PPI’s and Gastric Cancer Risk

Objective The association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.

Design This study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication.

Results The analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).

Conclusion PPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.

Association between proton pump inhibitor use and gastric cancer: a population-based cohort study using two different types of nationwide databases in Korea — https://gut.bmj.com/content/early/2021/05/11/gutjnl-2020-323845?rss=1
  • Prevacid 24HR
  • Nexium 24HR
  • Prilosec OTC
  • Zegerid OTC

OTC PPIs are only intended for a 14-day course of treatment and can be used up to three times per year.

Over-The-Counter (OTC) Heartburn Treatment — https://www.fda.gov/drugs/information-consumers-and-patients-drugs/over-counter-otc-heartburn-treatment

I was thinking of a snarky comment but decided against posting any snark.

But if you routinely pop a PPI before and/or after chowing down on a meat lover’s pizza you can’t say you weren’t advised that maybe it might be a better idea to give up the pizza.

Poor gut health is Associated With Severe COVID-19

In a review published this week in mBio, microbiologist Heenam Stanley Kim, Ph.D, from Korea University’s Laboratory for Human-Microbial Interactions, in Seoul, examined emerging evidence suggesting that poor gut health adversely affects COVID-19 prognosis. Based on his analysis, Kim proposed that gut dysfunction — and its associated leaky gut — may exacerbate the severity of infection by enabling the virus to access the surface of the digestive tract and internal organs. These organs are vulnerable to infection because they have widespread ACE2 — a protein target of SARS-CoV-2 — on the surface.”There seems to be a clear connection between the altered gut microbiome and severe COVID-19,” Kim said.

American Society for Microbiology. “Poor gut health connected to severe COVID-19, new review shows.” ScienceDaily. http://www.sciencedaily.com/releases/2021/01/210112085347.htm (accessed January 15, 2021).

Journal Reference: Heenam Stanley Kim. Do an Altered Gut Microbiota and an Associated Leaky Gut Affect COVID-19 Severity? mBio, 2021; 12 (1) DOI: 10.1128/mBio.03022-20

Eat more legumes, plants and other sources of dietary fiber.

Eat less meat, dairy, and eggs.