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Over-the-counter packages of Nexium, Prevacid and Prilosec tell you to take the pills—known to doctors as proton-pump inhibitors, or PPIs—for just two weeks at a time unless otherwise directed by a physician. Yet drugs of this best-selling class prevent heartburn and ease related ailments so well that patients—particularly those who suffer from a condition called GERD (gastroesophageal reflux disease)—are often advised to take the medications for years. By decreasing acid production in the stomach, the agents prevent the caustic liquid from backing up—or refluxing—into the esophagus, where it can cause pain and can damage the food tube’s delicate lining.
In recent years, though, safety questions have been raised about prolonged use of the blockbuster drugs. (The medications appear to be safe when taken for a short period, as directed.) Some studies, for example, have linked continuous treatment with proton-pump inhibitors to serious infections caused by the bacterium Clostridium difficile. Presumably something about lowering the acid environment of the stomach allows the pathogens to survive when they otherwise might not. Other investigations suggest long-term changes in the stomach’s acid content can lead to improper absorption of several vitamins—such as B12—and minerals, triggering bone loss, among other ill effects.
Perhaps the biggest surprise came last year when two studies linked the regular use of proton-pump inhibitors to conditions that were seemingly unrelated to the acid levels of the stomach. One of the studies, published in JAMA Neurology, found that the drugs increased the risk of developing dementia, including Alzheimer’s disease; the other, published in JAMA Internal Medicine, suggested a greater risk of kidney problems.
ailment: n. 小病
agent: n. 药剂
caustic: adj. <化>苛性的;腐蚀性的
esophagus: n. 食管,食道
lining: n.组织,膜
dementia: n. 〈医〉痴呆