New Study Showing Dementia Risk in Long-Term PPI Users

They are sold over the counter, and millions of Americans take them daily for weeks, months, or even years. Most patients don’t investigate their potential adverse effects, and there are many. What are these medications? Proton Pump Inhibitors or PPIs. You often see PPIs sold as omeprazole and similar names ending in “ZOLE.” Brand names. Include Nexium, Prilosec and Zegerid. Unfortunately, the availability of these drugs has led to a general perception that they do not have significant side effects. Also, ubiquitous availability leads people to believe they can be taken over in the long term. However, a recent study has shown yet another significant risk associated with PPI use over the long term.

Let’s Talk About What We Already Know

Long-term PPI use, for one, is not recommended, and in fact, the warning label states that they should not be taken for more than six weeks unless ordered by your doctor. This is because they can cause several potentially serious concerns, including rebound acid reflux, the potential for bone mass loss (and subsequent osteoporosis), increased risk of fractures, and, we now know, an increased risk of dementia.

Study Details

The study followed patients over 45 taking PPIs for several years. The researchers found that patients who took PPIs for an average of 4.4 or more years were over 30% more likely to develop dementia. This is, of course, alarming news and yet another warning for patients taking PPIs.¹

Does this study conclusively prove that long-term PPI use will cause dementia? No. This observational study requires additional research with a wider population before we can prove any causality. However, it does show that there are potential risks associated with the drug that ultimately doesn’t need to be taken for more than six weeks, being that we have such effective surgical alternatives.

The Alternative

Of course, we always look for alternatives to PPIs and their many potential side effects. Ideally, patients would modify their lifestyles by improving their diet and exercise routines, ultimately losing weight. However, this is challenging for most patients.

As such, many patients turn to three very effective surgical solutions that we perform here at MASJAX:

1. The grandfather of surgical GERD treatment called fundoplication. During this procedure, the upper portion of the stomach is wrapped around the lower portion of the esophagus to put additional pressure on the lower esophageal sphincter. This minimally invasive procedure has few significant risks and is well tolerated by most patients. However, it has its distinct downside, including a relatively long recovery, the need for significant diet modification in the first six weeks, as well as the potential for gas-bloat syndrome, where it becomes challenging to belch or vomit if necessary.
2. We also specialize in a 15-minute implant procedure called the LINX reflux management system, essentially a magnetic bracelet. Beaded bracelet made of titanium beads with the magnetic class. This places additional pressure on the lower esophageal sphincter while allowing enough flexibility for the patient to Belcher vomit if needed.
3. Finally, the gastric bypass is an excellent reflux-busting surgery for patients with obesity. The gastric bypass has been performed for several decades with excellent results. For many patients, type 2 diabetes goes into remission within days after surgery, and most patients can control their GERD long-term with low recurrence rates.

No matter what option you choose, you should be under the care and supervision of knowledgeable medical and surgical experts like those at MASJAX to ensure you are pursuing the best course of treatment. Remember, there are options.

¹https://www.neurology.org/doi/10.1212/WNL.0000000000207747