Long-Term Use of Naisan: Risks and Effects on Stomach Health

Q: Long-Term Use of Naisan: Risks and Effects on Stomach Health

Hello： 1. It is recommended to use Nizatidine only after a diagnosis is confirmed via gastroscopy. 2. Side effects may include leukopenia and achlorhydria, but these are very rare, and there is little impact on the kidneys. 3. It can be taken as ne

Long-term use issues of Naisilin?

Hello Dr.
Chen, three years ago I injured my back and took anti-inflammatory medication for six months, after which my stomach has not been well.
Over two years ago, due to increased stress, I underwent an endoscopy that revealed gastric inflammation.
At that time, the doctor prescribed Nexium, and after taking it for six months, a follow-up endoscopy showed improvement.
However, one month later, the symptoms recurred, so I started buying Nexium at the pharmacy and continued taking it, initially one pill a day, now down to half a pill a day.
If I reduce it to a quarter pill a day, my stomach becomes very uncomfortable (feeling very acidic and a bit nauseous).
I am concerned that if I stop the medication, the gastritis will flare up again, so I have been taking Nexium for two years.
Can Nexium be used long-term (for two years)? Will it have an impact on my kidneys? Given my previous experience with long-term anti-inflammatory medication, could it have caused thinning of the gastric mucosa, preventing recovery? Because when I stop the medication, my stomach feels very uncomfortable (mild pressure pain), but taking half a pill a day makes me feel relatively normal.

Chad, 30~39 year old female. Ask Date: 2014/12/21

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello:
1.
It is recommended to use Nizatidine only after a diagnosis is confirmed via gastroscopy.

2.
Side effects may include leukopenia and achlorhydria, but these are very rare, and there is little impact on the kidneys.

3.
It can be taken as needed.

Wishing you peace and health.

Dr.
Chi-Feng Chen, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2014/12/21

More Info

Long-term use of Naisan (Esomeprazole), a proton pump inhibitor (PPI), raises several important considerations regarding its safety and potential effects on stomach health, especially in patients with a history of gastric issues.
Firstly, it is essential to understand that PPIs like Naisan are commonly prescribed for conditions such as gastroesophageal reflux disease (GERD), peptic ulcers, and gastritis. They work by reducing the production of stomach acid, which can help heal the stomach lining and alleviate symptoms. However, prolonged use of PPIs has been associated with various risks and side effects.

One of the primary concerns with long-term PPI use is the potential for gastric mucosal atrophy. Chronic suppression of gastric acid can lead to changes in the stomach lining, making it more susceptible to infections and potentially leading to conditions such as gastric cancer, although this risk is still under investigation. Additionally, long-term PPI use can disrupt the natural balance of gut microbiota, leading to an increased risk of gastrointestinal infections, such as Clostridium difficile.

Regarding your specific situation, it is concerning that you have been self-medicating with Naisan for two years without medical supervision. While it is understandable to want to manage your symptoms, this approach can lead to complications. The fact that you experience discomfort when reducing the dosage suggests that your body may have become reliant on the medication to manage gastric acidity. This phenomenon is sometimes referred to as "rebound acid hypersecretion," where the stomach produces more acid after stopping the medication, leading to worsened symptoms.

As for kidney health, studies have indicated that long-term use of PPIs may be associated with an increased risk of chronic kidney disease (CKD) and acute interstitial nephritis. However, the exact mechanism and the extent of this risk are still being researched. If you have any pre-existing kidney issues or other risk factors, it is crucial to discuss these with your healthcare provider.

Your history of taking anti-inflammatory medications (NSAIDs) for back pain could also contribute to your current gastric issues. NSAIDs are known to irritate the gastric mucosa and can lead to gastritis or ulcers, which may explain your initial gastric problems. The combination of previous NSAID use and long-term PPI therapy raises concerns about the overall health of your gastric mucosa.

In light of these factors, it is highly advisable to consult with a healthcare professional regarding your ongoing use of Naisan. They may recommend alternative treatments or lifestyle modifications to manage your symptoms without the need for long-term PPI therapy. This could include dietary changes, stress management techniques, or the use of other medications that may have a lower risk profile for long-term use.

In summary, while Naisan can be effective for treating gastric conditions, its long-term use carries risks that should not be overlooked. Regular follow-up with a healthcare provider is essential to monitor your gastric health and adjust your treatment plan as necessary. It is also important to explore non-pharmacological approaches to managing your symptoms, which can help reduce your reliance on medication and improve your overall well-being.

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