Can Proton Pump Inhibitor Cause Joint Pain?


. By Gordon Gibb

There are various adverse reactions and side effects associated with use of a Proton Pump Inhibitor (PPI) for acid reflux—including hip fracture. However, in rare cases, PPI use can trigger joint pain. There can also be a complication of rebound acid production if and when the PPI is abruptly stopped.

The popular class of drug sold in both prescription form and over-the-counter (OTC) is used to treat heartburn and gastroesophageal reflux disease (GERD, commonly known as acid reflux). The various brands—there are about a dozen combined—are among the best-selling medications in the world, with US sales alone tipping the scales at nearly $14 billion annually.

For patients with serious complications from GERD and other reflux maladies, any resulting proton pump inhibitor side effects are worth the benefits won by using what is generally held as one of the most potent forms of reflux control. However, natural health advocates are of the view that too many PPI patients rely on the drugs without merit, if heartburn and GERD is capable of being controlled through maintaining a proper diet, holding to an appropriate weight and getting regular exercise.

Often, acid reflux and related complaints will come up in questions to syndicated columnists who dispense expert advice on various health-related topics.

One such communist is Dr. Paul Donohue, whose syndicated offering "To Your Health" appears in more than 175 newspapers across the country. Early in the New Year a reader wanted to know about the potential for Proton Pump Inhibitor PPI for causing joint pain, together with the chance for a rebound with more severe acid reflux when PPI is discontinued (in the reader's case, Dexilant had been prescribed for acid reflux).

Dr. Donohue noted that Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole), Dexilant (dexlansoprazole) and AcipHex (rabeprazole) could all potentially cause joint pain, however rare it may be. He advised the reader to consult a family doctor to that point.

As for the chance for a rebound effect when attempting to stop a proton pump inhibitor, Dr. Donohue indicated that such a temporary overproduction of acid when PPI therapy is halted could occur, although it doesn't happen to everyone. The columnist advocated a gradual reduction of PPI use—taking them every other day, then every third day before stopping completely.

Other alternatives to PPI use include eating smaller meals while avoiding fatty and fried foods. Losing excess weight if applicable is another way to avoid heartburn and over-production of stomach acids—even sleeping at night with one's head elevated by raising the head of the bed six inches off the floor.

As for PPI fracture and other potential adverse reactions, health advocates have been debating the tendency to over-prescribe proton pump inhibitors like candy, rather than advocate the hard work and lifestyle changes required to control heartburn and GERD naturally. While proton pump inhibitors have become a lifesaver for those with extreme cases, critics have suggested previously that PPI drugs are over-prescribed. With the first wave of aging baby boomers on the cusp of retirement, the incidence of Proton Pump Inhibitor adverse reactions is bound to increase.


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