A new study reveals an alarming link between one of America’s most common groups of drugs and the formation of liver cancer. If you take them you nearly double your risk.1
And you’ve got lots of company – some 15 million people take proton pump inhibitor drugs (PPIs) like Prilosec OTC and Nexium for heartburn, acid reflux, ulcers, and other GI issues.
Aside from cancer, there’s already a laundry list of other ominous side effects – including increased risk of heart, kidney, and brain diseases, plus reduced nutrient absorption and bacterial overgrowth.2,3,4,5,6
Now there’s a new study to confirm the dangers. I’ll look at that, and also try to suggest some ways you can deal with your tummy problems without drugs…
From “magic pills” to magnified symptoms
When PPIs were developed in the 1980s, they were hailed as a miracle for people with ulcers or just upset stomach. Those with acid reflux — gastroesophageal reflux disease (GERD) — thought they’d found their “magic pill.”
Today, doctors recommend these drugs for six different stomach disorders.
Little did consumers realize what they were getting into – especially as time went by and millions transitioned from using these drugs once in a while to taking them every day for life.
Now that these pills have been around for three decades, their darker side is all too clear. We shouldn’t be surprised. Some adverse side effects were identified long ago – serious enough to scare well-informed people off reliance on PPIs.
What the studies now say
Recent animal studies have shown an increased risk of not only stomach cancer,7,8 but also liver damage.9
Another study showed a clear correlation between consumption of PPIs and development of liver cancer in rats.10
Naturally, these results caused cancer epidemiologists – the scientists who search for disease patterns and causes – to become concerned.
Now, epidemiologists can’t intentionally expose anyone to a substance they believe might cause cancer, just to see what happens, so they combined two proven epidemiological study techniques in order to cross check for errors or gaps.
Human study links liver cancer to PPI use
In the first part of the study, researchers identified people with liver cancer, and also selected control subjects without the disease. They then compared each group’s exposure to a potential risk factor – in this case, PPIs.
The groups were painstakingly matched for age, gender, and primary care physician (to validate results). There were 434 cancer patients and 2,013 disease-free controls.
This is what’s known as a case-control study. The second part was a prospective cohort study.
In part two, researchers identified 500,000 people and collected extensive health data on them, in order to pick up links between certain exposures (i.e., PPIs) and the onset (or not) of liver cancer.
Both parts of the study confirmed a link between PPIs and liver cancer.
The case-control study tied PPIs to a horrendous 80% increased risk. And the news was even worse from the huge 500,000-person cohort study: an 83% increased risk among those who took omeprazole (commonly sold as Prilosec or Zegerid).
All told, the big study found those who took PPIs nearly doubled their risk of liver cancer, compared to those who’d never taken them.11
Can we actually say PPIs cause cancer?
As you may know (and I often repeat), even the strongest epidemiological studies can’t prove causality… as in, “Does exposure to Drug A cause Disease B?” They can only demonstrate that the two phenomena are found side by side. We don’t know the mechanism by which one might bring on the other, of if there is one.
These studies certainly establish a cozy connection. Enough to warrant avoiding PPIs. (Warning: don’t go off these drugs cold turkey. More on that below.)
Since we can’t study humans directly to see what these drugs are doing inside them, we have to rely on animal studies to show us why PPIs influence cancer risk. Here’s what we know so far:
- Studies on rats show a direct increased risk of liver cancer.12
- PPI usage causes rats to secrete excessive amounts of the stomach hormone gastrin, known for its cancer-promoting effects (especially on liver tissue).13
- PPIs also promote the overgrowth of pathogenic bacteria because the drugs reduce stomach acidity, which kills off many microbes.14,15
Part of their hazard is in how they work
It’s important to understand that PPIs don’t specifically target stomach cells. Nor is stomach acid usually the culprit that causes chronic heartburn.
Every cell in your body that produces acid uses a proton pump.
Meaning: proton pump inhibitors will inhibit the production of acid in all of these cells – not just those in your stomach.
Some scientists believe this may be the reason for the dangerous side effects of PPIs. Your cells use acid to remove waste. So inhibiting acid allows toxins to accumulate, speeding up internal damage and aging.
Critical info: how to wean yourself off PPIs
If you’ve been taking PPIs, it’s critical that you DO NOT stop cold turkey.
Yes, they do reduce heartburn in the short term. But if you suddenly stop taking them, you’ll experience a whiplash-like rebound. And boost your risk of other health issues.
You must allow your body to detoxify from these drugs gradually.
Here’s the regimen Dr. Joseph Mercola suggests – but please note that this should only be done under your doctor’s guidance.
- Gradually decrease your PPI dose until you start experiencing heartburn.
- At that point, begin substituting an over-the-counter H2 blocker like Zantac, Raniditine, Tagamet, or Cimetidine.
