Smoking and Heartburn may Lead to Fractures

Heartburn drugs linked to hip fractures in older women

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When you have heartburn, you might turn to common medications like Nexium, Prevacid, or Prilosec. But if you're an older woman, who smoked, these drugs may have the dangerous side effect of hip fractures.

A new study has found that heartburn drugs called proton-pump inhibitors (PPIs) increase the risk of hip fractures in postmenopausal women.

Being on the medication for more than two years, along with a current or old smoking habit, can raise a woman's risk by 35 to 50 percent.

"Discuss the risks of long term PPI use with your doctor."

The study was led by Dr. Hamed Khalili, a clinical and research fellow in gastroenterology at Massachusetts General Hospital. Previous studies have linked PPI use to bone fractures, but this research narrows down the category of greatest risk.

Heartburn is a symptom of acid reflux, or gastroesophogal reflux disease (GERD). It occurs when gastric pressure pushes acid in the stomach back up the esophagus.

PPIs act to suppress the acid in the stomach from forming.

The researchers examined data from 80,000 postmenopausal women over the course of eight years. From 2000 to 2008, they saw 900 fractures.

Women who took PPIs had an increased risk of 35 percent over women who did not take the medications. Women who smoked and took PPIs had an even higher risk – up to 50 percent.

The longer the women were on the medication, the greater their risk was.

Fortunately, risk of fracture returns to the baseline if the woman has been off PPIs for two years, the researchers found.

But there's little reason to be on PPIs over two years in the first place, Dr. Khalili said.

Concern about PPIs has been on the rise in the healthcare community recently. Many healthcare professionals believe that PPIs are overprescribed, and that patients should not be using them on a long-term basis.

In many cases, heartburn may be resolved with lifestyle changes. Getting rid of your extra weight around your middle may relieve the pressure on your stomach that's causing acid reflux.

Heartburn sufferers may also be able to identify certain foods that cause their symptoms, and avoid them. Caffeine and alcohol, in particular, are common triggers.

Postmenopausal women are already at higher risk for osteoporosis, a disease that is characterized by fragile bones and fractures. Women 65 and above should be screened by their doctors for bone density.

The study was published in the journal BMJ in January 2012.

Reviewed by: 
Review Date: 
February 3, 2012
Last Updated:
February 8, 2012