Grant: Operating Grant - PA: Musculoskeletal Health, Arthritis, Skin and Oral Health

Proton pump inhibitors (PPIs) are widely used for the treatment and prevention of gastroesophageal reflux disease and ulcer disease, and are among the most commonly prescribed drugs in all of medicine. Recent studies have suggested that the chronic use of PPIs may significantly increase the risk of developing hip fracture, though the relationship is far from proven. To date, there is not yet a proven mechanism through which PPIs increase the risk of fracture, and there is great uncertainly as to whether PPIs truly lead to an increase in fracture risk. Because of this uncertainly, there is considerable confusion among patients and clinicians as to whether they chould be concerned about the risk of fracture in patients who are chronically using this mechanism. Currently, there are no studies which have demonstrated whether PPIs truly have an effect on bone structure and strength. With this proposed study, we will compare bone structure and strength between patients who have been exposed to PPIs for 5 or more years to those who have never received PPIs. This will be performed by using volumetric quantitative CT scanning (vQCT) and the use of finite element analysis (FEA), which is a computer created model to determine whether PPI use is associated with changes in bone structure that could make them more susceptible to fracture.