I was diagnosed with pneumonia yesterday, and this morning it finally dawns on me that I really should educate myself about my condition. Lo and behold, I come to find this at WebMD:
Well, sumbitch. As it happens, I am on omeprazole (Prilosec OTC x 2 a day) because my ENT doc believes that reflux is contributing to the polyp I have on my vocal cord.
My question is this: what is the mechanism of this risk, if known? I don’t have access to JAMA, so I can’t look up the cited article from WebMD. Is it purely statistical, is it the reflux itself that actually increases the risk, or is there something specific about those two meds?
I’m shooting from the hip here, so take it with a grain of salt!!
I believe the risk is increased because omeprazole and similar proton pump inhibitors do not cure reflux, rather they make reflux far less uncomfortable, as the refluxed stomach contents are now not nearly so acidic and burning.
Severe reflux raises anyone’s risk for pneumonia. But if reflux is so painful that it gets the person’s attention immediately and they sit up, cough like a banshee, and use a pillow to prop themselves up to reduce further symptoms then that helps clear the airway, and reduce further reflux exposure.
But if the refluxed material is not so noxious due to medicaton, more of it gets refluxed and threatens the airway more often.
Thanks, Q! If I’m hearing you right, the connection is that severe reflux is the actual risk factor, and the p.p.i. masks the most notable symptoms of reflux, thereby making possible that one might not realize how severe one’s reflux is.
Alas, that only furthers my irritation with my ENT, since I have repeatedly told him that I have no other symptoms of reflux whatsoever. And yet, I’m on the Prilosec, I’m taking antacid right before bed, and I’m still sleeping (if you can call it that) on that f&cking bed wedge.
Of course, at last check up, he said something we were doing was working, so I guess I have to suck it up. Anyway, that’s a different discussion.
I think the theory is that lack of stomach acid induced by omeprazole (and similar drugs) leads to more bacterial proliferation in the stomach than normal. Hence, if one aspirates (and we all have at least microaspirations), one is more likely to aspirate a bigger load of bacteria than “normal”.
Basically, there was one study that looked at this and purported to show a link. But, read this for a proper take on the results.
