Skip to main content

Do Nexium and Heartburn Medicines Cause Dementia?

Proton pump inhibitors, or PPIs, are among the most common drugs prescribed in the United States.  They are extremely safe and highly effective for gastroesophageal reflux disease (GERD).  Are there potential side-effects?  Of course.  Look up the side effects of any of your medicines and you will soon need an anxiety medicine to relieve you of side-effect stress.  The side-effect lists of even our safest medicines are daunting. 

PPIs are associated with a growing list of potential serious side-effects, at least according to the lay press.  A few clicks on your computer, and you will find that these medicines can cause pneumonia, C difficile colitis, malabsorption of nutrients, bone fractures and anemia.   The latest report to emerge links these drugs with dementia.  In the past two weeks, I’ve been questioned about this repeatedly by my patients.  One stopped her medication from fear that her heartburn medicine might be incinerating her neurons.

Enemy of Heartburn Medicines?

While no drug, including PPIs, is entirely safe, I have never seen a serious PPI side-effect having prescribed them to thousands of patients.  I’ll bet that your gastroenterologist and internist can boast a similar track record.  Doesn’t that experience mean something? 

The lay press, in my view, often covers medical science carelessly and without context.  The science underlying the above listed PPI side-effects is extremely thin.  Yet, the headlines describing them can sound authoritative and persuasive.  Remember the adage of local TV news, if it bleeds it leads?  Same concept.

Which of these two headlines or sound bites would be more likely to appear?

Nexium, superb heartburn fighter, may have questionable effect on bones, although results preliminary.

Nexium leads to hip fractures!

The scientific studies that link PPIs to bone disease or dementia are not high quality research studies.  These studies are done on large populations of individuals and do not demonstrate any actual causative effects of the medicines.  When you read the word associated, as in Nexium is associated with cognitive decline, you can accurately interpret that statement to mean there is no proof that Nexium causes dementia.  Association is a weak link which has results from a weak study.

For the same reason, favorable results from similar studies should be viewed with great skepticism.  Next year we may read that Nexium is associated with a reversal of male pattern baldness and enhanced libido.  (If this hypothetical were to truly occur, then I hope that I can time my stock purchase just prior to the announcement.)

So, if heartburn patients have forgotten their keys somewhere, there is no need to flush your heartburn medicines down the toilet.  You are not losing your mind, just your keys.  Remember, much of what we read and hear in the lay press is associated with ignorance.


  1. What about the new reports about kidney damage? As a patient, I must confess that it is hard to know what to do. My GI has me on omeprazole 40 mg after an endoscopy for the last four years and he said not to worry about previous reports of cardiac problems or osteoporosis. Now, they are adding dementia and kidney problems to the news alerts. I am a caregiver for a severely disabled son, so I want to stay healthy. I also know that it is hard to stop taking these drugs. Sigh...


Post a Comment

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Why This Doctor Gave Up Telemedicine

During the pandemic, I engaged in telemedicine with my patients out of necessity.  This platform was already destined to become part of the medical landscape even prior to the pandemic.  COVID-19 accelerated the process.  The appeal is obvious.  Patients can have medical visits from their own homes without driving to the office, parking, checking in, finding their way to the office, biding time in the waiting room and then driving out afterwards.  And patients could consult physicians from far distances, even across state lines.  Most of the time invested in traditional office visits occurs before and after the actual visits.  So much time wasted! Indeed, telemedicine has answered the prayers of time management enthusiasts. At first, I was also intoxicated treating patients via cyberspace, or telemedically, if I may invent a term.   I could comfortably sink into my own couch in sweatpants as I guided patients through the heartbreak of hemorrhoids and the distress of diarrhea.   Clear

Solutions for Medical Burnout

Over the past few months, I’ve written enough posts on Medical Burnout that I have created a new category to house them.  Readers will find there posts detailing the causes and consequences of burnout in the medical profession. The profession has been long on the causes but short on solutions.   What must be done to loosen the burnout shackles from medical professionals? It will be a huge undertaking for caregivers and society at large to turn this ocean liner around.  And it will take time.  The first step must be to obtain a commitment to the overall mission from as many constituents as possible.   Support will be needed from medical professionals, hospital leadership and administrators, physician employers, insurance companies and the public.   As with many reform efforts, many of the players must be willing to sacrifice some of their own interests in order to server the greater good – a worthy and rare event.   Without adequate buy-in from stakeholders, the effort will never ge