Q. I have just read that powerful acid-suppressing drugs are linked to hip fractures. My doctor wants me to stay on Prevacid even though I have expressed my concerns to him. When I told him what I had read about the dangers of proton pump inhibitors (PPIs), he said, “Don’t read so much.” I wish he would read more!
A. The hazards of long-term use of PPIs such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex) have gradually become clearer. Data from nearly 80,000 women in the Nurses’ Health Study show that women who took PPIs were 30 percent to 35 percent more likely to fracture a hip during eight years of follow-up (BMJ online, Jan. 31).
This can be devastating, particularly for older people. As one reader reported: “My mother took a PPI and then had a hip fracture. She died 19 days later.”
There are other drawbacks to long-term PPI use, such as susceptibility to infectious diarrhea, pneumonia and vitamin B-12 deficiency. We are sending you our Guide to Digestive Disorders, with a discussion of the pros and cons of PPIs and instructions about how to get off them, since stopping these drugs can cause rebound reflux. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (65 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
No one should stop a PPI without consulting the prescriber. Some people require such drugs to protect themselves from esophageal damage.
Q. What do you know about the medicinal properties of nopal cactus?
A. Nopal or prickly pear cactus (Opuntia ficus-indica) has been a staple of the Mexican diet for centuries. The fleshy pads are eaten as vegetables and are high in fiber and nutrients (vitamins A, C, K, B-6 and riboflavin).
Years ago, a family-practice physician wrote that his diabetic patient was able to control his blood sugar better when he drank tea made from nopal pads. Animal research demonstrates that Opuntia (a different species) can help lower blood sugar and cholesterol (Nutrition Research, June 2011). Another animal study found that an extract of nopal cactus flowers protected against stomach ulcers caused by alcohol (Environmental Toxicology and Pharmacology, November 2011).
Q. I have tried everything for constipation, including Metamucil, MiraLAX, vegetables, cooked oats, prune juice and the power pudding recipe. I have the best success eating cooked great northern beans.
A. It’s always good to hear that a simple dietary approach is helpful. Thank you for sharing it.