The Medical Advisor

In the U.S., 66% of adults are estimated to have at least one prescription, and the average person has nine filled annually (1). As an awake physician (2), one of the most depressing aspects of my work is seeing patients, especially the elderly, weighed down by numerous prescriptions that frequently do more harm than good. For example, as I showed here , statins provide a negligible benefit (e.g., at best, taking them for five years extends one’s lifespan by 3 to 4 days) but create significant side effects such as severe muscle pain and cognitive impairment for 20% of users. This tragic situation is best demonstrated by a 2007 study which showed that simply discontinuing the least necessary prescriptions resulted in a 23% reduction in the death rate and an 18.2% decrease in hospital referrals (3). Sadly, since the trend in medicine is always to have people on more drugs, data like this has had no effect on the practice of the overprescription of medications. Over the years,...

I have had acid reflux for many years. About six months ago, a doctor looked down my esophagus and into my stomach (a test he called an upper endoscopy) because the symptoms were getting worse. My esophagus was inflamed, and I was told to take pantoprazole indefinitely. But now I rarely have heartburn. Do I really need to stay on this medication forever? (Dreamstime/TNS) Answer: Pantoprazole is a proton pump inhibitor (PPI). Drugs in this class are the most potent stomach acid inhibitors. Other proton pump inhibitors include omeprazole, esomeprazole, lansoprazole, dexlansoprazole, and rabeprazole. There is no simple yes or no answer to your question, but here is how I approach this very common situation. My recommendation depends on some details about your reflux symptoms that I don’t have. Was the heartburn present for a long time before you had the endoscopy? Did you start the pantoprazole many weeks before the endoscopy last year? The reason for these questions is to get a better pi...