regulations at a high level
According to the current Drug Ordinance Report, German doctors prescribed around 3.7 billion daily doses of gastric protective agents, so-called proton pump inhibitors, in 2020. The number of prescriptions is 70 percent higher than ten years ago, but has been stable since 2017.
Actual consumption is likely to be even greater, because some of the active ingredients such as omeprazole, pantoprazole or esomeprazole are also available without a prescription.
Proton pump inhibitors are considered all-rounders
Acid blockers almost completely suppress the formation of stomach acid. The number of people suffering from reflux disease, in which those affected often take the medication, is increasing. However, that alone cannot explain the persistently high number of prescriptions. It is probably also due to the fact that the remedies are considered all-rounders and are even used for stomach problems without a clear diagnosis or irritable bowel syndrome.
Notes on risks with long-term use
In general, the active ingredients are well tolerated. With long-term use, however, there are indications of risks from studies – such as an increased risk of esophageal cancer, broken bones, cardiovascular diseases, pneumonia and intestinal infections. The acid-free stomach probably makes it easier for the causative bacteria to enter the body.
Study results with uncertainties
However, the risk data are subject to uncertainties: They mainly come from observational studies and therefore cannot reliably prove a causal connection. Patients who are prescribed acid blockers are often older or more ill than non-users.
Danger of a vitamin B12-lack
It is also known that gastric protective agents can promote a vitamin B12 deficiency in the long term. The absorption of the vitamin from food requires gastric acid. This also applies to magnesium, iron and calcium.
If there is a lack of calcium, osteoporosis can develop, which in turn increases the risk of fractures already described. In addition, antacids can affect how other medicines are absorbed into the body.
Diarrhea, constipation, abdominal cramps – what helps
- Medicines for the stomach and intestines. Whether heartburn, constipation or Crohn’s disease – in our medication database you will find reviews for numerous remedies for many stomach and intestinal diseases.
- irritable bowel syndrome If you have irritable bowel syndrome, some over-the-counter medications can provide relief. In our test of remedies for irritable bowel syndrome, however, 13 out of 19 proved to be less suitable.
Daueranwendung von Magenmitteln überprüfen
Doctors and patients should take a critical look at the long-term use of acid blockers: their benefit has not been proven, for example, when they are taken prophylactically to prevent stress-related stomach pain.
Another problem is that patients who are hospitalized are routinely given a stomach protector, which they often continue to take after discharge for no reason. Long-term use is also not appropriate for digestive problems such as pressure in the stomach area, heartburn, feeling of fullness and belching.
Tipp: You should take over-the-counter stomach protectors against heartburn without medical advice a maximum of three times a year for a maximum of two weeks. In our special blocking or inhibiting, we explain what helps best with heartburn.
The dosage should be as low as possible
Physicians should only specifically prescribe proton pump inhibitors for approved indications. The drug experts at Stiftung Warentest rate them as suitable for persistent heartburn, esophagitis and gastric and duodenal ulcers.
They are also useful as a preventive measure, for example when patients with joint diseases have to take long-term painkillers, which can trigger gastric and duodenal ulcers. The dose should be chosen as low as possible and the need to be checked regularly.
Tipp: Seek medical advice as to whether taking an acid blocker still makes sense in your case. Perhaps you can omit the remedy or reduce the dose. It is important that the doctor keeps an eye on all of your medication.
Do not discontinue gastric protective medication abruptly
Patients should not imprudently and abruptly remove a gastric protective agent from their medication list. Otherwise heartburn or other acid-related stomach problems can occur more severely than before after prolonged use. Because the elimination of the acid blockade leads to increased gastric acid production.
Tipp I: In consultation with your doctor, gradually reduce the dose: cut it in half for a week or two. Or take the acid blocker alternately with an acid-inhibiting agent. You can then only take the reduced dose every other day for a further week. Finally, you can try to omit them altogether.
Tip II: Don’t just share pills or capsules. Many are equipped with an acid-stable coating so that they do not already dissolve in the stomach, but only in the small intestine: There the body absorbs the active ingredients and transports them through the blood to their site of action. Instead, choose lower-dose capsules or tablets.
An exception are so-called multi-unit pellet systems – recognizable by the abbreviation “MUPS”. The active ingredient is packed in small balls (pellets). You can break these. However, do not bite or chew the pellets.