Posted By Posting
May 26, 2010
PPIs in the news
I saw on the NBC nightly news last night that the FDA has issued a new warning about PPIs. Apparently with long term use, one has an elevated risk of bone fractures because it reduces calcium in the bones. And NBC included a higher risk of pneumonia in their piece, as well. I did this: Anyone hear anything else?
May 26, 2010
Kathryn, Pager Volunteer and mommy to Emily Mia 02/04/07. 3 years old with GERD. 30mg Prevacid and Pepcid AC. Mylanta needed for flares. Failed prilosec med switch. Tried and failed many med weans but GERD and pain are well controlled. Functional constipation. Reoccurring SBBO. Suspected IBD or autoimmune disease. Resolved issues: MSPI, CSID (acquired), Stage 2 kidney reflux, Chronic diarrhea.
Audrey Meadow 06/20/08. born 34/35 weeks. Still b/f and eats everything! ftt and chronic constipation.
just so that it does not scare parents new to reflux, the benefits of these PPIs in our kids usually GREATLY out way the risks associated with them. it's great to hear about potential risks but remember that these risks are from long term use.

one thing to consider, is asking your dr what you can do to counteract these effects or reduce the risks. thank you for the links!
May 27, 2010
I understand that you wanted to post this, but the PPI's were the only thing that healed my child's esophagus so she could eat...please don't scare parents, I hate that my three month old is on these, but I agree with emibug, the benefits far outweigh the risks. It's the only way she can eat.
May 28, 2010
Aurora born March 17, 2007
3 years, 8 months old
Weighs 25.8 lbs
8 lbs 11 oz at birth.
Recovered Chronic Projectile Vomiter
Prevacid Free since September 08
Egg allergy diagnosed Jan 26/09
Has a Pectus Excavatum
Has an Epipen
I certainly don't mean any disrespect, but I don't think maxmommy was trying to scare anyone, but rather to share information in a relevant community.

I understand the need for PPI's, trust me, I do. But I think that new mommies should have ALL the facts before administering a PPI to their child. There are a number of alternative treatments and ways in which to deal with and treat GER, before opting for a PPI, which is a medication that stops the stomach pumps from producing acid, and acid is necessary for digestion. PPI's are indicated for children with GERD, and there is a difference between GERD and GER. Also, PPI's are only indicated for use for 8 to 12 weeks.

The FDA considers long term use to be anything over a year.

I totally agree with Kat above, that you should speak with your doctor about ways to counteract the effects, if your child absolutely requires a PPI.

I am in NO WAY denying that PPI's are a necessary treatment for many cases of GERD, but these are our babies, and we have a right and a responsibility to make informed and educated decisions on their behalf. Thank you maxsmommy, for sharing this with the reflux community. (((HUGS)))

May 28, 2010
PAGER Volunteer Services Coordinator
Melina 7/24/02 now reflux free!!
Ella 5/3/05 GERD, asthma, hypotonia, food intolerances, esophagitis, IBS //
Ava 5/3/05 asthma, food allergies
Pic: My girls! They are getting so big!
Most of bone loss research is done on those older than 50. That group is also one that would "normally" loose bone mass. It is hard to know what if any effect it would have on children at this time when they are really unsure as to the real role it had in adult bone loss. I agree with pp's that we really need to work with our doctors to weigh the risks vs the benefits of any medication we give our children. If you do have to use PPI's (and many of us do HAVE to) then being proactive about strengthening bones is a great idea. Making sure you have enough calcium, magnesium and D in your child's diet and weight bearing excercise can be a wonderful start.

This is the American College of Gastroenterology's position on the FDA's statement:

The FDA in its press statement today acknowledged that "based on the available data, at this time it is not clear if the use of proton pump inhibitors is the cause of the increased risk of fractures seen in some epidemiologic studies." The FDA cites reports which are observational case-control studies with overall low hazard ratios and inherent bias potential, and the associations found in those studies were not supported by more recent reports. Clearly, the current science reflects uncertainty about the magnitude of the possible risk of bone fractures in patients using PPIs. The College urges patients not to stop PPIs without consulting a physician and notes that frequent, severe, and/or longstanding heartburn can be serious.

The pneumonia cases are interesting. They found more pneumonia in those with PPI use. As most of us know, severe GERD puts you at an increase for pneumonia to being with. So, I wonder if it is a case of "what came first the chicken or the egg". These people may have been at a higher risk to start with. Or, as noted in the hospital aquired cases, many patients' risk was lessened if they were kept upright and were not laying flat while recovering. Proper cough to clear the lungs also needs to be utilized in the hospital. Again, in those cases it may be wise to weight the risk vs benefits. Part of the issue may involve people being given these meds when they don't really need them.
Check with your
doctor first!