DEAR DOCTOR K: I suffer from heartburn and have been taking a proton pump inhibitor for the past few years. Should I be worried about long-term side effects?

DEAR READER: For many people with heartburn, proton pump inhibitors (PPIs) provide great relief. Stomach acid contains lots of hydrogen ions, which are protons. PPI drugs inhibit the production of those protons. The PPIs include esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec).

PPIs work by reducing the acid in our stomachs — although we need some acid to help digest our food. it also helps to kill bacteria and other germs in our stomachs that could otherwise make us sick.

But sometimes excess stomach acid backs up into the esophagus, the tube that connects our mouths to our stomachs. This condition is called gastroesophageal reflux disease, better known as GERD. The acid reflux irritates the lining of the lower esophagus, causing heartburn.

If you suffer from chronic heartburn and quite possibly GERD, join the crowd: There are millions of us. many people with chronic reflux take a PPI indefinitely. That’s because reflux often returns once you discontinue the medication.

One concern is that PPIs may increase the risk of pneumonia. how does that happen? When we get reflux, the stomach contents can sometimes go all the way up to the top of the esophagus. The top of the esophagus opens in the throat, right near where the breathing tube leading to the lungs opens. The stomach contents that reflux up to the top of the esophagus can then drop down into the lungs.

You don’t want to know all of the things that are in our stomach contents. Suffice to say that along with the acid are bacteria. if those bacteria get into the lungs, they can cause pneumonia (a lung infection). By reducing stomach acid, PPIs make the stomach a friendlier home for bacteria. This increases the chance of pneumonia. However, this risk is very low. It’s not high enough that you should stop PPIs if they are giving you good relief.

PPIs may also increase the risk of infection with bacteria that can cause life-threatening cases of diarrhea and a serious colon condition. Normally stomach acids would kill these bacteria. but by making the stomach less acidic, PPIs open the door to infection. This risk, too, is very low.

PPIs might also indirectly increase the risk of osteoporosis and fractures, because acid contributes to the absorption of calcium. and PPIs may lower your body’s levels of vitamin B12, because acid also helps you absorb more of that vitamin.

We have a lot more information on preventing and treating reflux in our Special Health Report, “The Sensitive Gut.” you can find out more about it at my website.

I understand your concern, but try to keep this in perspective. Fortunately, my symptoms of GERD are mild and I don’t need PPIs. but if I did, and if they gave me great relief, I wouldn’t stop them because of these possible small risks.

Dr. Komaroff is a physician and professor at Harvard Medical School. go to his website to send questions and get additional information: AskDoctorK.com.

They can show symptoms as soon as they are born. Some are born with meconium ileus due to the thick sticky mucus and they are diagnosed straight away
suht.nhs.uk/OurServices/Child…

Others can be months or years old and have symptoms such as failure to thrive or constant chest infections.

Bloated stomachs and foul smelling nappies can also happen in babies.

it depends how severe the case of cystic fibrosis is.. if it is a severe case symptoms can appear as a baby but if it is a mild case they could appear in early childhood.

If so is it a different kind of tired than if you were pregnant? I feel very weak & tired. Sometimes I am tired but can not go to sleep. also my nipples were hurting up until today. that feeling we get when we suck our stomachs in as much as we can I feel that too. and a little bit of cramping. what do you think? Period isn't due until Sept 4th. has any one else experienced this? Thanks

Sounds exactly like my early symptoms. I was exhausted all the time, I slept like crap, my nipples and breasts hurt to badly that I couldn't even stand to have the water run over them in the shower. I took a pregnancy test a week before my period was due, because of those symptoms and it was positive.

My husband and I had been trying for three years, so it was pretty exciting to find out we were having our first baby, then four months later found out we were having twins!

Oh yes ma'am… With my daughter and this pregnancy…

Both in the first trimester.. along with sore nipples and breast. Everyone has different symptoms though.

I would take a test around the 4th if you haven't started. best of luck!

with my first pregnancy yes it started in the first trimester along with the sore breasts. with this pregnancy no the fatigue didn't start until i was 18 weeks pregnant

I didn't really feel tired until I was 6 weeks, which is also when my morning sickness started. I first got the inkling that I could be pregnant when I started getting heartburn and had sore breasts.