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Heartburn Drugs Tied to Bone Fractures in Children

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Proton pump inhibitors — the widely used heartburn drugs — may slightly increase the risk for bone fractures in children, a new study suggests.

P.P.I.’s are approved for use in children over a year old for treating gastroesophageal reflux disease, the persistent regurgitation of food and stomach acid.

Using Swedish government health records, researchers studied 231,866 children, half of whom had been prescribed P.P.I.’s. During an average follow-up of a little more than two years, there were 5,354 cases of broken bones in the children who took the medicine, and 4,568 in those who did not.

Over all, the use of P.P.I.’s increased the risk for fracture by 11 percent. The drugs were associated with an 8 percent increase in broken bones of the arm, a 19 percent increase in leg fractures, and a 51 percent increase in the small number of other breaks. There was no association with the very few skull and spine fractures.

The study, in JAMA Pediatrics, did not control for bone mineral density or physical activity, which could be important contributions to bone fracture incidence.

“We’re not saying that all children should avoid P.P.I.’s,” said the lead author, Yun-Han Wang, a doctoral candidate at the Karolinska Institute in Stockholm. “but this is a small increased risk. Where these drugs are necessary, the doctor should keep an eye out for these kinds of events.”


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