These Hips Don't Lie They say there are only six degrees of separation between you and any other person on earth. If so, there must be only a couple degrees separation at most between you and all the people who use proton-pump inhibitor drugs to address gastrointestinal reflux disease (GERD). According to WebMD Medical News, in 2005 more than 95 million U.S. prescriptions were written for Nexium, Prilosec, Prevacid, and other proton-pump inhibitors (PPIs). So forward this e-mail along your friends who use these drugs and let them know they may be putting themselves at greater risk of hip fractures. Fortunately, you can also let them know there's a safe alternative treatment for GERD that's far less expensive than PPI drugs. An absorbing issue
The WebMD article notes that PPIs turn off the "pump" mechanism that the stomach cells need to make acid. And the article adds that PPIs are "very effective for treating GERD." Why the free promotional comment? Wyeth, AstraZeneca, and TAP Pharmaceutical Products are PPI manufacturers that just happen to also be WebMD sponsors. I suppose WebMD editors figured they'd throw their benefactors a bone before delivering the bad news. Here's the root of the problem: PPIs may interfere with calcium absorption, and may also reduce bone resorption (part of the natural process that constantly renews the structure of bones). To investigate just how pronounced this problem might be, researchers at the University of Pennsylvania compared PPI use with incidence of hip fracture. STUDY ABSTRACT Researchers examined 15 years of data contained in the UK's General Practice Research Database - Data included more than 13,500 hip fracture cases and more than 135,000 patients without hip fracture - all subjects were at least 50 years of age
- Results showed that low dose PPI therapy produced a slight risk of hip fracture
- Subjects who used PPIs for more than one year increased risk of hip fracture by 44 percent compared to subjects who didn't use PPIs
- Subjects who used high doses of PPIs for long periods were significantly more likely to fracture a hip
- Researchers noted that the detrimental effect of PPI use is probably most pronounced among patients at high risk of osteoporosis.
Fighting acid with acid
You might feel caught between the devil and the deep blue sea if you have both osteoporosis and GERD. But don't despair. HSI Panelist Allan Spreen, M.D., has a solution that can address GERD, improve overall digestion, and won't compromise bone health. In the e-Alert "Fire Down Below" (12/23/02), Dr. Spreen outlined a simple two-step plan that starts with acidophilus supplements; available at most health food stores and through many Internet sources. Dr. Spreen recommends refrigerated varieties in capsules or powdered form. And he adds: "They should be measured in billions (with a 'B') of cfu (colony-forming units)." In step two, believe it or not, acid is added, along with digestive enzymes. Dr. Spreen explains: "It isn't acid that's the problem (you need it desperately for digestion); it's acid reaching the esophagus. Proper digestion allows for higher concentration of acid while tightening the GE junction and protecting the esophagus. I do that using Super Enzymes by TwinLab, two capsules at mid-meal. I hate to push just one company, but it's one of the few enzymes that includes betaine hydrochloride, a plant-based form of acid." You'll find much more information about Dr. Spreen's GERD protocol in "Fire Down Below" at this link: http://www.hsibaltimore.com/ealerts/ea200212/ea20021223.html | 
