PPI Use May Be Linked to Stomach Cancer

02. 23. 2018

There are many known risk factors for stomach cancer, but doctors are still unsure of how these factors impact cancer development.

H.pylori and Gastric Health

Research indicates that prolonged infection with Helicobacter pylori, or H. pylori, is the main contributor to pre-cancerous changes in the stomach. H. pylori is a spiral-shaped bacterium that grows in the mucus layer coating the inside of the human stomach. Although H. pylori infection usually does not cause illness, it is a significant risk factor for peptic ulcer disease and is responsible for the majority of ulcers of the stomach and upper small intestine.

PPIs and Stomach Cancer Risk

A new study published in the journal, Gut, suggests that long-term use of proton pump inhibitors (PPIs) is responsible for increasing stomach cancer risk, not H. pylori. PPIs reduce the amount of stomach acid by blocking production made by glands in the lining of the stomach.

Scientists at the University of Hong Kong and University College London studied 63,397 adults between 2003 and 2012. Participants were given PPIs, antibiotics to kill off the H. pylori, and acid-limiting H2 blockers, and the scientists monitored them until the end of the study in 2015.

While H2 blockers were not found to increase stomach cancer risk, PPI use increased according to dose and duration, even if H. pylori was removed from the body. A total of 153 people in the study developed stomach cancer, and all of them exhibited chronic gastric inflammation. However, none of them tested positive for H. pylori.

Daily use of PPIs increased the risk of stomach cancer by 4.5 times compared to those who used it weekly. When PPIs were used for more than a year, the risk increased five-fold. After three years, risk was as high as eight-fold. 

Balancing PPI Use with Lifestyle Changes

One out of five Americans experiences reflux symptoms every week, so should everyone who takes PPIs be worried about stomach cancer? The short answer is no. Taking Nexium, Prilosec or a generic PPI drug for GERD on an occasional basis has not been shown to increase the risk of stomach cancer. The Gut study concluded that stomach cancer risk was proportional to the dose and duration of PPI treatment, meaning long-term PPI users were at the highest risk.

The current recommended treatment term for anti-reflux medications is 14 days. Ongoing studies show extensive side effects of long-term PPI use, and stomach cancer risk is only one of them.

The most successful way to manage acid reflux and GERD is to visit your gastroenterologist and adopt healthy lifestyle changes like avoiding trigger foods, eating smaller meals and managing stress. PPIs can relieve the initial pain of heartburn, but modifying your diet and daily choices will provide the healing your digestive system needs (source: The Guardian).

Related Article:

PPIs and Antibiotics: A Dangerous Duo

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