I am 4 years post-op RNY gastric bypass surgery. I had severe acid reflux [GERD] prior to surgery. That is why I went with gastric bypass vs. sleeve; because the sleeve will only make this condition worse. I have not had a problem with GERD since surgery.
I used a PPI [proton-pump inhibitor] called Prilosec [Omeprazole] to periodically treat this condition prior to surgery. I also was prescribed this drug for the first year after surgery, in order to allow my stomach to heal. But after the year was up, I could tell the this condition was in remission.
You indicated that ppi medication reducing life expectancy 25 percent. GERD is a dangerous disease. It can lead to Barrets' esophagus, and many other problems. According to the internet:
GERD is most often not a life limiting disease. Approximately 23 million Americans have GERD. The chances of Barret's is pretty small and even then less then 10 percent with Barrets will develop esophageal cancer. An estimated 13,000 people in the US are diagnosed with EC each year, so it is pretty rare.
Everyone starts off with a normal lower esophageal sphincter and no reflux. The severity of GERD probably correlates best with the degree of damage to the sphincter, but this is not easy to determine in practice. These are the four stages of GERD:
Stage 1 – Mild GERD
The majority of adults today have minor damage to their LES [lower esophageal sphincter] and experience mild GERD occasionally. In most cases they either tolerate occasional heartburn or use over-the-counter acid suppressive medications with the onset of symptoms. Because their symptoms are controlled quickly, easily, and inexpensively with these drugs, their quality of life is unaffected.
Stage 2 –Moderate GERD
Stage 2 GERD is more difficult to control with acid suppressive drugs and reflux is more frequently accompanied by higher intensity symptoms. Damage to the LES is more extensive compared to Stage 1. Many symptoms can be satisfactorily managed long-term with acid suppressive medications. Over-the-counter medications often provide inadequate relief, so prescription strength medications are necessary to manage symptoms.
Stage 3 – Severe GERD
Stage 3 GERD results in a substantially lower quality of life and is considered to be a very serious problem. Prescription level acid suppressive drugs do not control symptoms to the individual’s satisfaction and regurgitation is frequent. It is also likely that one or more of the complications associated with erosive GERD may be present.
Stage 4 – Pre-cancerous condition or reflux induced esophageal cancer
Stage 4 is the result of many years of severe reflux. 10-15% of long-term sufferers progress to this very advanced condition. Due to long-term reflux, the lining of the esophagus has been damaged, resulting in cellular changes. Interestingly, these changes may occur in some with only minimal symptoms. Stage 4 involves the development of a pre-cancerous condition called Barrett’s esophagus, or a more severe condition called dysplasia. These conditions are not cancers, but raise the risk of developing actual reflux-induced esophageal cancer. At this stage, typical GERD symptoms may also be accompanied by burning in the throat, chronic cough and hoarseness. Strictures, or a narrowing of the esophagus, can also occur which is characterized by the sensation that food is sticking in the esophagus. This same symptom can also be caused by esophageal cancer.
So perhaps it is not the use of PPI that causes the lowered life expectancy but the damage from the disease itself. Anyways from my perspective there is treatment for this condition and that is RNY gastric bypass surgery.