One type of antacids, commonly prescribed for conditions such as acid reflux, could potentially be damaging the kidney if used over a long period of time.
The set of drugs, known as proton-pump inhibitors (PPIs), have been shown in recent studies to elevate risk of chronic kidney disease by anywhere between twenty and fifty percent. Despite a number of these studies being published in recent years, the potential for serious harm resulting from overuse of PPIs has only been thoroughly discussed in the last few months.
Concerns in the medical community were brought up during the Annual Conference of Nephrologists and at an Association of Physicians of India conference. A major issue raised was the overprescription of the medications.
PPIs are among the top ten most commonly prescribed medications. They are used for all manner of digestive issues such as acid reflux, indigestion and peptic ulcers. A trip to the doctor with any manner of stomach problem can easily result in the prescription of antacids to alleviate the symptoms. Many patients will not understand the potential risks of long term use and continue using them indefinitely if the symptoms return.
If use continues beyond eight weeks, a patient’s kidney function and magnesium levels should be monitored said Dr Pradeep Arora, speaking at the annual conference of the Indian Society of Nephrology in Delhi.
Experts suggest that even physicians themselves may be unaware of these potential risks. The information regarding kidney damage is only now being widely discussed. Before this point the information was largely restricted to nephrology journals where only specialists in the field would take notice.
This is contrasted by information available in the US. The FDA specifically states that over the counter PPIs should only be used for a fourteen day period, and at most, three times over the course of a year. This would indicate the potential for long term damage is a more widely known issue outside of India.
In some cases, digestive issues can be caused by serious conditions such as Crohn’s disease or Celiac disease. Crohn’s disease – a form of inflammatory bowel disease (IBD) – was once considered rare in India. However, its incidence is rising and India is now thought to have the highest prevalence of IBD in southeast Asia. Celiac disease, meanwhile, affects around six to eight million Indians according to the All India Institute of Medical Sciences. In these cases dietary changes must be made to accommodate the condition as they are long-term diseases that require lifelong management.
In many cases indigestion and stomach acid issues are caused by more simple issues, often associated with an individual’s diet. Dietary risk factors include the consumption of large meals, particularly before bed. Acidic or fatty foods can also cause digestive issues. Longer term problems such as smoking or obesity can cause recurrent issues that will not be resolved with short term use of antacids.
Making changes to the diet can often be a more effective long term solution than the temporary fix of antacids. Along with this, probiotics like yoghurt and natural antiemetics such as ginger can also aid digestive health and alleviate symptoms. Positive change to the diet may also have longer term benefits for kidney health and health overall in addition to limiting the need for antacids.