PPI long term side effect worries

[nessajane]

Hi all,

Long time lurker and all round anxious type with my first post as I'm feeling really stressed tonight.

I've been on PPIs (Rabeprazole/Pariet) for 5 years with a few breaks in between. I have GERD and gastritis (had an endoscopy and 3 years ago but no cause was found and I was negative to H. Pylori).

Today I saw something about people on PPIs being at higher risk of severe COVID and some Googling revealed there are studies that show long term use is linked to kidney disease, heart disease, dementia and a bunch of other scary things. I did find one study in June 2019 that showed there was no increased risk of disease found, but I can't help but worry now. Also I don't know why my GP has had me on this drug for so many years. Surely she knows the risks and should have told me. Of course she is on holidays until next month but I want to stop taking the Pariet straight away.

This on the back of a full on panic last night after reading about Zantac being recalled. Both my kids had that for months as babies due to severe reflux. They are now teenagers and I'm so scared what the consequences might be for them and now for me with the PPIs. God I hate reflux so much I could cry. So many regrets for taking these drugs and giving them to my kids.

I know what's done is done and I'll have to face the consequences if they come, but how to get the worry under control? I'm too afraid to take anxiety medication (ironic I know given the content of this post) and my mind races too much so I'm hopeless at meditation.

[nomorepanic]

Hi

This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

Please also read this post:

http://www.nomorepanic.co.uk/showthread.php?t=213239

[panic_down_under]

Hi all,

:welcome: to NMP,


Today I saw something about people on PPIs being at higher risk of severe COVID and some Googling revealed there are studies that show long term use is linked to kidney disease, heart disease, dementia and a bunch of other scary things. I did find one study in June 2019 that showed there was no increased risk of disease found, but I can't help but worry now.

Most of these are observation studies which follow people on a med for extended periods and then compare the diseases they develop with those of a similar cohort that hasn't taken the med. While useful these are lower quality studies the results of which should be treated with caution until verified by higher quality randomised controlled clinical trials as correlation isn't necessarily causation. Most of the studies found only weak associations and some contradict others.


Also I don't know why my GP has had me on this drug for so many years. Surely she knows the risks and should have told me.

She probably thinks whatever risks there may be less than that of not taking the med. But long-term meds should be reviewed annually, IMO.


Of course she is on holidays until next month but I want to stop taking the Pariet straight away.

I urge you to wait until you've discussed this with your GP.


This on the back of a full on panic last night after reading about Zantac being recalled. Both my kids had that for months as babies due to severe reflux. They are now teenagers and I'm so scared what the consequences might be for them and now for me with the PPIs.

The N-nitroso contaminants are probably relatively recent being first detected in 2018 so your children are unlikely to have been effected. N-nitroso compounds are also found in smoked and cured meats and an air pollutant. According to the Therapeutic Good Administration (https://www.tga.gov.au/alert/ranitidine-0) (TGA), the risk from ranitidine is very tinyl. Taking one Zantac every day for 70 years increases the risk of cancer by 1 in 100,000.


I'm too afraid to take anxiety medication (ironic I know given the content of this post) and my mind races too much so I'm hopeless at meditation.

Treating the anxiety may also ease, possibly eliminate, the GERD and gastritis.

It is becoming increasingly clear that the enteric nervous system (http://www.scientificamerican.com/article/gut-second-brain/) (ENS), the mini brain which controls the gut is also a significant force in anxiety and depression. The ENS is directly linked to the brain via the vagus nerves and seems to be the more dominant partner with most of the data flow originating from it (it is also connected to the heart and lungs). It is arguably the tail wagging the dog. Electronic vagus nerve stimulators which affect the ability of the gut to communicate with the brain have proven to be effective for treatment resistant depression, though much less so for anxiety disorders.

In turn the ENS is influenced (https://www.apa.org/monitor/2012/09/gut-feeling) by the gut microbiome. How you feel emotionally can literally be effected by your poop! Indeed, it is possible to make a strong argument for us being merely the life support system for the bugs in our guts who can lead us on a merry chase at times. They outnumber the cells of our bodies by about 10:1 so we don't stand a chance if they turn on us!

The gut is by far the most serotonergic organ of the body, making about 50 times as much serotonin as the brain and is replete with serotonin receptors so antidepressants can have significantly more influence on it than they do the brain. Gut microbes also have (https://institute.progress.im/en/content/microbes-and-brain-share-neurochemistry) binding sites targetted by ADs and may also be affected by them. In addition to their direct impact on the ENS, there is also evidence that they can alter the mix (https://www.medicalnewstoday.com/articles/326299.php) of gut flora. Together these may be responsible for the improvement in IBS symptoms often seen with SSRIs and other serotonergic ADs.


See also:

Gut microbiota plays a role in brain function and mood regulation (Article (https://www.sciencedaily.com/releases/2020/12/201211115507.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain%2Fd epression+%28Depression+News+--+ScienceDaily%29) | Study (https://www.nature.com/articles/s41467-020-19931-2))

How your gut might modify your mind (https://cen.acs.org/biological-chemistry/microbiome/gut-might-modify-mind/97/i14?PageSpeed=noscript)

Gut bacteria, the vagus nerve and the brain (PDF (http://www.old-herborn-university.de/wp-content/uploads/publications/books/OHUni_book_26_article_4.pdf))

Gut bacteria and the brain: Are we controlled by microbes? (https://www.medicalnewstoday.com/articles/312734)

Gut communicates with the entire brain through cross-talking neurons (https://www.sciencedaily.com/releases/2020/04/200402155733.htm)

Gut microbes may talk to the brain through cortisol (https://news.aces.illinois.edu/news/gut-microbes-may-talk-brain-through-cortisol)

[nessajane]

Thanks so much for your comprehensive reply. The potential for kidney damage was the thing that freaked me out the most (my health anxiety brain has already worried about all the other potentials so tends to latch on to something new). However, I have blood tests regularly and my kidney function has been normal. I’ve made an appointment with another GP in the practice to talk about coming of the Pariet.

Your information about gut health was very interesting. Thanks again for sharing 😀