- Once off PPIs and on the H2 blockers for several weeks, begin weaning off the H2 drugs as well.
Remember to do this under your doctor’s guidance.
Safer alternatives for stomach issues
While undergoing the weaning process – or to avoid using PPIs altogether – consider using the following natural tactics to address acid reflux:
- Optimize your stomach acid by drinking one tablespoon of raw unfiltered apple cider vinegar in a large glass of water.
- Take a betaine hydrochloric supplement to aid digestion and help kill pylori bacteria, which can cause ulcers when out of control.
- Take ½ to 1 teaspoon of baking soda (sodium bicarbonate) mixed into 8 ounces of water to neutralize stomach acid. But not every day. Save this for days the pain is awful.
- Ginger tea is a popular remedy to calm the GI tract and suppress pylori. It’s also six to eight times more effective than lansoprazole (brand name Prevacid) at preventing ulcers.16 Simply add two or three slices of fresh ginger root to two cups of hot water, and let it steep for half an hour. Enjoy it 20 minutes before your meals.
- Take more B vitamins. Research suggests they lower your risk of acid reflux. Folate may reduce acid reflux by about 40%. On the flip side, low B2 and B6 levels predispose you to acid reflux.
- Eat smaller and more frequent meals. It’s also best to eat your last meal of the day at least three hours before bedtime. Being upright aids digestion. Eating just before bed is a bad idea for many reasons.
- Stop smoking. Nicotine is a leading cause of GERD.
- Avoid things that trigger acid reflux for you. Caffeine, alcohol, and nicotine are key suspects.
- Licorice root and zinc-carnosine actively promote the healing of the stomach lining, and are useful for treating ulcers and heartburn. They have an excellent safety record.
- Raft-forming alginates block stomach gases from moving back up the esophagus and inflicting pain and damage.17 They’ve been used to treat stomach and esophagus issues for decades. Raft-forming alginates, derived from algae, are readily available online.
PPIs were always intended for short-term use, nothing more. So work with your doctor to wean off them. Or better yet, if you haven’t already started them, don’t.
- Tran KT, McMenamin UC, Hicks B, et al. Proton pump inhibitor and histamine-2 receptor antagonist use and risk of liver cancer in two population-based studies. Ailment Pharmacol Ther. 2018 Jul;48(1):55-64.
- Davis TME, Drinkwater J, Davis WA. Proton Pump Inhibitors, Nephropathy, and Cardiovascular Disease in Type 2 Diabetes: The Fremantle Diabetes Study. J Clin Endocrinol Metabl. 2017 Aug 1;102(8):2985-93
- Gomm W, von Holt K, Thome F, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. 2016 Apr;73(4):410-6.
- Sukhovershin RA, Cooke JP. How May Proton Pump Inhibitors Impaiar Cardiovascular Health?Am J Cardiovasc Drugs. 2016 Jun;16(3):153-61
- Corsonello A, Lattanzio F, Bustacchini S, et al. Adverse Events of Proton Pump Inhibitors: Potential Mechanisms. Curr Drug Metab. 2018;19(2):142-54.
- Tai SY, Chien CY, Wu DC, et al. Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan. PLoS One. 2017;12(2):e0171006.
- Cheung KS, Chan EW, Wong AYS, et al. Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study. Gut. 2018 Jan;67(1):28-35.
- Brusselaers N, Wahlin K, Engstrand L, et al. Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden. BMJ Open. 2017 Oct 30;;7(10):e017739.
- Llorente C, Jepsen P, Inamine T, et al. Gastric acid suppression promotes alcoholic liver disease by inducing overgrowth of intestinal Enterococcus. Nat Commun. 2017 Oct 16;8(1):837.
- Hayashi H, Shimamoto K, Taniai E, et al. Liver tumor promoting effect of omeprazole in rats and its possible mechanism of action. J Toxicol Sci. 2012;37(3):491-501.
- Tran KT, McMenamin UC, Hicks B, et al. Proton pump inhibitor and histamine-2 receptor antagonist use and risk of liver cancer in two population-based studies. Aliment Pharmacol Ther. 2018 Jul;48(1):55-64.
- Hayashi H, Shimamoto K, Taiai E, et al. Liver tumor promoting effect of omeprazole in rats and its possible mechanism of action. J Toxicol Sci. 2012;37(3):491-501.
- Fossmark R, Sagatun L, Nordrum IS, et al. Hypergastrinemia is associated with adeoncarcinomas in the gastric corpus and shorter patient survival. APMIS.2015 Jun;123(6):509-14.
- Thorens J, Froehlich F, Schwizer W, et al. Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomized double blind study. Gut. 1996 Jul;39(1):54-9.
- Lewis SJ, Franco S, Young G, et al. Altered bowel function and duodenal bacterial overgrowth in patients treated with omeprazole. Aliment Pharmacol Ther. 1996 Aug;10(4):557-61.