Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.

Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.

The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.

Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.

Doucefleur/Shutterstock

Which drugs are involved in Australia?

The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:

  • Nexium (esomeprazole)
  • Losec, Asimax (omeprazole)
  • Somac (pantoprazole)
  • Pariet (rabeprazole)
  • Zoton (lansoprazole).

Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.

They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.

They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.

These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.

Helicobacter pylori in the gut
This class of drugs is also used with antibiotics to treat Helicobacter pylori infections. nobeastsofierce/Shutterstock

What do we know about the risks?

Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.

When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.

Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.

In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.

How about the cancer and kidney risk?

Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.

So what does the evidence say about the risk?

Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.

In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.

While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.

Human kidney illustration with blood vessels
Researchers have not yet shown these drugs cause kidney disease. crystal light/Shutterstock

What can I do if I’m worried?

Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.

But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.

There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.

These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.

Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.

If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.

Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

  • How worried should I be about cryptosporidiosis? Am I safe at the pool?
  • Overdosing on Chemo: A Common Gene Test Could Save Hundreds of Lives Each Year
    Chemotherapy’s Hidden Danger: A common gene test could prevent hundreds of deaths from chemo drug overdoses each year, yet it’s vastly underutilized.

Learn to Age Gracefully

Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Peony Against Inflammation & More

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Yes, this is about the flower, especially white peony (Paeonia lactiflora), and especially the root thereof (Paeoniae radix alba). Yes, the root gets a different botanical name but we promise it is the same plant. You will also read about its active glycoside paeoniflorin, and less commonly, albiflorin (a neuroprotective glycoside present in the root).

    It’s one of those herbs that has made its way out of Traditional Chinese Medicine and into labs around the world.

    It can be ingested directly as food, or as a powder/capsule, or made into tea.

    Anti-inflammatory

    Peony suppresses inflammatory pathways, which thus reduces overall inflammation. In particular, this research review found:

    ❝Pharmacologically, paeoniflorin exhibits powerful anti-inflammatory and immune regulatory effects in some animal models of autoimmune diseases including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE)❞

    The reviewers also (albeit working from animal models) suggest it may be beneficial in cases of kidney disease and liver disease, along with other conditions.

    Source: The Regulatory Effects of Paeoniflorin and Its Derivative Paeoniflorin-6′-O-Benzene Sulfonate CP-25 on Inflammation and Immune Diseases

    Here’s a larger review, which also has studies involving humans (and in vivo studies), that found it to effectively help treat autoimmune conditions including rheumatoid arthritis and psoriasis, amongst others:

    ❝Modern pharmacological research on TGP is based on the traditional usage of PRA, and its folk medicinal value in the treatment of autoimmune diseases has now been verified. In particular, TGP has been developed into a formulation used clinically for the treatment of autoimmune diseases.

    Based on further research on its preparation, quality control, and mechanisms of action, TGP is expected to eventually play a greater role in the treatment of autoimmune diseases. ❞

    (TGP = Total Glucosides of Paeony)

    Source: Total glucosides of paeony: A review of its phytochemistry, role in autoimmune diseases, and mechanisms of action

    Antidepressant / Anxiolytic

    It also acts as a natural serotonin reuptake inhibitor (as per many pharmaceutical antidepressants), by reducing the expression of the serotonin transporter protein:

    Gut Microbiota-Based Pharmacokinetics and the Antidepressant Mechanism of Paeoniflorin

    (remember, most serotonin is produced in the gut)

    Here’s how that played out when tested (on rats, though):

    Effects of Paeonia lactiflora Extract on Estrogen Receptor β, TPH2, and SERT in Rats with PMS Anxiety

    Against PMS and/or menopause symptoms

    Peony is widely used in Traditional Chinese Medicine to reduce these symptoms in general. However, we couldn’t find a lot of good science for that, although it is very plausible (as the extract contains phytoestrogens and may upregulate estrogen receptors while dialling down testosterone production). Here’s the best we could find for that, and it’s a side-by-side along with licorice root:

    ❝Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin❞

    Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production

    (note: that it didn’t affect estradiol levels is reasonable; it contains phytoestrogens after all, not estradiol—and in fact, if you are taking estradiol, you might want to skip this one, as its phytoestrogens could compete with your estradiol for receptors)

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

    Share This Post

  • Why We Get Fat: And What to Do About It – by Gary Taubes

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve previously reviewed Taubes’ “The Case Against Sugar“. What does this one bring differently?

    Mostly, it’s a different focus. Unsurprisingly, Taubes’ underlying argument is the same: sugar is the biggest dietary health hazard we face. However, this book looks at it specifically through the lens of weight loss, or avoiding weight gain.

