Although many gastroenterologists say the PPIs are relatively safe, the FDA recently changed the labels to reflect the increased risk of fracture that some patients face—especially those over the age of 50—when using the medications for more than a year.
Gastroenterologists like PPIs because they work for many patients. Surgeons, however, say PPI medications just hide the problems of acid reflux, whereas surgery would provide a permanent solution. According to the 7/20/10 edition of the Plain Dealer, those doctors say some patients do not respond well to medication and wind up paying a lot over the long term for expensive medications. They point to a surgical procedure that strengthens the valve between the stomach and the esophagus, preventing acid from moving up into the esophagus.
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What's more, patients who undergo successful surgery are once again able to eat almost any foods they like, unlike patients who take PPIs their whole lives. Furthermore, PPIs prevent acid from moving into the esophagus, it may not prevent the movement of other substances, such as bile, which can cause other health problems.
For now, there is no easy answer in the debate between surgery and medication. Proton pump inhibitors are still recommended for short-term use. Patients with persistent heartburn have to weigh the risks and benefits of surgery and medication and decide which route they want to take. Patients who are currently taking proton pump inhibitors should not discontinue their medication without first speaking to a medical professional.