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chrisrob
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Quote chrisrob Replybullet Topic: PPI's may raise risk of pneumonia
    Posted: 29 Dec 2010 at 1:41pm
Recent research has shown patients taking PPI's may have an increased risk of developing pneumonia.
This link takes you to the relevant article.

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RichardT
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Quote RichardT Replybullet Posted: 30 Dec 2010 at 11:02am
> Recent research has shown patients taking PPI's may have an increased
> risk of developing pneumonia.
> <a href="http://www.webmd.boots.com/heartburn-gord/news/20101222/heartburn-drugs-may-raise-risk-of-pneumonia">

This may be a red-herring...

There are many claimed problems 'caused' by certain diseases/drugs. In fact it's more likely that people who develop the disease also tend to have that problem.

To link PPIs to pneumonia could be missing a point; a large number of people who have GORD are obese and generally unheathy. Unhealthy peope tend to have problems! Obese people tend to get GORD, Barrett's, heart attacks, strokes, cancer and anything else going!

To make statistics like this meaningful, you have to examine the underlying cause of the original problem.

Edited by RichardT - 30 Dec 2010 at 11:03am
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chrisrob
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Quote chrisrob Replybullet Posted: 30 Dec 2010 at 1:31pm
The links between respiratory diseases and GORD have been known for a while with higher incidence of asthmatics developing Barrett's and, conversely, the incidences of Barrett's sufferers developing asthma.

The links between PPi usage and pneumonia were brought to light in studies of hospitalised patients between 2004 and 2007 see here.
And this recent article in the student edition of The Lancet takes the connection as a a recognised fact. The Boots/WebMD article reports the conclusions of a carefully controlled new study of non- hospitalised patients.

I had always had concerns over the use of acid suppressant induced hypochlorhydria from the point of view of malabsorption of essential minerals (although when talking with two of the country's top GI specialists last year, they hadn't considered it!) but had hitherto ignored the importance of stomach acid in suppressing harmful bacteria.

PPIs are generally safe and a great benefit to GORD sufferers but I suggest it is wise to be aware of the adverse effects of them and attempt to minimise their use. Perhaps after 20 years of use, we are only really beginning to understand them?
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RichardT
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Quote RichardT Replybullet Posted: 30 Dec 2010 at 3:40pm
> The links between respiratory diseases and GORD have been known for a
> while with higher incidence of asthmatics developing Barrett's and,
> conversely, the incidences of Barrett's sufferers developing asthma.

I would argue that that is not a direct link.

Yes, acid or bile reflux can get into the lungs. But so can food or drink. "It went down the wrong way".

Any foreign substance in excess in the lungs can cause damage and make disease more likely. Healthy lungs can cope with occasional small amounts of mos likely foreign substances. I'm well aware of that as I have bronchiectasis. But I know exactly when the infection that caused that was - it is not related to Barrett's. Though of course, statistically, I am such a 'link'. That infection occurred when I was in a very low state after a divorce. So I could claim that divorce and bronchiectasis are linked... a *very* long chain of linkage!

Health 'links' that are from a common cause, or are indirect, can be misleading and cause misunderstanding, as well as directing 'cures' in the wrong direction. I try and understand why such links are apparent!

Surely inhaling refluxate causes violent coughing, same as drink going down the wrong way. Maybe some people have bad cough reflexes.

Certainly stomach acid has many functions: it pre-digests meat. It acts as an antiseptic, so food poisoning is more likely if it's suppressed. It helps the assimilation of calcium and other minerals, hence the link to hypocalcaemia hence broken bones. reducing stomach pH also affect gut flora - hence the link to flatulence and other digestive irregularity.

Most of the side-effects of PPIs seem to me to be due to the excessive overdose levels in general use (but that's all on my www site). I wonder if there's some effect on the immune system also. The jama.ama-assn.org/ link clearly says that most PPI prescription is unnecessary. All of it is at overdose levels!

One way the government should and easily could reduce NHS budget would be to stop over-prescribing. But there is a strong culture of 'can't you just give me a pill for it'.
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org

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