Heartburn drugs can raise the risk of a broken hip in people older than 50 when they are taken for more than a year, according to a study of more than 145,000 seniors.

The researchers believe the drugs may make it more difficult for the body to absorb calcium, leading to weaker bones and fractures.

The drugs causing the most problems were of a class known as proton pump inhibitors, which include Nexium, Prevacid and Prilosec. There was a similar but smaller risk of hip fractures for drugs called H2 blockers, such as Tagamet and Pepcid.

Patients who used proton pump inhibitors for more than a year had a 44 percent greater risk of hip fracture, and the longer they took the drug, the greater the risk. And those who took high doses had more than twice the risk of hip fractures. Men in the study were more at risk than women, possibly because women may get more calcium in their diets.

Nexium is the third best-selling drug in the world, with annual sales exceeding $5 billion. People with chronic heartburn can develop painful ulcers in the esophagus, and in rare cases, some can end up with damage that can lead to esophageal cancer.

Journal of the American Medical Association December 27, 2006; 296(24): 2947-2953

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Antacids — drugs that relieve heartburn by decreasing levels of
stomach acid — are among the best-selling drugs of all time,
pulling in billions of dollars in windfall profits for pharmaceutical
companies.

Who among us hasn’t heard the dire warnings about the
perils of “excess stomach acid”? Yet as Dr. Rubman and I have
pointed out, we need stomach acid to activate pepsin and to digest
the food we eat. True excess stomach acid is a rare condition. As
such, these warnings are really about selling a product that most of
us dont need, and which may be harmful, cautions Dr. Rubman. In
his view, they are “hucksterism” and “much ado about nothing.”

What is being marketed as excess stomach acid is really acid
produced at the wrong time, explains Dr. Rubman. He told me that
there are two phases to stomach acid production…

* Digestive phase. When you have a meal and food enters the
stomach, stomach acid is produced to help dissolve the food and
extract the nutrients you need from it.

* Quiescent phase. Between meals, when the stomach is empty,
normally there is little or no stomach acid. The intestinal tract
needs its rest, too.