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health today drug dilemma If you suffer from chronic acid reflux, deciding whether or not to take medication may be as worrying as the symptoms By Dr. Art Hister about as howdy-do-do as you get. On the bright side, acidreducing drugs are pretty effective and not only reduce (often eliminate) the uncomfortable symptoms that reflux produces, but these drugs are also said to lower the risk of complications from chronic acid reflux, which may include, studies have suggested, a higher risk of esophageal cancer. As another great figure of literature, Homer Simpson, says, “That’s good.” studies have linked the use of acid-reducing drugs, particularly PPIs, to several very troubling complications including a higher risk of fractures from osteoporosis, as well as a higher risk of pneumonia. In fact, according to a recent review in the Canadian Medical Association Journal, acidsuppressing drugs increase the risk of pneumonia by 22 to 27 per cent, which is not really a huge increase. But it’s still something Stomach cells becomes so “addicted” to PPIs that the cells produce excess acid when the drug is withdrawn 82 TVWEEKonline.ca April 23, 2011 stomach, really doesn’t relish spending its days bathed in hydrochloric acid, life is often intolerable. At the very best, it’s highly uncomfortable due to the pain, burning and other unpleasant symptoms GERD produces on a regular basis. This is why, of course, so many of us end up taking some form of acidsuppressing medication. The problem, however, is that acid-suppressing drugs might end up killing some of us who take it, which is you want to avoid if you can, especially if you’re in a higher-risk group, such as the elderly or someone with a chronic heart or lung condition. Bottom line: as with nearly everything in this business, there is no easy formulaic answer to what anyone with GERD should do. If you have GERD symptoms, you have to decide for yourself how significant those symptoms are. And if you find them difficult to tolerate, then you have to decide what to take and for how long to take it. Doh! n Dr. Art Hister is a medical writer and health analyst for Global TV and Corus Radio. i s to c k “H ere’s a howdydo,” to cite the wise words of one of the greatest creations in literature, the Lord High Executioner in The Mikado. On the one hand, for those of us unlucky enough to be suffering from GERD (gastro-esophageal reflux disease), in which stomach acid regularly washes back up into the esophagus, a body part, that unlike the On the not-so-bright side, these drugs, which include histamine receptor agonists (like cimetidine and ranitidine, a.k.a. Zantac) and PPIs or proton pump inhibitors (like Losec, Nexium, Pariet), are way over-prescribed and often handed out for even minor symptoms. Homer: “That’s bad.” Worse, many people stay on these drugs forever, partly because studies have shown that even after only a few days of using a PPI, the stomach cells becomes so “addicted” to the drug that the cells produce excess acid when the drug is withdrawn. Homer: “That’s bad.” Worst of all, of course,