GERD drugs are connected to osteoporosis


POSTED: Saturday, October 04, 2008

GERD and osteoporosis are both common and growing health problems. Now there is evidence that some cases of osteoporosis might be linked to the use of GERD medications.

Question: What is GERD?

Answer: The medical translation is gastroesophageal reflux disease. A popular term for this condition is heartburn.

Q: What causes GERD?

A: The pain occurs when stomach acid flows from the stomach up into the lower part of the esophagus (the tube between the mouth and the stomach). The acid irritates the esophagus, causing the painful heartburn symptoms.

GERD often develops over time, and eating too close to bedtime promotes the development. When a person lies down, the stomach acid needed for food digestion seeps into the esophagus if the muscular valve at the top of the stomach does not close tightly. The result is chemical damage to tissues in the lower esophagus.

Q: How is GERD treated?

A: Heartburn is commonly treated with medications that decrease the production of stomach acid. Known medically as proton pump inhibitors, these drugs effectively treat painful GERD symptoms and can protect the esophagus from damage over time.

Q: What is the evidence that GERD medications increase the risk of osteoporosis?

A: Three major studies have linked the long-term use of heartburn medications to an increased risk of bone loss and osteoporosis. Since heartburn is such a widespread health problem, researchers are stressing the need for further understanding of this apparent risk to bone health.

Q: How could these medications cause bone loss?

A: The most widely accepted explanation is that stomach acid plays an important role in the absorption of calcium. This acid is needed to dissolve common forms of calcium found in various foods and supplements. Consequently, reduced stomach acid production due to medications might decrease the amount of calcium absorbed from a supplement or a meal.

The researchers recommend taking a calcium supplement with meals because the meal can stimulate the release of stomach acids and likely help calcium compounds dissolve and be absorbed better.

Q: Are there better calcium sources for those taking GERD medications?

A: Calcium citrate dissolves in low stomach acid conditions and is likely a better calcium supplement for those taking GERD medications.

Here are two tips to keep your esophagus healthy:

1. Allow at least two hours between mealtime and bedtime.

2. Don't exercise too soon after a meal, and avoid high-fat snacks before exercise.

Joannie Dobbs, Ph.D., C.N.S., and Alan Titchenal, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.