Association of Long-Term Use of Proton Pump Inhibitors and Osteoporosis-Related Fractures
Proton-pump inhibitors (PPIs) such as omeprazole have been used for years to reduce gastric acid reflux. Recent studies have shown, however, that long-term use of proton-inhibitors may increase a patient’s risk for hip fracture.
Hip fracture is the main manifestation of senile osteoporosis, which results from secondary hyperparathyroidism associated with low calcium intake, calcium malabsorption and other factors. The mortality rate during the first year after a hip fracture is 20% and among those who survive this period, 1 in 5 require nursing home care.
Limited animal and human studies have shown that PPI therapy may decrease insoluble calcium absorption or bone density through induction of hypochlorhydria.
This recent study looked at the duration of time that a patient was on a PPI before there was danger of hip fracture. The conclusion of this study was that use of PPIs for 7 or more years is associated with a significant risk of an osteoporosis-related fracture. There is an increased risk of hip fracture after 5 or more years of exposure.
Further study is needed to determine the mechanism, the clinical importance of this finding and to determine the value of osteoprotective medications for patients on long term PPI therapy.
About the author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
