I see many patients taking Acid blockers long term. On a near weekly basis I'm telling a patient acid blockers aren't meant to be taken long term. Sometimes patients may not take this advice seriously, as their family doctor is fully aware they are on acid blockers long term without much concern. This article will shed light on the evidence, that acid blockers must not be used long term.

What Are Acid Blockers?

Acid blockers work by reducing stomach acid production. Acid is vital in protein digestion, mineral absorption and protection against pathogenic bacteria.

They are actually quite effective in multiple gastro-intestinal disorders including: peptic ulcer disease (and associated bleeding), eradicating H. pylori, Zollinger-Ellison Syndrome, GERD and Dyspepsia [1].

In fact, the safety profile of acid blockers short term, is quite good, with little to no adverse effects when taken appropriately. Issues arise when acid-blockers are used long term and inappropriately.

Acid Blocking Medications Shouldn't Be Taken Long Term

Quite surprisingly, even the manufactures themselves don't recommend taking these medications for more than 1 year, some even recommend no more than 6 months.

Official labels of lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) and omeprazole (Zegerid) state: "controlled studies do/did not extend beyond 12 months [2]. Official labels for esomeprazole (Nexium) states "controlled studies do not extend beyond 6 months" [2]. The drug fact panel for omeprazole, over the counter medication says: consumers are advised to take no more than one 14 day course of treatment of therapy every 4 months" [2].

In other words no research has been conducted on acid blockers in humans for more than 6 or 12 months. These medications are not meant for long term use, and beyond that, there are no studies investigating the adverse effects beyond 12 months.

The concept of long term maintenance is therefore not safe. None of the official labels of acid blockers recommend a specific time span for maintenance therapy [2], which likely indicates they are not intended to be used long term for 'maintenance'.

Proof Long-Term Use of Acid Blockers is Unsafe

When a person uses acid blockers long term, a wide range of associated conditions are well documented.

• reduced mineral absorption [3], including magnesium, calcium, vitamin B12 - acid helps get these out of the foods in which they are in [1]
• As a consequence of reduced calcium absorption, increased risk of fracture. In fact, research has shown PPIs (one type of acid blocker) increased risk of hip fracture after only 1 year of use [1]
• Impaired protein digestion [3]
• Lowered tryptophan, tyrosine, phenylalanine which can be associated with depressed mood [3] (depression occurs more often in those taking acid blocking medications) [3]
• Increased potential for gastric adenomas (cancer) [4]
• Increased risk of gut infection (acid helps kill bacteria entering our digestive tract). Salmonella, C. difficile, claustrum difficile.