OT- GERD drugs and pneumonia

Those who take GERD drugs or OTC remedies may want to read this: http://www.webmd.com/heartburn-gerd/new ... monia-risk

Did you notice they're talking about Hospital-Acquired Pneumonia?

DreamLady wrote:Did you notice they're talking about Hospital-Acquired Pneumonia?

You might conclude that they are only talking about hospital-acquired pneumonia from the brief WebMd article. However, if you read the study in CMAJ, http://www.cmaj.ca/cgi/rapidpdf/cmaj.09 ... 09ac70d2d3 , you will see:

Description of studies
The selected studies were published between 1985 and 2009.
Five articles reported population-based studies,2,6,7,14,23 and 26
articles, including the 23 randomized controlled trials,
reported hospital-based studies.10,22,24–47 Of the observational
studies, five evaluated the association between use of acidsuppressive
drugs and risk of community-acquired pneu -
monia,2,6,7,14,23 and three evaluated the association between use
of these drugs and risk of hospital-acquired pneumonia.10,22,24

and

Interpretation: Use of a proton pump inhibitor or histamine2
receptor antagonist may be associated with an increased risk
of both community- and hospital-acquired pneumonia. Given
these potential adverse effects, clinicians should use caution
in prescribing acid-suppressive drugs for patients at risk.

Snoredog always would tell us that our bodies produce all that stomach acid for a good reason and inhibiting it might cause problems.

In our family we have treated GERD by raising the head of every bed in the house by four inches and eating at least four hours before bedtime. No GERD drugs here.

Oh yes, the CPAP was needed before we could clear up GERD.

I haven't read the studies--did they involve control groups of people that have GERD but did not take PPI's to rule that out???? Otherwise, how did they differentiate between the risk of pneumonia which is a result of aspiration regardless of PPI's?

Frankly, elevating the head of the bed does nothing to help my GERD, and even PPI's don't stop me from having reflux. I continue to take PPi's, but if I fall asleep without my CPAP--even while sitting up--I WILL have reflux. I've got a narrow airway, apneas happen right away, and reflux as a result. CPAP seems to be the only thing that prevents me from having reflux.

I'm with Jan. Elevating my bed did NOTHING for my GERD, and I also have it while sitting up or standing. Lying down doesn't make it any worse. I do take Prilosec and will continue to do so. Although more acute in nature, pneumonia is still usually easier to treat than stomach cancer, Barrett's Esophagus, aspiration into the bronchus, scarring of the vocal chords, chronic cough, and the myriad other problems that would/could result if my GERD was untreated.

I do appreciate the fact, however, that cpap means that I no longer have breakthrough attacks of acid reflex, which means LESS medication than I would otherwise have to take.

ETA:

There was this interesting paragraph when I read the entire article more thoroughly: "Longer duration of acid-suppressive therapy before the date of pneumonia diagnosis weakened the associations, with the most striking risk in the first week of use and no significant links for use lasting more than six months prior to pneumonia diagnosis. "These findings might reflect tolerance," Eom's group suggested in CMAJ, noting that administration of H2 blockers generates tolerance marked by a decline in acid suppression, generally within two weeks. Another explanation may be that those most susceptible to pneumonia get it early after starting on acid-suppressive drugs. "That is, patients who remain on the drug are those who can tolerate it, whereas those who are susceptible select themselves out of the population at risk," they added in the paper. " (Bold text is my addition)

So, IMO, while this might be of interest for doctors considering prescribing PPIs to the chronically ill, the research shows there is no significant risk to those who have been using them for more than six months. Once again, another case of someone 'cherry-picking' facts out of article, while leaving out one of the most important findings.