Turmeric – as effective as omeprazole for treating acid reflux and safer for bone and kidney health?

Categories: Winter 2023

Indigestion due to gastro-esophageal reflux disease (“GERD” or “heartburn”) is caused by stomach acid

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refluxing into the esophagus. Omeprazole is a commonly-used pill that is used to treat GERD by decreasing the production of stomach acid. However, a potential serious side effect of long-term use of omeprazole is an increased risk of bone fractures and decreased kidney function. Therefore, patients receiving long-term omeprazole treatment should pay careful attention to their bone health status. The relationship between long-term omeprazole and fracture is still unclear. However, the fracture risk is more apparent in patients with other strong risk factors of bone fragility (osteoporosis), such as hormonal therapy that is a standard of care in the management of prostate and breast cancer or as an adjunct to other cancer treatments. Hormonal therapy decreases the density and strength of bones resulting in an increased risk for fracture.

The food spice, turmeric, from a plant related to ginger grown in many Asian countries and tropical areas, is a major ingredient in curry powders. Its main active component, curcumin, has diverse biological properties, making it a potential traditional treatment for a variety of different health conditions, including acid reflux, protection against osteoporosis, and promoting fracture healing. In Southeast Asia, turmeric has long been used as a medicinal remedy for indigestion.

A recently published randomized clinical trial suggests that turmeric may be as effective as omeprazole for treating GERD. To compare the effectiveness of turmeric with omeprazole to curb indigestion, the researchers randomly assigned 206 patients, aged 18-70 with recurrent upset stomachs of unknown cause to one of three treatment groups for 28 days. One group received capsules containing turmeric, the second received omeprazole, and the third received turmeric plus omeprazole. All three groups had significant reductions in symptom severity, and no serious side effects were reported, although liver function tests indicated some abnormalities among turmeric users who were more overweight.

Acknowledging the small study size, the short intervention period, and the lack of long-term monitoring data, the researchers concluded turmeric can be used for GERD in a number of ways. It is sold at the grocery storein a powder form that can be added to meals or added to boiling water as a turmeric tea. It also can be produced by grinding turmeric stems to acquire the powder. When taken by mouth, turmeric- and the curcumin it contains — appear to be generally safe when limited to less than 8 grams per day.

Considering the possible excess risk of osteoporosis leading to fracture, patients on long-term omeprazole should be regularly monitored with annual bone- mineral density scans (called DEXA scans), and routine prophylaxis for osteoporosis (regular sunshine exposure, weight-bearing exercise, vitamin D3, calcium supplements, and other treatments for severe cases, such as zoledronic acid infusions or denosumab injections, to avoid osteoporotic fractures.

Dr. Catalona believes that more research is necessary to confirm these effects.

BMJ Evidence-Based Medicine Published Online First: 11 September 2023. doi: 10.1136/bmjebm-2022- 112231

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