I’ve been on acid reflux medication for many years. Now I’m wheezing and suffering chest infections: DR SCURR reveals unexpected signs your omeprazole may have stopped working
I’ve been on 10mg a day of the acid reflux drug omeprazole for many years but read recently of the risks from long-term use. I’ve been suffering dry throat, tickly cough and chest infections, with high levels of mucus, as well as bouts of breathlessness and wheezing. Could omeprazole be to blame?
Michael Redwood, Bristol.
Dr Martin Scurr replies: Omeprazole is a type of drug known as a proton-pump inhibitor (PPI).These work by suppressing stomach acid production.
As with any drug, there are potential side-effects. In the short term, these include headache, nausea and increased flatulence (seen in up to 10 per cent of patients). Long-term use is linked with low magnesium levels, vitamin B12 deficiency, intestinal infections, bone fractures and kidney disease.
This is why the benefits of taking the drug – reduced acid reflux and heartburn – must be weighed against the potential risks.
But having looked through the studies on these drugs I’ve not been able to find any convincing evidence they are linked to the symptoms you describe. And I wonder if your underlying condition is the key.
Acid reflux is generally due to malfunction of the valve at the lower end of the oesophagus, where it meets the stomach.
It’s possible that over the years, despite the omeprazole, your acid levels have increased – affecting not just your oesophagus but also the larynx and even the lungs.
This can cause a chronic cough, chest infections and an increase in mucus production in the throat.
All of this may be relatively silent, in the sense that you may not experience the classic sign of acid reflux (i.e. heartburn), as stomach acid often tends to leak back into the oesophagus at night when you’re lying flat in your sleep and may, therefore, go largely unnoticed.
As with any drug, there are potential side-effects. In the short term, for omeprazole, these include headache, nausea and increased flatulence
I suggest asking your GP for investigations to confirm you do have reflux. Typically this would involve a barium meal X-ray, where you swallow a liquid that shows up on X-ray. You then lie on the X-ray table which is tipped gently backwards, with your head down: if you do have reflux the liquid will be seen refluxing up into the oesophagus through the faulty valve (the radiologist films it actually happening).
This is preferable to merely increasing the dose of omeprazole. If reflux is confirmed, the decision will be whether you need further treatment to resolve your symptoms – which may involve surgery to support the valve.
In the meantime, try eating your evening meal early – at 6pm or so – and always take a walk in the evening for half an hour to aid stomach emptying.
Last September I had surgery to remove my gallbladder and since then I’ve gained more than a stone (6.3kg), despite eating and drinking the same. I’m also passing less when I go to the loo, but the frequency is the same. Are these connected?
Philip Johns, Cornwall.
Dr Martin Scurr replies: This type of surgery is generally carried out to relieve the symptoms caused by gallstones – typically abdominal pain following eating. One possibility is that the changes you describe are due to the gallstones being removed.
These can block the flow of bile from the liver into the duodenum, the first part of the digestive tract where we absorb our food – bile helps break down foods, particularly fats.
With the stones gone, the bile may be flowing more efficiently, meaning you’re taking in more calories from the food you’re eating, and this could explain the weight gain, along with the reduction in the volume of your stools (as there is less undigested food getting through).
It’s also possible that something unrelated to your gallbladder removal could be to blame. For instance, an under-active thyroid gland (which controls functions such as metabolism) is a known cause of ‘silent’ – i.e. inexplicable – weight gain.
This would be confirmed by a blood test to check your levels of the thyroid hormone, thyroxine.
Treatment involves replacing the lacking hormone with L-thyroxine, taken as a daily pill, for the rest of your life.
In my view… It’s worth getting a Covid booster jab
The days of the pandemic are, thankfully, disappearing into the mists of time, but the Covid virus continues to be a considerable cause of respiratory tract infection. Some people (e.g. older ones and the immune-compromised) can end up really ill.
It’s proven that vaccines reduce the risk and severity of infection, halve hospital admissions and cut the risk of death. Despite that, many are still sceptical about having a Covid jab, concerned about the potential side-effects.
But a new review of the data published in the journal JAMA shows not only are Covid vaccines 50 per cent effective in reducing hospital admissions, but there have been no new safety worries emerging from the research.
There have been more than seven million deaths worldwide from the virus. Do not be an addition to this statistic – accept vaccination when offered (currently to over-75s, people in care homes or with weakened immune systems) and ignore misinformation on social media.
