The Skinny

A recent study published on October 31rst in the medical journal Gut, found that PPI use can more than double the risk of developing stomach cancer, even after eradicating a stomach bacteria associated with GERD called Helicobacter pylori (H. pylori).

H. pylori is thought to cause abdominal pain, suppressed appetite, bloating, and nausea. (1)

Research has shown that when you eradicate H. pylori from the stomach using a combination of antibiotics and acid suppression drugs, the risk for stomach cancer is reduced somewhere between 33-47%. (2) (3)

However, this study actually showed that many patients who take PPIs still develop stomach cancer despite getting H. pylori removed from their stomach.

The results of this study seem to indicate that the more frequently you take PPIs, the higher your risk for stomach cancer. (2) (3)

How the Study was Conducted

The study was conducted using a large database of medical information from 63,397 subjects in Hong Kong.

Researchers of this study had access to diagnoses and drug prescriptions of their subjects. They were also able to pinpoint when, in the course of their treatment, patients took PPIs. (2) (3)

Study Weaknesses

The weakness of this study is that it is retrospective. It uses past data as its basis for conclusions. This is a disadvantage because you don’t have live patients in front of you, so other factors that influence the risk of stomach cancer can be missed.  

A better, more accurate study would have analyzed both data from past patients, and data from current patients, with experimental controls and variables in place.

Secondly the database the researchers accessed did not contain information about variables that are known to affect the risk of cancer such as socio-economical status, obesity, diet, alcohol use, smoking, and family history. (2) (3)

So, now what?

So how should we respond to this study? Well, it should concern us. Many of us who are diagnosed with GERD are told that PPIs lower the risk of getting cancer.

Clearly, this isn’t the case for all GERD patients. Apparently, many people can still get stomach cancer even if they take PPIs and have H. pylori eradicated from their stomach.

It’s important to note that PPIs come with serious health risks. You can read about that in an article I wrote here.

On the flip side, we shouldn’t overreact. There are many people with serious gastro conditions like esophagitis, Barrett’s Esophagus, and esophageal adenocarcinoma(cancer) that benefit from PPI treatment. In these cases, PPIs cause the stomach to make less acid which can reduce damage and allow the esophagus to heal.

We shouldn’t go to either extreme, but instead, try to adopt a balanced view. This study suggests that doctors should use caution when prescribing long-term PPI treatment for GERD even after successful H. pylori eradication.

Patients who are unresponsive to PPIs should not be given more to take. Instead, patients should be closely examined and checked for conditions that cause similar symptoms, such as indigestion and thrush.

You can read my article about how common it is for GERD is be misdiagnosed here.

It’s may be better to treat acid reflux holistically before resorting to pharmaceutical drugs. A change of diet and lifestyle has been shown effective.

You can read more about GERD and diet here.

*This post may contain affiliate links. See my disclosure here.

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