For years, doctors and researchers believed that Proton Pump Inhibitors (PPIs) can reduce the risk of esophageal cancer. Over the past decades, esophageal cancer has increased over 600% and is now the fastest growing cancer in the United States*. Esophageal cancer is also one of the deadliest cancers, as less than 20% of those diagnosed with esophageal cancer will only survive five years.
While there are no known reasons for this alarming rise in esophageal cancer, researchers agree that the increase in obesity and Gastroesophageal Reflux Disease (GERD) may be to blame.*
But new research shows that PPIs may also play a significant role in the increase of esophageal cancer.
What are Proton Pump Inhibitors (PPIs)?
Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach. PPIs are used to treat the symptoms of Gastroesophageal Reflux Disease.*
Gastroesophageal Reflux Disease (GERD) is a primary risk factor for esophageal cancer.
Gastroesophageal Reflux Disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.
What causes GERD?
GERD occurs when the lower esophageal sphincter (LES) is weakened or damaged. The LES is then unable to close and keep food, acid and other secretions from flowing backwards or refluxing into the esophagus. Overtime, the reflux of stomach contents and acids can cause serious damage to the esophagus, including bleeding and scarring of the esophagus, ulcers, Barrett’s esophagus and esophageal cancer.
Lifestyle changes can help to manage GERD symptoms.
Some of these changes are to avoid eating at least three hours before bed, stay upright after meals, lose weight, moderate exercise and avoiding certain foods that trigger symptoms. Surgery may be an option for some patients.
PPIs only treat the symptoms of acid reflux disease.
Many chronic heartburn sufferers turn to antacids or other over-the-counter medications for relief. Others seek help from their doctors and are prescribed medications known as Proton Pump Inhibitors (PPIs), which reduce the amount of acid in the stomach; treating the symptoms of GERD but not the disease. Some PPIs do not require a prescription and can be also purchased over-the-counter.
RefluxMD states: “since their introduction in 1989 the cost of [PPIs] has grown to over $11 billion dollars annually while adenocarcinoma, esophageal cancer that results from GERD, has become the fastest growing cancer in the US, Europe, Japan and Australia (Reflux-Induced Esophageal Cancer Trends)
PPIs work to control the symptoms of GERD but they do not reduce acid reflux or prevent the progression of the disease and the damage to the esophagus, RefluxMD
Dr. Jaime Koufman, a physician in New York who specializes in voice disorders and acid reflux, wrote an article in the New York Times which details the dangerous link between acid reflux, PPI use and esophageal cancer.
“A Danish study published this year concluded that there were no cancer-protective effects from using the common anti-reflux medications, called proton pump inhibitors and that regular long-term use was actually associated with an increased risk of developing esophageal cancer.”
The Danish study also showed that “PPI use may facilitate the formation of carcinogenic bile acids.” These bile acids are responsible for the sometimes pre-cancerous condition known as Barrett’s esophagus and an elevated risk of esophageal cancer.
Stomach juices also contain the compound gastrin, which has been shown to “stimulate cell growth that may contribute to cancer.” The Danish study showed that levels of gastrin can increase with the use of PPIs and other similar medications and that PPIs “may increase the risk of gastrointestinal tumours.” (People’s Pharmacy)
Danish researchers agree that further research is needed to study the association of PPIs, acid reflux and esophageal cancer. However, they offer the following suggestion for PPI use:
“Until the results from future studies can further elucidate the association, PPIs should be restricted to symptom control according to current guidelines. Hence, PPIs may not protect against malignant progression in BO [Barrett’s Oesophagus] patients and in selected high-risk patients, clinicians may consider adding or replacing long-term medical treatment with other modalities.”*
Do not stop taking any medications and do not make any changes regarding your health without first consulting your doctor. It is important to discuss these issues with your doctor and explore alternate ways to reduce and/or treat your acid reflux disease and to reduce your risk of esophageal cancer.