Proton pump inhibitors (PPIs), H2 blockers, and antacids are commonly prescribed medications to treat ulcers in the stomach and the upper part of the small intestine and also prescribed for some other common GIT complications such as gastroesophageal reflux disease, esophagitis, irritable bowel syndrome, and dyspepsia. Previous studies claimed that, apart from other side effects, these anti-ulcerant therapies significantly altered bone mineral density (BMD) by interfering with intestinal reabsorption of calcium and phosphate, and the most widely prescribed PPIs were significantly associated with increased risks of hip and spine fractures. However, potential skeletal side effects of these antiulcerants are unknown in Bangladesh. To examine safety concerns of anti-ulcer therapies and their impact on bone health among patients in Bangladesh, the present work surveyed 200 patients in five different hospitals from December 2019 to February 2020.
Among the 200 patients, those taking PPIs alone or with other anti-ulcerants (>5 years; 95% respondents) claimed some unusual side effects, such as weakness, flank pain, spasm of hands and feet, muscle aches, numbness, and tremor. About 61% of patients taking PPIs experienced low back pain whereas 22% of respondents experienced dull pain and the respondents with the neck pain and knee joint pain were 10% and 7%, respectively. Although further studies are required to confirm the impact of these antiulcerants on the bone, these patient responses suggest that these musculoskeletal-related side effects might have some links with altered bone metabolism. It is possible that anti-ulcerant therapies may worsen the bone metabolism of patients suffering from osteoporosis or other bone disorders, and awareness and precautions should be raised among the patients and clinicians for the careful administration of PPIs to patients suffering from bone disorders.