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Heartburn medicines could shorten life span : Study

People taking PPIs for a year or more had a 51 percent increased risk of premature death, compared with 31 percent for people on the drugs for six months to a year, and 17 percent for three-to six-month users

Raghu Kshitiz

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KATHMANDU  — Popular heartburn — medically as gastroesophageal reflux disease (GERD) — medications like Nexium,  Pantoprazole, Omeprazole, Lansoprazole, Esomeprazole or Prevacid may increase your risk of early death when taken for extended periods, a new study has warned.

Further, the longer you take these drugs, known as proton pump inhibitors (PPIs), the greater your risk of early death, said senior researcher Dr. Ziyad Al-Aly, a kidney specialist and assistant professor of medicine with the Washington University School of Medicine, in St. Louis.

“There was a relationship between duration of use and risk of death,” Al-Aly said adding “More prolonged use was associated with even higher risk.”

The study, published online on July 3 in the journal BMJ Open, found that people taking PPIs for a year or more had a 51 percent increased risk of premature death, compared with 31 percent for people on the drugs for six months to a year, and 17 percent for three-to six-month users.

That said, Al-Aly pointed out that some patients really do need to take PPIs to deal with medical issues, even long-term.

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“Proton pump inhibitors actually save lives,” Al-Aly said. “We don’t want to leave people with a scary message. If you need this drug and you’re under guidance of a doctor, you should continue to take your medication until otherwise advised.”

Short-term use of PPIs — up to 90 days –however, did not appear to affect death risk, the findings showed.

PPIs work by blocking the enzyme system that produces stomach acid. PPIs have become one of the most commonly used classes of drugs in the United States, with 15 million monthly prescriptions in 2015 for Nexium alone, the researchers said.

However, concerns about the drugs’ safety have been growing in recent years, as studies have linked PPIs to kidney disease, heart disease, pneumonia, bone fractures and dementia.

To take a broad look at PPIs and whether they increase a person’s chances of premature death, Al-Aly and his colleagues compared the medical records of nearly 276,000 users of PPIs against those of about 73,000 people who took another class of heartburn drug called H2 blockers.

Overall, PPI users have a 25 percent increased risk of premature death compared with people taking H2 blockers (such as Pepcid or Zantac), the investigators found.

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The researchers calculated that for every 500 people taking PPIs for a year, there is one extra death that would not have occurred otherwise, Al-Aly said.

“This finding is certainly cause for concern and something that should be considered as doctors continue to prescribe PPIs at a high rate and often fail to discontinue these drugs in a timely fashion,” said Dr. Louis Cohen. He is an assistant professor of gastroenterology with the Icahn School of Medicine at Mount Sinai, in New York City.

At the same time, Cohen noted that people taking PPIs also tend to have many other health problems, and these might influence their risk of death as well.

No one is sure why PPIs might cause all these health problems or increase risk of early death, Al-Aly said. It is possible the drugs might cause cellular or genetic damage.

Even though this study could not prove a direct cause-and-effect relationship, Al-Aly noted that the increased risk with longer duration adds weight to concerns over the drugs’ safety.

“Why would prolonged use be associated with higher risk if there were no real relationship between exposure and untoward outcomes?” he said.

Recommended treatment regimens for most PPIs are relatively short, the researchers said. For example, people with ulcers are advised to take the drugs for only two to eight weeks.

But since the drugs are available over-the-counter, many people take PPIs for months or years to manage heartburn or acid reflux, Al-Aly said.

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Health

Red meat, white bread and sugar-laden drinks might increase risk of colon cancer

Raghu Kshitiz

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Heavy diet like red meats, refined grains, white bread and sugar-laden drinks might increase long-term risk of colon cancer, a new study suggests.

These foods all increase inflammation in our body, and the inflammation they cause is associated with a higher chance of developing colon cancer, according to pooled data from two major health studies appeared in JAMA Oncology journal.

According to researchers, a diet high in foods with the potential to cause inflammation, including meats, refined grains and high-calorie beverages, was associated with increased risk of developing colorectal cancer for men and women.

Basically, what makes for a healthy diet overall also appears to promote a cancer-free colon, said senior researcher Dr. Edward Giovannucci. He is a professor of nutrition and epidemiology at Harvard TH Chan School of Public Health in Boston.

“It’s consistent with what we already recommend for a healthy diet in general,” Giovannucci said, adding “I see that as good news. We’re supporting the current evidence, and not telling people to do something completely different from what they’ve been told.”

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For the study, conducted by Fred K Tabung from the Harvard TH Chan School of Public Health in Boston, the team analysed 1,21,050 male and female health care professionals, who were followed for 26 years in long-term studies. The researchers completed the food questionnaires about what they ate, on the basis of which data analysis was done last year.

The scores were based on 18 food groups characterised for their inflammatory potential and were then calculated from the questionnaires given to participants every four years.

The results indicated that higher scores reflecting inflammation-causing diets were associated with a higher risk of developing colorectal cancer in men and women.

Previous studies have linked diet factors with colon cancer, but there’s been no clear explanation why that might be, he added.

With Agency Inputs

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