clear medical indication and where benefit outweighs potential risk.”
For any concerns, discuss them with your family physician, who is familiar with your individual health details.
* * *
Chocolate and your heartbeats

Chocolate lovers can rejoice: A 13-year study of 55,000 individuals in Denmark revealed that those who ate chocolates “often tended to have a lower risk of atrial fibrillation, an irregular heartbeat that raises stroke risk.” The risk of AF was about 10 percent lower among those who had one to 3 servings of chocolates a month, and 17 percent lower risk for those ate one serving a week and 20 percent lower still among individuals who had 2 to 6 servings a week. The benefit was found to taper off at 16 percent among adults who ate one or more 1-ounce serving of chocolate a day. Although chocolates contain high levels of flavanol, it is not clear why it provides this anti-arrythmic benefit. But the researchers advise moderation as a prudent key.
* * *
Over-the-counter hearing aids
Hearing aids today could cost as much as $6,000 or more. They are so small one could hardly see them and works very well. Obviously, this is too pricey for most of us and many have no choice but to accept the hearing handicap or consider over-the-counter hearing aids, whose quality is mostly doubted.
But there is good news: The Journal of the American Medical Association recent study shows that “some over-the-counter sound amplification devices are nearly as effective as prescription hearing aids.”
The investigators evaluated and “compared five personal sound amplification products on the market with one hearing aid in 40 older adults with mild-to-moderate hearing loss.”
The findings revealed that “speech understanding improved with the hearing aid and four of the amplification products. For three of the products (Sound World Solution sCS50+, Soundhawk, Etymotic BEAN), the improvement in speech understanding was within 5 percentage points of that of the hearing aid.”
The conclusion of this study “lend support to current national initiatives … requesting that the US Food and Drug Administration to create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter.”
* * *
In the past, we have pointed out the alarming association between poor oral hygiene and dental infections and cardiovascular diseases. While this link may sound remote and ridiculous, this relationship is evidence-based, medically proven.
Statistics from 2011 to 2014 show that among 5-19 years of age, untreated dental caries was about 18.6 percent and among adults (20-44) about 31.6 percent. Between ages 18-64, 36 percent had not visited a dentist in 2016.
Unfortunately, dental care is not only for a “mouth or oral” problem. It would be more expensive and life threatening to have heart attack/stroke, etc., than a visit to the dentist every six months.
* * *
Loud music causing deafness?

Yes, and not only music. Prolonged or repeated exposure to any type of very loud noise or sound can cause damage to the auditory nerve damage, which could lead to varying degrees of hearing impairment, and even to permanent deafness. Headset users should set the volume of sound to a safe level. A simple way to do this is to turn the volume down until you can barely hear it, then gradually increasing the loudness (and adjusting the treble and the base if possible) to a comfortable level.

* * *

Does surgery make cancer spread?

No, this is a myth. Doing surgery or “opening the patient up” does not cause metastasis (spread) of the cancer. In general, cancer proliferates rapidly to invade surrounding tissues and distant organs. The misconception resulted from the refusal of patients suspected or confirmed to have cancer to be operated on early when first advised, and had delayed the surgery so much that the malignant tumor had already spread beyond help before acceding to have the operation. So, when the surgeons operated on them that late, invariably the cancer had already spread all over. When the patients soon expired, people blamed the surgery as the cause of the spread. Today, almost everybody knows that prompt detection and early operation in the treatment of cancer gives the best chance for a cure for majority of patients with malignancy.