There have been reports that PPIs cause stomach cancer, but the link between these heartburn drugs and illness is not concrete or well understood.

What are PPIs?

Proton pump inhibitors (PPIs) are medications used to treat gastrointestinal conditions such as gastroesophageal reflux disease (GERD), ulcers, heartburn and more. These drugs work by reducing the production of acid in the stomach.

There are several PPIs available for prescription including:

• Prilosec (omeprazole)
• Nexium (esomeprazole)
• Prevacid (lansoprazole)
• AcipHex (rabeprazole)
• Protonix (pantoprazole)
• Dexilant (dexlansoprazole)
• Zegerid (omeprazole with sodium bicarbonate)

Prilosec, Nexium, Prevacid, and Zegerid are also available in over the counter forms.

Do PPIs Have Serious Side Effects?

Recent research suggests that PPI drugs may be linked to some serious side effects. In 2017, researchers from the Washington University School of Medicine in St. Louis published research that linked PPI drugs with several serious side effects such as heart disease, kidney problems, and death.

According to WebMD, a study showed that people who take PPIs regularly are reportedly at a 25 percent increased risk of death. This could result in thousands of deaths each year due to the widespread use of PPIs.

“I would say it is a small but significant risk,” lead researcher Ziyad Al-Aly, assistant professor of medicine at Washington University and director of clinical epidemiology at the VA St. Louis Healthcare System, told WebMD. “It should prompt people to look at whether they should be on PPIs in the first place or not.”

Although the results of the study are alarming, Al-Aly noted that the research did not prove causation – it only showed an association.

Can PPIs Cause Stomach Cancer?

PPI drugs have also been linked to the development of stomach cancer. The Washington University study showed that, out of 1,000 patients on PPI drugs, two died from stomach cancer. In comparison, four out of every 1,000 died from chronic kidney disease and 15 out of every 1,000 died from heart disease.

“Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them,” Al-Aly said, according to UPI. “Overuse is not devoid of harm.”

A 2017 study conducted by Chinese researchers reportedly corroborates these results. The study investigated the outcome of patients who had been treated for H. pylori with triple therapy, the use of two antibiotics and a PPI medication. When compared to patients who were treated with H2 blockers, patients who took PPIs were reportedly over twice as likely to develop stomach cancer.

The presence of H. pylori is associated with the development of stomach ulcers but can also play a significant role in the development of stomach cancer. Even after the bacteria, people who have had an H. pylori infection reportedly still develop stomach cancer. This risk is reportedly increased significantly with PPI usage.

Even more, the stomach cancer study reportedly showed that the frequency of use also plays a role. Patients who took PPI drugs daily were reportedly at 4.55 times increased risk of developing stomach cancer when compared with people who took the drugs weekly.

Additionally, the longer the drugs are taken, the more likely patients were to develop stomach cancer. Swedish scientists found similar results. After over a year of use, the Chinese study showed the risk reportedly increased fivefold. After two or more years, the risk increased more than sixfold. After three or more years, the risk reportedly increased eightfold.

Although researchers cannot confirm that PPIs cause stomach cancer, the association is certainly compelling.