This story starts back in September when I suddenly developed a severe stomach ache that lasted about 24 hours. It was like nothing I’d ever had before (or since) and prompted a visit to my doctor. We were both concerned and curious as to what would cause it. An endoscopy was ordered. Shortly after that, a Cologuard test came back suspicious prompting an order for a colonoscopy. The tests were completed in December and I patiently awaited the results.
The first call I got was from an assistant from the gastro office during which I was told my colonoscopy was normal but that I should return in three years for another endoscopy. She was about to hang up and I stopped her, asking “Wait, why do I need to come for another endoscopy?” She paused and said this, “Oh, I’ll have the doctor call you.” “Huh?”, I thought.
In my subsequent call with the doctor, I was told that the biopsy of an area in my stomach showed signs of precancerous changes. My mind was spinning. What causes this? How fast-growing is it typically? He gently explained that excess stomach acid is not uncommon and went on to explain that there is a simple fix to stop the progression of the cell changes and therefore nix any possible cancer. “All you have to do is take an OTC acid-blocker.” “What?!”, I responded anxiously. “Isn’t there anything else I can do?” I was reluctant to do this as I know acid-reducing meds are problematic with regard to the absorption of nutrients. “No, this is the only way”, was his adamant answer. I bargained, “Aren’t there lifestyle changes I can make to address it?” I was distraught but not bull-headed as he told me again that this was the only way he knew to handle this. I bargained some more and we agreed to a dose of Prilosec three times a week. Why Prilosec? It was the only name that came into my head when he suggested an OTC solution! It didn’t seem to matter to him which one I took. That afternoon I purchased the generic version, omeprazole, and began taking it three times a week.
A few days later at an appointment with my PCP, we went over the test results. Upon hearing about the stomach biopsy and the gastro doc’s recommendations, she urged me to take the acid reducer daily. “You don’t want stomach cancer Anne and you don’t want to wait three years for another endoscopy.” I love my doctor and trust her, so I agreed because I adamantly do not want to chance getting cancer in my stomach.
It was uncharacteristic of me to blindly accept any doctor’s advice, as I am an ardent researcher and question everything. It’s what I love about accessibility to the Internet so much – the credible information that is available – if you know how to find it. After a week of being on the omeprazole daily, I had a nagging urge to get online and investigate the relationship between acid-blockers and stomach cancer. My curiosity was peaking. “Look into this more deeply” was the refrain in my head. I was unprepared for what I found.
While I was expecting to see information on the benefits of acid-blockers to stop cancer, what I found were studies, including from the National Institutes of Health in 2017, that concluded there is a LINK between stomach cancer and the daily use of OTC proton pump inhibitors such as Prilosec (omeprazole), Prevacid (lanscoprazole), Protonix (pantoprazole), AcipHex (rabeprazole), Nexium (esomeprazole)and Dexilant (dexlansoprazole). A study published in 2016 by the American Gastroenterological Association1, looked at over 80,000 patients and showed that the use of proton-pump inhibitors was associated with a significant increase in the risk of gastric cancer.2 Long term use is defined as greater than 12 months.
Now my head was really spinning. I already follow most of the lifestyle guidelines to reduce gastric acid. I don’t smoke, I avoid foods that I know cause me indigestion, I try not to eat big meals late at night (that’s a challenge!) and I rarely drink alcohol. Yet I still had frequent heartburn. What to do? My curious mind went to work and I dug deeper into the world of acid-reducing meds and the relationship to gastric cancer. It didn’t take long to learn that the older versions of acid-blocker meds – the H2 blockers are not associated with an increased risk of gastric cancer. A meta-study by the Department of Medicine at the University of Hong Kong in China showed that people who took PPIs had more than twice (2.44) the risk of developing stomach cancer, whereas H2 blockers were not associated with an increased risk.3
I threw away the omeprazole and replaced it with famotidine, reportedly the most potent of the H2 blockers and the generic of Pepcid. Other H2 blockers are Tagamet (cimetidine), Axid (nizatidine) and ranitidine. (Zantac, a brand of ranitidine was taken off the market for another cancer-causing problem not related specifically to ranitidine, which is widely available.)
The take-away. I am ever-grateful for the freak stomach-ache that caused my PCP to order an endoscopy. Without that, I would not have known about the pre-cancerous cells in my stomach. I am ever grateful for my curious mind that urges me to look deeper into things and not just accept the opinions of others. With this information I am empowered with knowledge to change and improve my health. Without my curious mind I would be blindly following instructions and taking a medication that might well have cemented a future gastric disaster. Doctors are human. They are busy taking care of patients so much that a lot of their education comes from pharmaceutical reps whose job it is to get their products into the most people they can. I still love my PCP. I am, however, going to get a second and maybe even a third opinion from other gastro docs. I have also further modified my diet to foods that produce an alkaline, rather than acid effect in the body (google ‘alkaline food’), so lots and lots of greens for me on a regular basis and strict avoidance of the foods (most meats and certain veggies like nightshades) that cause my indigestion. The good news is that my acid stomach is finally feeling better and I feel more in control.
Be a Savvy Senior! Be curious. Ask questions. Don’t accept information on face value. Do your own research. If you’re not good with the computer, ask a friend for help or go to the library. Be empowered. Be responsible for your own health.