Reflux remedy faces acid test
Medicine in general being a good thing, one might suppose “the more the better.” But not necessarily.
Prozac can be highly effective for those with severe melancholia, but when prescribed for the millions who are just unhappy, its adverse effects will outweigh any benefit it might confer. Here, the nostrum coined by Mies van der Rohe in defence of minimalist architecture would seem appropriate: “Less is more.”
This applies even to the safest and most effective drugs, and there are few safer and more effective than the acid-suppressant omeprazole and other proton pump inhibitors (as they are known) that promptly and gratifyingly abolish the discomforts heartburn.
This is fair enough when the purpose is to heal some underlying cause, such as a stomach ulcer, or reflux-induced inflammation of the esophagus. But most of those prescribed omeprazole have neither, and a simple antacid would do the job just as well.
This would be less of an issue except that omeprazole is perhaps not as safe as presumed. The high concentration of hydrochloric acid in the stomach — potent enough to burn a hole in concrete — serves other functions than aiding digestion of food, including killing 99.9 per cent of all bacteria.
Hence omeprazole could increase the risk of contracting a nasty bowel infection such as clostridium difficile (C. diff ) — which it does, twofold.
It also predisposes to fractures, anemia and, when discontinued, a rebound in acid secretion that can result in ... stomach ulcers and esophagitis. Thus, in the balance sheet, less (omeprazole) could mean more (health).