    Taubes argues for low-carb in general; he doesn’t frame it specifically as the ketogenic diet here, but that is what he is advocating. However, he also acknowledges that not all carbs are created equal, and looks at several categories that are relatively better or worse for our insulin response, and thus, fat management.

    If the book has a fault it’s that it does argue a bit too much for eating large quantities of meat, based on Weston Price’s outdated and poorly-conducted research. However, if one chooses to disregard that, the arguments for a low-carb diet for weight management remain strong.

    Bottom line: if you’d like to cut some fat without eating less (or exercising more), this book offers a good, well-explained guide for doing so.

    Click here to check out Why We Get Fat, and manage yours!

    Share This Post

  • The voice in your head may help you recall and process words. But what if you don’t have one?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Can you imagine hearing yourself speak? A voice inside your head – perhaps reciting a shopping list or a phone number? What would life be like if you couldn’t?

    Some people, including me, cannot have imagined visual experiences. We cannot close our eyes and conjure an experience of seeing a loved one’s face, or imagine our lounge room layout – to consider if a new piece of furniture might fit in it. This is called “aphantasia”, from a Greek phrase where the “a” means without, and “phantasia” refers to an image. Colloquially, people like myself are often referred to as having a “blind mind”.

    While most attention has been given to the inability to have imagined visual sensations, aphantasics can lack other imagined experiences. We might be unable to experience imagined tastes or smells. Some people cannot imagine hearing themselves speak.

    A recent study has advanced our understanding of people who cannot imagine hearing their own internal monologue. Importantly, the authors have identified some tasks that such people are more likely to find challenging.

    fizkes/Shutterstock

    What the study found

    Researchers at the University of Copenhagen in Denmark and at the University of Wisconsin-Madison in the United States recruited 93 volunteers. They included 46 adults who reported low levels of inner speech and 47 who reported high levels.

    Both groups were given challenging tasks: judging if the names of objects they had seen would rhyme and recalling words. The group without an inner monologue performed worse. But differences disappeared when everyone could say words aloud.

    Importantly, people who reported less inner speech were not worse at all tasks. They could recall similar numbers of words when the words had a different appearance to one another. This negates any suggestion that aphants (people with aphantasia) simply weren’t trying or were less capable.

    image of boy sitting with diagram of gold brain superimposed over image
    Hearing our own imagined voice may play an important role in word processing. sutadimages/Shutterstock

    A welcome validation

    The study provides some welcome evidence for the lived experiences of some aphants, who are still often told their experiences are not different, but rather that they cannot describe their imagined experiences. Some people feel anxiety when they realise other people can have imagined experiences that they cannot. These feelings may be deepened when others assert they are merely confused or inarticulate.

    In my own aphantasia research I have often quizzed crowds of people on their capacity to have imagined experiences.

    Questions about the capacity to have imagined visual or audio sensations tend to be excitedly endorsed by a vast majority, but questions about imagined experiences of taste or smell seem to cause more confusion. Some people are adamant they can do this, including a colleague who says he can imagine what combinations of ingredients will taste like when cooked together. But other responses suggest subtypes of aphantasia may prove to be more common than we realise.

    The authors of the recent study suggest the inability to imagine hearing yourself speak should be referred to as “anendophasia”, meaning without inner speech. Other authors had suggested anauralia (meaning without auditory imagery). Still other researchers have referred to all types of imagined sensation as being different types of “imagery”.

    Having consistent names is important. It can help scientists “talk” to one another to compare findings. If different authors use different names, important evidence can be missed.

    bare foot on mossy green grass
    We’re starting to broaden our understanding of the senses and how we imagine them. Napat Chaichanasiri/Shutterstock

    We have more than 5 senses

    Debate continues about how many senses humans have, but some scientists reasonably argue for a number greater than 20.

    In addition to the five senses of sight, smell, taste, touch and hearing, lesser known senses include thermoception (our sense of heat) and proprioception (awareness of the positions of our body parts). Thanks to proprioception, most of us can close our eyes and touch the tip of our index finger to our nose. Thanks to our vestibular sense, we typically have a good idea of which way is up and can maintain balance.

    It may be tempting to give a new name to each inability to have a given type of imagined sensation. But this could lead to confusion. Another approach would be to adapt phrases that are already widely used. People who are unable to have imagined sensations commonly refer to ourselves as “aphants”. This could be adapted with a prefix, such as “audio aphant”. Time will tell which approach is adopted by most researchers.

    Why we should keep investigating

    Regardless of the names we use, the study of multiple types of inability to have an imagined sensation is important. These investigations could reveal the essential processes in human brains that bring about a conscious experience of an imagined sensation.

    In time, this will not only lead to a better understanding of the diversity of humans, but may help uncover how human brains can create any conscious sensation. This question – how and where our conscious feelings are generated – remains one of the great mysteries of science.

