By David Liu

Tuesday Jan 31, 2012 (foodconsumer.org) -- A study published recently in BMJ-British Medical Journal discovered that women taking indigestion drugs were at high risk for hip fracture after menopause.

The study showed that women who took indigestion drugs known as proton pump inhibitors or ppis were 35 percent more likely after menopause to suffer hip fracture than those who did not use the drugs.

For those who used both the drugs and smoked, the risk was increased by 50 percent, compared to those who did not smoke or take these drugs. 

PPIs are one of the medicines most commonly used worldwide to often treat heartburn and acid reflex. One of the known side effects is that these drugs inhibit the adsorption of calcium, which boosts risk for fractures.

Researchers from the Massachusetts General Hospital found the associations after looking at data on use of PPIs and incidence of hip fractures in 80,000 post-menopausal women during an eight-year period from 2000 through 2008. During the follow-up, a total of 893 hip fractures were identified.

The authors suggest that women with a prolonged use of these drugs, particularly those who also smoked, faced up to 50% increased risk for hip fractures, compared to women who did not smoke or take these drugs.

This is not the only study that has ever been done.  Several studies have already been carried out in response to the growing concerns between the long-term use of PPIs and the risk of hip fractures.  But those studies have some significant limitations, according to the authors.

The issue has drawn attention of the Food and Drug Administration.  In May 2010, FDA issued a warning of hip fractures and taking PPIs. But it still concluded that more data was needed for a full analysis.

The drugs are not the only risk factor for hip fractures.  Menopausal status, body weight, physical activity, smoking status, alcohol consumption status and calcium supplement usage may also have an impact on the risk and the researchers considered them also in their study. For the study, calcium intake from food and low and moderate traumas relating to fracture were also recorded and included in the analysis.

The number of women who are taking PPIs regularly is increasing to 18.9 percent in 2008 from 6.7% of women in 2000, said the researchers.

The FDA reportedly wishes to revise labelling on these drugs and the authors stress the importance of evaluating the need for long-term use of PPIs among those who have a history of smoking. 

The good news as reported by the researchers is that the risk of hip fracture returned to a normal level two years after stoppage of taking PPIs.

Proton pump inhibitors are known to have other side effects, which include vitamin B12 deficiency, increased risk of pneumonia, headache, nausea, diarrhea, abdominal pain, fatigue and dizziness. Long term use can also increase risk hypomagnesemia.  Infrequent adverse effects include rash, itch, flatulence, constipation, anxiety and depression.

Vitamin B12 deficiency and increased risk for pneumonia has something to do with suppression of gastric acid by long-term use of proton pump inhibitors.