Health chiefs issue warning for common acid reflux drug taken by millions over infection fears

Health officials have warned that long-term use of acid reflux drugs to combat indigestion could increase the risk of developing a potentially deadly bacterial infection. 

Acid reflux—when stomach acid repeatedly flows back into the gullet—is a common cause of indigestion, and the burning pain this produces is what most people describe as heartburn. 

Proton pump inhibitors (PPIs), such as omeprazole, are one of the UK’s most prescribed medications in the UK to treat the condition, with 73million NHS prescriptions dispensed in England in 2022-23, as a cost of £190million. 

But the NHS has issued a statement warning against taking the drug for longer than two weeks without a prescription, over fears it could increase the risk of Clostridioides difficile. 

Commonly referred to as C. diff, the highly contagious bug, which initially infects the bowel and causes diarrhoea, can trigger life-threatening complications. It kills up to one in five patients that fall ill with it. 

C. diff usually lives harmlessly in the bowel, but PPIs such as omeprazole, which work by reducing stomach acid, can throw off the natural balance of bacteria in the organ, increasing the risk of a C. diff infection. 

The bug becomes life threatening if the bacteria infect other parts of the body outside the bowel. 

This can trigger sepsis, a life-threatening over-reaction from the immune system to an infection. 

Another potential complication is the bacteria spilling into other areas of the abdomen causing a potentially deadly infection called peritonitis. 

The warning comes amid debate over the long-term use of common acid-suppressing medications. 

PPIs work by reducing acid production in the stomach—large amounts of which can cause indigestion, acid coming ‘back up’ the oesophagus, and sometimes stomach ulcers. 

Normally, a valve called the lower oesophageal sphincter prevents acid reflux from occurring, but if it weakens or relaxes at the wrong time, acid can escape and irritate the oesophagus.   

PPIs stop stomach acid from collecting in the stomach, relieving uncomfortable symptoms such as indigestion, heartburn and acid reflux. 

But, experts have long cautioned that relying on acid-suppressing medicines for simple heartburn can have long-lasting, damaging effects. 

Pharmacist Deborah Grayson, known as the godmother of pharmacology on TikTok, warned in a viral video: ‘It can be helpful to have omeprazole if you’ve got gastritis or erosion in your oesophagus, but if you’ve only got simple heartburn-related problems, longer term it can have greater impacts on the body.’ 

While reflux is uncomfortable, stomach acid is essential for digestion. It activates pepsin, an enzyme that breaks down proteins in the gut, and helps soften food. 

It also protects against harmful microbes in food. 

‘Reduced stomach acid can also compromise the gut’s natural defense barrier, increased susceptibility to infections such as C. diff, campylobacter and small intestinal bacterial overgrowth (SIBO),’ Ms Grayson added. 

‘These can cause further gastrointestinal symptoms and, in some cases, serious complications.’

The NHS adds: ‘Do not take omeprazole for longer than two weeks if you bought it without a prescription. 

‘See a GP if your symptoms get worse or do not get better.’ 

It comes as health officials warned in May that cases of a c. diff have surged by a third in just a year, as experts point the finger at an overwhelmed NHS. 

In the report, the UK Health Security Agency (UKHSA), said the number of cases seen in 2023-24 was 29.5 per 100,000 people. 

This is 33 per cent rise since 2020-21 and the highest level seen in over a decade, the body said. 

C. diff is thought to be the leading cause of healthcare-associated infections, those that happen when a patient is in hospital. 

The bacteria is spread by spores in infected patients’ faeces that can survive for an extremely long time in the environment.

This allows them to be spread by people who have been in contact with infected patients or contaminated surfaces.

Symptoms of a C. diff infection include diarrhoea, a high temperature, loss of appetite, nausea and stomach pain.

People who have had diarrhoea and recently taken antibiotics, have any bloody diarrhoea or have had diarrhoea for a week or more should contact NHS 111 or their GP for advice.

Research has also showed that up to 40 per cent of patients do not respond to a PPI, so the drug is rendered useless in those cases.