Thursday, 8 September 2016

The dangers of long-term PPI (Proton Pump Inhibitor)treatment.

Proton pump inhibitors (PPIs) like omeprazole, lantoprazole, are being used very frequently, and in many cases long-term, to treat peptic ulcers and gastro-oesophageal reflux, and "indigestion". They act by reducing the production of gastric acid. While they are incredibly effective in treating these conditions, they do have other less desirable and sometimes fatal effects:
By raising the gastric pH they can affect pepsin and other enzymes used to dissolve proteins.
The elevated pH also enables bacteria and viruses to survive where otherwise they would be killed, sometimes leading to infection in the lower GI tract.
Diseases resulting from prolonged use of PPIs include:

  • Gastric and gut infections, especially traveller's diarrhoea.
  • Pneumonia – the bacteria surviving in the stomach can migrate up the oesophagus and down into the lungs.
  • Increasing fractures, presumably due to a direct effect of these drugs on bone architecture.
  • Vitamin B12 deficiency – these drugs greatly affect the absorption of vitamin B12, particularly in the elderly. This can result in peripheral nerve problems, but also dementia.
  • Heart disease and strokes, there is an increased incidence of heart disease and almost doubled increase in heart deaths according to a recent study from Stanford University. (http://www.ncbi.nlm.nih.gov/pubmed/26061035)


While there are many cases where these drugs are extremely useful, the need for long-term treatment needs to be carefully studied, and they should only be used if necessary. Like all drugs, they have significant side-effects.

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