Proton Pump Inhibitors: Review of Emerging Concerns

Avinash K Nehra, Jeffrey A Alexander, Conor G Loftus, Vandana Nehra
Mayo Clinic Proceedings 2018, 93 (2): 240-246
First introduced in 1989, proton pump inhibitors (PPIs) are among the most widely utilized medications worldwide, both in the ambulatory and inpatient clinical settings. The PPIs are currently approved by the US Food and Drug Administration for the management of a variety of gastrointestinal disorders including symptomatic peptic ulcer disease, gastroesophageal reflux disease, and nonulcer dyspepsia as well as for prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. PPIs inhibit gastric acid secretion, and the most commonly associated adverse effects include abdominal pain, diarrhea, and headache. Although PPIs have had an encouraging safety profile, recent studies regarding the long-term use of PPI medications have noted potential adverse effects, including risk of fractures, pneumonia, Clostridium difficile diarrhea, hypomagnesemia, vitamin B12 deficiency, chronic kidney disease, and dementia. These emerging data have led to subsequent investigations to assess these potential risks in patients receiving long-term PPI therapy. However, most of the published evidence is inadequate to establish a definite association between PPI use and the risk for development of serious adverse effects. Hence, when clinically indicated, PPIs can be prescribed at the lowest effective dose for symptom control.

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Manfred Ernesti

Excellent and timely review of an abuse group of drugs that are extremely beneficial when prescribed properly


J. O

Sure, for the shortest amount of time possible to get out of an emergency level of pain. Taking these somehow also equates to continued or even increased health eroding habits...21 yr olds doubled over because their stomach's can no longer produce acid on its own.

I stopped taking these: people on forums educated me after it was too late for them. I became obsessed with what foods hurt and what didn't, how to combine food and drink water, increase alkaline greens decrease candy and skipping meals. I grabbed handfuls of lettuce in lieu of the less effective pills

Young people especially need options.
It seems too beneficial to companies that they are not given options nor given more than an absent minded warning about two week usage then continue to prescribe it.


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