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Hip Fracture Risk is High with Proton Pump Inhibitors

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The proton pump inhibitors (PPIs) have been around for more than two decades. The drugs are very effective for the treatment of peptic ulcer disease, GERD and gastritis. Millions of people regularly use these drugs.

The impact these drugs have had in medicine is immeasurable. Prior to the availability of PPIs, many people required surgery for treatment of ulcer disease and its complications. Today, surgery is very rare since PPIs very effectively control acid secretion.

Now there is a report which indicates that use of PPIs by postmenopausal women may be associated with an increased risk of fractures. Postmenopausal women already have a decline in the levels of estrogen which is a major factor in bone growth.

This new report published by Dr. Khalili from the Massachusetts General hospital says that the use of PPIs increased risk of fractures to more than 50 percent among postmenopausal women who also smoke. (1)

Dr Khalili and his colleagues followed close to 80,000 postmenopausal women who used PPIs from 2000-2008. They were interested in measuring the incidence of hip fracture.

What they discovered was that the risk of hip fracture was significantly increased among users of PPIs -- the longer the drug was used, the higher the risk. Also noticed was that the risk of hip fracture was particularly high in women with a history of smoking.

So what now?

Well, the first thing to know is that several other studies in the past have looked at PPIs and hip fracture and have produced conflicting results. (2)

By now it is well-known that smoking is a bad habit and is associated with many health problems. In my opinion, the best thing to do is to discontinue smoking. Even though these data show that risk of fractures is higher with PPI use, these drugs are very effective for peptic ulcer disease and GERD.

Women who chronically use PPI may want to discuss with their physicians about other options like and histamine blockers, which also work well and may be cheaper. Other means of preventing bone thinning include changes in lifestyle such as regular exercise and a healthy diet rich in calcium.


1. Khalili H et al. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study
Abstract: http://www.bmj.com/content/344/bmj.e372

2. Ngamruengphong S, Proton pump inhibitors and risk of fracture: a systematic review and meta-analysis of observational studies.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/21483462

Reviewed February 7, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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