What is the latest in proton pump inhibitors (PPIs) and long-term safety?
A recent, large placebo-controlled trial of 17,598 participants confirmed the safety of proton pump inhibitors (PPIs).
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Private Healthcare Navigation and Patient Advocacy when YOU need it most"Researchers find no evidence to support claims that proton pump inhibitors (PPIs) cause serious health issues such as pneumonia, chronic kidney disease, diabetes, and dementia."
Pantoprazole was not associated with any adverse event when used for three years, except for an increased risk of enteric infections.
Thus, limiting prescriptions of PPI therapy because of concerns of long-term harm is not appropriate based on this study. However, this risk was lower than estimated by previous systematic reviews of observational studies.
Do Proton pump inhibitors (PPIs) cause serious health issues such as pneumonia, chronic kidney disease, diabetes, and dementia?
Researchers find no evidence to support claims that proton pump inhibitors (PPIs) cause serious health issues such as pneumonia, chronic kidney disease, diabetes, and dementia. This research is published in Gastroenterology, the official journal of the American Gastroenterological Association.
What are Proton pump inhibitors (PPIs)?
PPIs, such as omeprazole, Prilosec, and Nexium, effectively block gastric acid secretion.
PPIs are one of the most widely used drugs in the United States.
"Around 25% of the population has gastroesophageal reflux disease (GERD)"
What are Proton pump inhibitors (PPIs) used for?
PPIs are used for the treatment of peptic ulcer disease (PUD), gastroesophageal reflux disease (GERD), and much rarer conditions such as Zollinger-Ellison syndrome (ZES).
GERD occurs in over 25 percent of the population.
PPIs also prevent NSAID or nonsteroidal anti-inflammatory drug-associated gastroduodenal mucosal injury. NSAIDs are drugs such as ibuprofen and Advil.
PPIs plus antibiotics are used in the treatment of Helicobacter pylori infection.
Are there drug interactions with Proton pump inhibitors (PPIs)?
Clinically significant drug interactions with PPIs are rare and should be addressed with your doctor and pharmacist.
When should I take Proton pump inhibitors (PPIs)?
Ideally, oral PPIs should be administered 30 to 60 minutes before breakfast or the day's first meal. This provides for maximal acid suppression.
PPIs should not be administered simultaneously with H2-receptor antagonists, such as Pepcid or Ranitidine is also being used.
For how long should I take Proton pump inhibitors (PPIs)?
PPIs should be prescribed at the lowest dose.
Like any medication, use for the shortest duration is appropriate.
These drugs are well tolerated in the short term.
Long-term treatment was associated with adverse events in observational studies.
As with all drugs, PPI therapy should only be used when the benefits outweigh the risks. As with all drugs, PPI therapy should be used according to the recommended dose and duration of treatment.
What has been published about PPIs and associated side effects?
PPI use has been associated with an increased risk of Clostridium difficile infection. C. difficile infection with diarrhea may occur even without antibiotic use.
PPI use can lead to other enteric infections and microscopic colitis.
PPIs can cause hypomagnesemia due to reduced intestinal absorption.
Disrupting the stomach's delicate balance may cause changes in the immune system and trigger new allergies.
Long-term therapy with PPIs has been associated with vitamin B12 malabsorption.
Although an association between PPIs and bone fracture is plausible, direct causality has not been established.
PPIs can cause acute interstitial nephritis and chronic kidney disease (CKD). However, further studies are needed.
The association between PPI use and dementia and pneumonia is not established and is conflicting—the same with an increased risk of death. Most likely, these associations are due to the overall state of health of the patients, not the use of PPIs, and more studies are needed.
Takeaway tips if you are on PPIs
Talk to your doctor before making any changes. You have been prescribed PPIs for a reason. Probably to treat a diagnosed medical condition.
Focus on lifestyle modifications for GERD. You may not need long-term use of PPIs or can reduce the dose. Read Heartburn, GERD, Acid Reflux—Are They Dangerous?
Headlines on PPIs can be "scary" and exciting, but if PPIs are needed and treat a medical diagnosis, you should stay on them. Especially if the benefits outweigh the risks.
Personally
I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.
"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"
Gut Health ➕ Patient Advocacy with Navigation ➕ Life Balance
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