What are the risks of acid reducers for heartburn?

I take an acid reducer for heartburn, but now I hear that there might be serious side effects, especially for women who take them every day. What are the risks, and should I stop taking this medication?

Michael Roizen, M.D.

Michael Roizen, M.D.

As chief wellness officer and chair of the Wellness Institute of the Cleveland Clinic, Michael F. Roizen, MD, is on a mission to inform... Read more

There is no medicine I know of that does not have risks. The best treatment for heartburn is reducing your waist size. After that, put your bed up on stilts so that your head is higher than your feet and stomach acid is less able to push up into your esophagus. For short-term treatment of two weeks or less, over-the-counter (OTC) and prescription antacid meds are really outstanding. They reduce stomach acid, which helps get rid of the burping and burning associated with heartburn. But over time, decreasing stomach acid can actually be a bad thing. One of the major roles of stomach acid is protecting you from infections. This acid kills a lot of bad bacteria in your stomach before it can get into your intestines and has a chance to be absorbed. The intestines are not as efficient in fighting off bacterial infection. It’s much better to have it killed with stomach acid. In addition, stomach acid helps with the absorption of certain foods and breaking down others.

The other consideration is the effect that a decrease in stomach acid may have on calcium absorption. This spring, the Food and Drug Administration recommended that OTC and prescription acid reducers, also known as proton-pump inhibitors (PPIs), carry labeling that says patients shouldn’t use these medications without discussing the risks of bone fractures. This research is somewhat controversial -- some studies show no associated risk or very minimal risks. Studies that did show some association involved women taking high doses of PPIs for extended periods. The bottom line: These medications are not a substitute for getting rid of the basic problem, which is typically extra weight and dietary choices that aggravate the problem.