在某些时间或另一个,我们都在那里。当ther one too many coffees, grandma’s homemade marinara sauce or a really indulgent holiday meal, now you’re reaching for some heartburn relief.
如果你像millions在患有胃食管反流疾病（GERD），消化系统疾病或其他反流疾病的美国人中，您可能会触及“紫色药丸”或其他类似的质子泵抑制剂（PPIS），以缓解下胸部灼痛的疼痛。
But recent studies have raised some questions about the serious and even life-threatening side effects of these drugs. ArePPI在治疗GERD方面比有帮助更有害吗？
好消息是，在大多数偶尔的胃灼热情况下，您可能不需要这些药物。但是，如果它成为一个反复出现的问题，饮食和非处方抗抗酸，例如rolaids和tums，那么您应该做什么？
绝对是“短期药物治疗helpful when it comes to symptom relief, but usually this relief is temporary, and the symptoms usually return after stopping the medication,” saidKhoi dinh le，医学博士，一名普通和机器人外科医生Banner Health Clinicin Greeley, CO. “The general研究共识是，在肥胖的人中，GERD更为突出。然而，饮食和生活方式的改变，以健康而持久的方式减肥，可以最大程度地减少甚至消除反流和胃灼热。”
GERD is more prominent for obese people, because they have less space within their abdominal cavity. So anywhere or any direction pressure can be released is what the body will tend to do. This can manifest in the form of belly button or groin hernias, shortness of breath, exercise intolerance, hiatal hernias, and heartburn.”
如果您已经用尽了所有短期措施和体重减轻，但仍在经历GERD，LE博士将解释长期服用PPI的利弊。
权衡利弊
PPIwork by blocking and decreasing the production of stomach acid and giving a chance for damaged tissue in your esophagus time to heal. They are found over-the-counter or by prescription. Generally, PPIs are intended for short-term use (4-8 weeks) to help control heartburn and ulcers.
The pros of PPIs
如果您过量产生酸，则您的风险较高，患吸毒性溃疡，酸会克服胃的保护机制，从而导致侵蚀和随后的溃疡。溃疡，如果不及时治疗，实际上会导致穿孔，使您生病或化粪池 - 如果发生这种情况，则是手术紧急情况。
Short-term use of proton pump inhibitors is helpful in healing ulcers, when used in conjunction with certain antibiotics and other medications.
Le博士说：“对于Gerd和Heart灼热，PPI在特别抑制或麻烦时可以帮助治疗症状。”“他们还可以帮助您的医生或外科医生确定某些类型的手术或手术是否有助于消除GERD。如果经过6-8周的治疗性PPI治疗后，您的症状恢复了，您可能是手术的候选者。”
其他药物，例如H-2阻滞剂（ZANTAC，通用：Ranitidine），阻止了酸产生的替代途径。但是，到2020年3月，食品药品监督管理局已有requested由于长期使用该药物，由于癌症的风险，立即将Zantac从市场上撤离。
PPIS的缺点
尽管PPI通常受到人们的耐受性，但每个人都可以做出不同的反应，并且有些不太愉快的副作用对他们而言是常见的。这些包括头痛，恶心，发烧，腹泻或便秘和呕吐。
断裂
Long-term, PPIs are associated with a greater risk of infections, certain conditions and vitamin deficiencies. One is an increased risk ofbone fracturesin the wrist, hip or spine.
“This is because long-term use can cause your body to absorb a lower amount of important nutrients, like vitamin B12, iron, calcium and magnesium,” Dr. Le said. “Although in many cases, a supplement can help correct nutrient deficiencies.”
用药互动
Some PPIs can interact with common prescription drugs, such asblood thinners。如果您服用任何非处方或处方PPI，请确保与医生讨论是否可以安全地一起进行。
“In general, the stomach wants to maintain a specific pH or acidity level,” Dr. Le said. “Absorption of many medications, nutrients, vitamins and minerals, begins with digestion in the stomach. Changing the pH level within the stomach can cause problems with absorption of these nutrients. Some of these problems can be unpredictable and can make certain medications more or less effective.”
Infection Risk
New evidence已经出现了PPI与感染的更大风险有关肺炎和C-Diff腹泻。
“Many adults diagnosed with adult onset asthma often have GERD or heartburn that can be easily overlooked as a reason,” Dr. Le said. “This is because chronic reflux can lead to aspiration, where small amounts of acid and other stomach contents are accidentally inhaled into the lungs, causing chronic scarring and asthma-like symptoms. If the acid level of the stomach is reduced by medication to help with symptoms of heartburn, the natural bacteria-killing effect of this acid is reduced. This allows for bacteria to grow within the stomach and then become inhaled into the lungs during episodes of reflux, leading to infection of the lungs, better known as pneumonia.”
C. difficile is a naturally occurring bacteria typically residing in your colon. There is a delicate balance of “good” and “bad” bacteria (C. diff is a bad kind of bacteria generally). When in balance, your GI tract functions normally. But if for some reason this balance is shifted or tipped in the wrong direction, “bad” bacteria can overgrow causing an infection.
“There is some evidence that chronic use of PPIs can lead to C. diff diarrhea by a similar mechanism as pneumonia,” Dr. Le said. “The acid in the stomach is reduced, allowing overgrowth of certain bacteria, or not neutralizing any bacteria ingested with meals, which can travel through the gut and disrupt the delicate bacterial balance in the colon, leading to infection.”
我还应该考虑PPI吗？
仍然需要进行研究，以查看PPI是否是这些条件的原因，但是任何服用它们的人都应该意识到潜在的风险，并与医生讨论利弊。
启动PPI时，LE博士建议以最低剂量开始，如果您服用PPI已有一段时间，则不要突然停止。
大外卖
If GERD is left untreated, it can result in some serious issues, such as ulcers, scarring, problems swallowing and even cancer. While there are some long-term risks associated with them, PPIs are still an important tool for preventing discomfort and further complications.
Le博士说：“现在PPI已经出现了数十年，我们开始看到越来越多的患者长期出现问题。”“永久服用药物可能并不是每个人的正确答案，其他选择，例如手术或内窥镜治疗。与您的医生交谈以权衡利弊。”
To find a doctor, visitbannerhealth.com。
