Your Heartburn's Connected to Your Hip Bone

Dec. 27, 2006 — -- Millions of individuals who suffer from heartburn look to acid-suppressing medications such as Prevacid, Prilosec and Nexium for relief.

Now a study published in today's issue of the Journal of the American Medical Association shows that high doses of these medications, called proton pump inhibitors (PPI), over a long period of time, can lead to increased risk of hip fractures.

But for many who require the drugs, going off them entails severe consequences.

The study conducted by Dr. Yu-Xiao Yang and colleagues at the University of Pennsylvania School of Medicine in Philadelphia looked at the medical records of more than 145,000 patients older than 50 in England.

Using the database, they compared 13,556 cases of patients with hip fractures to 135,386 controls.

The researchers report that people who used PPIs for more than one year increased their risk of hip fractures by 44 percent.

Moreover, the risk was more than 2½ times higher among long-term users of high-dose PPI therapy, showing that both the amount of PPIs the patients took and the period of time for which they took them affected their risk of hip fracture.

Experts speculate that the medications decrease acid in the stomach, making it more difficult for the body to absorb bone-building calcium. When this happens, osteoporosis occurs.

And bones affected by osteoporosis can fracture with only a minor fall or injury.

"I think this study should make doctors more aware of this potential side effect, and elderly patients on PPIs should be given as low a dose as possible," said Dr. Roshini Rajapaksa, assistant professor of medicine in the division of gastroenterology at the New York University School of Medicine.

Bones naturally become thinner as people grow older. This is because soon after middle age, the body's production of new bone can't keep up with the reabsorption of existing bone cells.

As this occurs, the bones lose minerals, heaviness and structure, making them weaker and more likely to break.

"Hip fracture results from demineralization of bone," said Dr. Joel Weinstock, chief of the division of gastroenterology at Tufts New England Medical Center.

"These thin bones are much more likely to fraction with minor trauma," he said.

Osteoporosis afflicts an estimated 25 million people in the United States and accounts for approximately 1.5 million new fractures each year.