In the treatment of gastropathy, proton pump inhibitors are the first choice, and their main characteristics are particularly strong acid inhibition and long duration. They are one of the most commonly used drugs in China and the world.
Especially in recent years, with omeprazole becoming an over-the-counter drug, more patients can choose proton pump inhibitors to treat stomach upset.
Some studies even show that the frequency of proton pump inhibitors has greatly increased in recent years, becoming the second largest drug in China.
By the way, the most commonly used drugs are hypertension drugs.
However, we should know that many people who use proton pump inhibitors for a long time have a good stomach, but their bones are gradually becoming fragile, and some patients even have fractures after applying stomach drugs for several years.
But is taking stomach medicine related to fracture?
Things that seem irrelevant are actually quite related.
Let's take a look today. What is the relationship between proton pump inhibitors and osteoporosis?
Proton pump inhibitors are widely used in clinic, mainly because of their good curative effect.
You can never resist a drug that is both effective and safe, and it is also very cheap.
But the effective security here is relative, not absolute. Even such commonly used drugs will have some complications and side effects.
Among many problems, osteoporosis accounts for a large part.
As early as 20 10, organizations in the United States warned that patients taking proton pump inhibitors for more than one year or taking high doses are very prone to the risk of hip, wrist and spine fractures.
Of course, the US Food and Drug Administration in China also issued the same warning. 20 13 announced that long-term use of higher doses of proton pump inhibitors would increase the risk of fracture.
We should know that osteoporosis has a great influence on people's quality of life, especially the loss of calcium in middle-aged and elderly people is very serious. Taking these drugs will aggravate osteoporosis year by year.
However, although many organizations have expressed their views, how are these two things linked?
Bone mineral density in human body will be affected by many factors, such as some hormones in the body and local growth factors.
Many substances and molecules can affect the density of bones.
The interference of proton pump inhibitors on bone metabolism is also obvious, but the specific mechanism is still unclear, but there are two mainstream theories.
1. Poor absorption.
There are two kinds of calcium in our diet.
Soluble calcium citrate and insoluble calcium carbonate and calcium phosphate.
Soluble calcium in food can be absorbed in small intestine, which is not difficult.
For insoluble calcium, gastric acid is needed to help. If the gastric acid in the stomach decreases, it is very unfavorable for calcium ion absorption.
However, people who often take stomach medicine have relatively reduced gastric acid secretion, which will affect the absorption of calcium ions in food.
This is one of the reasons for the decline of bone mineral density.
2. The damage has increased.
On the one hand, bones are in a stable state in the body, on the other hand, bones are constantly decomposing.
Under normal circumstances, human bone metabolism is regulated by many factors, and bone formation and bone absorption are in a balanced state.
Some studies have found that after using proton pump inhibitors, some cells related to bone formation will be inhibited, which will eventually lead to reduced bone turnover and increased bone fragility.
The above two aspects are the mainstream theory of proton pump inhibitors leading to osteoporosis, and everyone thinks it is very reliable.
However, is there really no way to prevent this kind of thing?
Drug-induced osteoporosis is very common, so prevention and treatment strategies are very important.
1. Calcium supplementation
For the reduction of bone resorption caused by gastric acid inhibition, it can be supplemented appropriately, and calcium carbonate is the first choice for calcium preparation.
Studies show that the calcium absorption rate of calcium carbonate is similar to that of milk. If vitamin D can be supplemented at the same time, the absorption of calcium will increase accordingly.
2. Physical therapy
Of course, in addition to calcium supplementation, there are some physical methods with little side effects and high safety, such as low-frequency pulse, electromagnetic field therapy and ultrashort wave therapy.
In many places, treatment can be carried out in outpatient clinics.
3. Lifestyle.
If possible, we should ensure enough exercise to maintain the normal metabolic balance of the body.
At the same time, avoiding smoking and drinking and developing a good lifestyle will help reduce the risk of osteoporosis.
Osteoporosis is actually a comprehensive symptom, certainly not a single factor, and there are many influencing factors.
Many studies have also shown that long-term or even large-scale use of proton pump inhibitors has a self-evident impact on osteoporosis.
In the long-term drug treatment, osteoporosis should be prevented as much as possible.
Once osteoporosis is diagnosed, we should try to stop using pathogenic drugs or reduce the dose.
Therefore, when many doctors apply proton pump inhibitors to patients, they often consider choosing low dose and short course of treatment, which will be more scientific.
refer to
[1] Yu Liyuan, Gong,. Research progress on osteoporosis caused by long-term use of proton pump inhibitors [J]. Pharmaceutical and Clinical Research, 2017,25 (03): 237-242.