The drugs, including such best-sellers as Prilosec, Nexium and Prevacid, change the mix of gut microbes. This leads to overgrowth of a bacterium that causes liver inflammation and cell death, the study found.
Possible links between acid reflux and liver health
A 2017 study suggested that people with GERD may be at a higher risk for nonalcoholic fatty liver disease (NAFLD).
Approximately half of all cirrhosis-associated deaths are related to alcohol. PPIs, which include brand names such as Prilosec, Nexium and Prevacid, are among the most commonly prescribed medications in the world, particularly among people with chronic liver disease.
Despite the wide use Esomeprazole it has not been associated with liver injury. Esomeprazole was not mentioned as a drug to cause liver injury in a large study on drugs causing liver injury [8]. Nonetheless it was associated with rise in serum Alanine Aminotransferase (ALT) in less than 1% of the patients [9].
However, Omeprazole reduces the amount of stomach acid in the body. Bacteria can thus multiply and damage the liver. This can lead to chronic liver diseases. It is particularly critical for the liver when the patient also takes the medication while consuming alcohol, further weakening liver performance.
Esomeprazole 20 mg was chosen as the comparator, because it is the only PPI which is assumed as “safe” for patients with advanced cirrhosis according to the available data on pharmacokinetics [48].
Omeprazole and esomeprazole therapy are both associated with a low rate of transient and asymptomatic serum aminotransferase elevations and are rare causes of clinically apparent liver injury.
The concerns around their extended use are that they may lead to increased risk of bone fractures, vitamin B and magnesium deficiencies, and infection with Clostridium difficile bacteria, which can cause serious bowel damage and in some vulnerable people, lead to an increased risk of premature death.
Nexium Kidney Injuries
Growing research tells us that Nexium and other proton pump inhibitors (PPI) like Prilosec may cause patients to develop chronic kidney disease and end-stage kidney failure is two-and-a-half times more like to occur with PPIs.
Certain side effects of Nexium become a concern with prolonged use. For example, low levels of magnesium and vitamin B12 can be an issue after months to years of treatment. Long-term and even lifelong treatment with PPIs is not uncommon.
However, there are some risks associated with them, particularly when used long-term. Although these risks are uncommon, kidney disease, fractures, infections and vitamin deficiencies are associated with using PPIs for more than a year. A recent study found that long-term PPI use may raise risk of liver cancer.
A study emerging from the University of California, San Diego, has revealed a correlation between the use of common acid reflux medications and chronic liver disease.
Metabolic Dysfunction-Associated Fatty Liver Disease Increases the Risk of Gastroesophageal Reflux Symptoms.
Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. This ring is called the lower esophageal sphincter (LES). If you have it, you may get heartburn or acid indigestion.
If you have an autoimmune disease, liver disease, low magnesium or vitamin B-12 levels or osteoporosis. If you're pregnant or if you plan to become pregnant. If you took OTC Nexium for more than 14 days and are experiencing bloody stools, severe heartburn, nausea, vomiting or unexplained weight loss.
Although proton pump inhibitors like Nexium are useful in some situations, they can be very difficult to quit. Stopping acid-suppressing drugs suddenly leads to rebound hyperacidity. You may need to reduce your dose even more gradually.
Long-term use warning: Using this drug for a long time comes with risks. It increases your risk of osteoporosis-related bone breaks in your hip, wrist, or spine. It may also cause inflammation of your stomach lining and low blood levels of magnesium.
According to Dr. Ghouri, Prilosec OTC “is usually sufficient in controlling symptoms in a majority of [heartburn] cases” and has been the #1 Doctor Recommended frequent heartburn relief medicine for 14 years.
The recommended dose is one Nexium 20 mg gastro-resistant tablet once a day for 4 to 8 weeks.
Conclusions: This current national wide cohort study suggests that PPI use was associated with an increased risk of fatty liver disease compared with non-use of PPIs. Clinicians should consider fatty liver as a potential risk when prescribing PPI.
Nonprescription pain relievers such as acetaminophen, aspirin, ibuprofen and naproxen can damage your liver, especially if taken frequently or when combined with alcohol.