Q&A on Arthritis and Heartburn Medication

Q. For the last 3-4 months, my husband has had a recurring sore throat, so bad at times that he has trouble swallowing.

Our doctor thinks it could be due to acid reflux, which my husband does get from time to time.

So he was given a prescription for Rabeprazole Sodium and a new diet to see if his sore throat is being caused by acid reflux.

My problem is that he was also recently diagnosed with osteoarthritis in both hips and his right knee. I am not sure if the acid reflux drug will hinder the arthritis in the hips? I searched your site for "acid reflux" and came across an article on how Nexium And Other Heartburn Drugs Can Cause Hip Fractures.

Do you know if this drug does the same thing?

Would appreciate any thoughts you have on this drug and my husband's arthritis.

- Kristen in British Columbia

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Hi Kristen,

Sorry to know about your husband's sore throat and arthritis.

Rabeprazole is similar to the drugs that I mentioned in my article - all of them are considered to be proton pump inhibitors, which is to say that they decrease the amount of acid that is in the stomach.

The reason why being on one of these drugs can, over the long haul, increase risk of fractures and dental problems is that the body uses stomach acid to help make minerals like calcium and magnesium in the foods that we eat available to our bloodstream.

Though stomach acid mainly works at breaking apart protein in food into amino acids, it's also needed to promote overall breakdown of our foods, which helps vitamins and minerals that naturally occur in our foods to become available for absorption into our bloodstream - this absorption takes place through the walls of our small intestine, which comes just after the stomach.

Over the long term, low stomach acid can lead to low calcium availability, which can lead to weaker bones and teeth.

Since your husband is taking this drug just as a short term test to help identify the cause of his sore throat, I don't think that you need to be concerned about the fracture risk issue.

But if he has to take a proton pump inhibitor over the long term, then you might want to have him take a quality calcium supplement, one that provides calcium that's from a real food source - such calcium doesn't require much, if any, stomach acid to become available to the bloodstream, and is easily absorbed. Fresh green vegetable drinks or even a quality green food powder without fillers are good choices because they are rich in calcium and other minerals that are needed to build and maintain strong bones and teeth.

Regarding your husband's hips and right knee, there's no doubt that years of pounding from athletics may have contributed to the development of osteoarthritis. I've found that in many cases, joint pain isn't caused solely by osteoarthritis - there is almost always a metabolic component.

This is to say that in just about every case I have seen, chronic joint pain has been the result of both degeneration (osteoarthritis) and ongoing inflammation brought about by regular intake of specific foods, namely pasteurized dairy and flesh meats.

This isn't to say that I think your husband absolutely needs to avoid all pasteurized dairy and flesh meats. But I do think that reducing his consumption of these foods for 30 to 60 days would be a worthwhile experiment - he can observe for himself if this makes a significant difference in his comfort level, as whenever there is a metabolic component to joint disease, one tends to notice improvement quickly when on a low dairy and low flesh meat diet. Of course, people who avoid these foods completely for several weeks to a few months tend to notice the best results.

These foods can contribute to arthritis in two major ways: the first is via the production of chemicals that promote inflammation. The second is via antigen-antibody complex formation - this is an autoimmune type mechanism where incompletely digested proteins from dairy and flesh meats illicit antibody production in the body, which can lead to inflammation in different tissues like the cartilage that lines joints.

If your husband tries a 30 to 60 day trial period of reduced dairy and flesh meat intake and doesn't notice any improvement, then it's likely that most or all of his joint pain is the result of wear and tear over the years.

The other thought is to consider if your husband needs to carry less overall weight on his frame. Sometimes, being too heavy - even if the extra weight is muscle - can be a significant cause of premature joint degeneration. In some cases, aiming to be a little light for one's frame can help a lot. But this is probably less important than addressing potential dietary triggers first.