    Derek Arnold, Professor, School of Psychology, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Share This Post

Related Posts

  • How worried should I be about cryptosporidiosis? Am I safe at the pool?
  • Rebounding Into The Best Of Health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    “Trampoline” is a brand-name that’s been popularized as a generic name, and “rebounding”, the name used in this video, is the same thing as “trampolining”. With that in mind, let us bounce swiftly onwards:

    Surprising benefits

    It’s easy to think “isn’t that cheating?” to the point that such “cheating” could be useless, since surely the device is doing most of the work?

    The thing is, while indeed it’s doing a lot of the work for you, your muscles are still doing a lot—mostly stabilization work, which is of course a critical thing for our muscles to be able to do. While it’s rare that we need to do a somersault in everyday life, it’s common that we have to keep ourselves from falling over, after all.

    It also represents a kind of gentle resistance exercise, and as such, improves bone density—something first discovered during NASA research for astronauts. Other related benefits pertain to the body’s ability to deal with acceleration and deceleration; it also benefits the lymphatic system, which unlike the blood’s circulatory system, has no pump of its own. Rebounding does also benefit the cardiovascular system, though, as now the heart gets confused (in the healthy way, a little like it gets confused with high-intensity interval training).

    Those are the main evidence-based benefits; anecdotally (but credibly, since these things can be said of most exercise) it’s also claimed that it benefits posture, improves sleep and mood, promotes weight loss and better digestion, reduces bloating, improves skin (the latter being due to improved circulation), and alleviates arthritis (most moderate exercise improves immune response, and thus reduces chronic inflammation, so again, this is reasonable, even if anecdotal).

    For more details on all of these and more, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • An Elegant Defense – by Matt Richtel

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In a way, Richtel got the best and worst of the publication date lottery. This book, which he’d obviously been working on for however long, was published in March 2020. Yes, that March 2020. So, it obviously got a huge boost in sales that launced it to bestseller status, and/but it doesn’t actually discuss COVID at all.

    What it does discuss, is—as one might expect—the immune system. Or really, the immune systems, plural, several systems working alongside each other. How we got to have such, how our immune functions work, where all the various immune cells come from and what part they play. What pathogens can do to fight and/or confuse (or even co-opt) our immune response, and what modern medicine can do to counteract the pathogens’ anti-countermeasure countermeasures. And how it can still go wrong.

    The “Four Lives” promised in the subtitle are stories, and Richtel explains the immune system through specific people’s specific battles. In particular, a friend of his who had quite a remarkable battle against cancer, which was of course terrible for him, but illustrative for us.

    The style of the book is very readably journalistic. The author is a Pulitzer-winning NYT journalist, and not normally a science writer. Here at 10almonds, “we like big bibliographies and we cannot lie”, and we didn’t get to enjoy that in this case. The book contained no bibliography (nor appropriate inline citations, nor equivalent footnotes). Maybe a future addition will include this.

    Bottom line: there’s a lot of “science for the lay reader” here. While the lack of references is a big oversight, the book does give a very good overview of what both sides (immune response and pathogenic invasion) bring to the battle of your body.

    Click here to check out Elegant Defense, and demystify immunology!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Salmon vs Tuna – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing salmon to tuna, we picked the tuna.

    Why?

    It’s close, and there are merits and drawbacks to both!

    In terms of macros, tuna is higher in protein, while salmon is higher in fats. How healthy are the fats, you ask? Well, it’s a mix, because while there are plenty of “good” fats in salmon, salmon is also 10x higher in saturated fat and 150% higher in cholesterol.

    So when it comes to fats, if you want to eat fish and have the healthiest fats, one option is to skip the salmon, and instead serve tuna with some extra virgin olive oil.

    We’ll call this section a clear win for tuna.

    On the vitamin front, they are close to equal. Salmon has more of some vitamins, tuna has more of others; all in all we’d say the balance is in salmon’s favor, but by the time a portion of salmon is giving you 350% of your daily requirement, does it really matter that the same portion of tuna is “only” giving you 294% of the daily requirement? It goes like that for a lot of the vitamins they both contain.

    Still, we’ll call this section a nominal win for salmon.

    In the category of minerals, tuna is much higher in iron while salmon is higher in calcium. The rest of the minerals they both have, tuna is comfortably higher—and since the “% of RDA in a portion” figures are double-digit here rather than triple, those margins are relevant this time.

    We’ll call this section a moderate win for tuna.

    Both fish carry a risk of mercury poisoning, but this varies more by location than by fish, so it hasn’t been a consideration in this head-to-head.

    Totting up the sections, this a modest but clear win for tuna.

    Want to learn more?

    You might like to read:

    Farmed Fish vs Wild-Caught: Important Differences!

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: