Proton Pump Inhibitors—Caught between a Rock and a Hard Place

Zanesville, OHJulie, age 53, started taking proton pump inhibitors several years ago to treat gastroesophageal reflux disease (GERD). She had no idea—until she broke her ankle—that prescription PPI medications have been linked to bone fractures when taken long term or in high doses.

There are many proton pump inhibitors on the market, including several sold over the counter. Julie's PPI of choice was Prevacid (iansoprazole), 30 mg per day. "The PPI worked really well; it kept my acid reflux symptoms at bay," says Julie, "but about three years ago I had a lot of pain in my ankles and my left ankle would tend to roll in when I walked, giving out on me. It started to affect my work—I'm a circulation clerk at the library—the job involved a lot of walking and standing.

"Last September I was out in the yard and the neighbor's dog knocked me down. My left ankle completely broke and I needed surgery with plates and screws to hold it all together. I thought it would take eight weeks to recover but I couldn't put any weight on that ankle for 12 weeks and I was off work for a total of 4½ months—a lot longer than I thought."

Julie's surgeon diagnosed Post Traumatic Osteoarthritis. (Osteoarthritis is a degenerative joint disease that is characterized primarily by progressive breakdown of articular cartilage, but post traumatic arthritis is the increased wear that occurs in a joint as the direct and indirect result of injury, and Julie didn't suffer an injury.) Julie was shocked with the diagnosis, even though her mother had osteoarthritis. But her mother also took proton pump inhibitors for chronic ulcers…

"I asked my surgeon if my broken ankle and the pain in both ankles could have been caused by the PPI and he said it was possible," says Julie, who now finds herself stuck between 'a rock and a hard place.' "When I found out about PPI side effects I swore never to take the drug again. I got something in the mail about a PPI lawsuit and went online. After I did a bit of research I found message boards and blogs where so many people were suffering from broken bones.

"I also lost my appetite, knowing that food is the trigger to acid reflux. I also cut down the dosage from 30mg down to 15mg. It has helped somewhat—like the lesser of two evils. But I'm still taking the PPI off and on. I tried to wean myself off it but it gets to the point where I can't stand the GERD anymore. I am trying to find an alternative. Meanwhile, I really have to watch my diet. I can't eat any spicy foods, tomato-based products, carbonated beverages, or fried foods.

"I find it upsetting that a prescription drug, something you think will help, can turn around and ravage something else. I've always been cautious about medications but when it comes to not being able to eat, you just have to take it to feel better."

Proton pump inhibitors have caused Julie more grief than a broken ankle." As of this week I think I am going to lose my job," she explains. "I filed for social security disability and tried to get unemployment but I was denied both because they thought I could get another job. I tried to go back to work (where I have been for six years) on light duties, but the library is not willing to work with me any longer. I was suspended this week and have to go into a meeting tomorrow, which I think it is going to be my termination. My surgeon has now confirmed that I am disabled, something he couldn't do until I tried to return to work, and my attorney is appealing the denial."

Julie is hopeful that her appeal will be granted, and that she will join a Proton Pump Inhibitor lawsuit. We will keep in touch…