The connection between gastric reflux drugs and C.difficile infections
Clostridium difficile has become one of the most difficult hospital-borne infections and is a major threat to people in hospitals and even those visiting. Because it virtually lives in hospital rooms and bathrooms it has become very resistant to antibiotic treatment and can prolong the hospital stay with severe diarrhea that sometimes can be lethal.
Whether you choose it or not, most people will find themselves on many medications when they are treated in a hospital. The majority of admissions are for heart conditions and these usually involve reducing the blood pressure and heart rate to stabilize the patient. In many cases a patient will be administered up to 3 different types of medication to control the blood pressure, one or two diuretics and possibly some pain relievers and an antidepressant. As a general rule the physician will probably add a proton pump inhibitor on the chance that all these drugs may upset the patients’ stomach.
These proton pump inhibitors known by names such as omeprazole, Nexium, Dexilant, Losec, Prevacid, Pantaloc, Tecta and Pariet reduce the amount of stomach produced by the stomach to stop heartburn and also stop extra acid from going up the esophagus of a reclining patient. However, the purpose of acid in your stomach is to destroy any bacteria that enter through your mouth so that it will not get into your system. Once you reduce the amount of acid produced by your stomach, you leave yourself wide open to foreign bacteria such as C.difficile.
Health Canada regards C.difficile bacterium as one of the leading causes of diarrhea and unfortunately it can only be treated with antibiotics. This of course makes this bacterium more resistant and more difficult to treat when recurrent infections occur.
The connection between the gastric drugs and C.difficile was first discovered in 2007. Three different studies found that there was a three times greater chance of acquiring this bacterium if you were on one of those drugs.
Over the next few years, more studies solidified the clinical association, particularly in elderly people with supressed immune systems and patients undergoing cancer therapy.
In 2012 Health Canada put out an advisory to hospitals outlining the risk of these drugs and told them to follow up with their patients more carefully and not use these drugs indiscriminately.
The United States Food and Drug Administration did a much more detailed study and found that there was a strong association of infection with continued use of proton pump inhibitors (PPI’s). In addition they found that these drugs caused decreased vitamin and mineral absorption, iron deficiency, and bone weakness because they prevented the absorption of calcium.
Of course once these studies were out, pharmaceutical companies rushed to produce their own set of new studies showing that these drugs were harmless and that the warnings from the US Food and drug were overstated. Most physicians had already started to cut back on prescribing PPI’s and the drug companies were losing billions of dollars.
In 2012, Health Canada requested that the Drug Safety and Effectiveness Network examine the details and produce a report. A committee headed by Dr. James Lunney confirmed that there was a strong association between the use of PPI’s and C.difficile infections.
Unfortunately once the report was published Health Canada did not pursue it and it was left up to Dr. James Lunney who held numerous press conferences and did everything he could to get Health Canada involved but could not get them to move on this issue.
While the experts and the health regulators continue this debate, the fact is that none of us would need any of these drugs if we led a healthy lifestyle. This includes the avoidance of fatty foods, coffee, soft drinks and processed chocolate as well as the inclusion of fruits, vegetables, licorice, peppermint and the herb curcumin. All of these dietary changes will keep stomach acid down to a level where it will not upset you but will be in sufficient quantity to protect your immune system from foreign bacteria.
The fact is that most people who suffer from gastric reflux are overweight. These are also people that eat heavy meals and drink alcohol late into the night and then as they recline into bed have huge amounts of acid produced in their stomach travelling up their esophagus.
Losing excess weight, moderate exercise and a good diet are the natural way to get off of these drugs and once doing so this effort may save your life from C. difficile, one of the most deadly bacterium of our times.